Mental Capacity Act Flashcards
The Mental Capacity Act (MCA) is designed to do what
(MCA) is designed to protect and empower people who may lack the mental capacity to make their own decisions about their care and treatment. It applies to people aged 16 and over
Examples of people who may lack capacity include those with
dementia a severe learning disability a brain injury a mental health illness a stroke unconsciousness caused by an anaesthetic or sudden accident
someone can lack capacity to make some decisions (for example,
someone can lack capacity to make some decisions (for example, to decide on complex financial issues) but still have the capacity to make other decisions (for example, to decide what items to buy at the local shop).
The MCA says: what 5 things
The MCA says:
assume a person has the capacity to make a decision themselves, unless it’s proved otherwise
wherever possible, help people to make their own decisions
don’t treat a person as lacking the capacity to make a decision just because they make an unwise decision
if you make a decision for someone who doesn’t have capacity, it must be in their best interests
treatment and care provided to someone who lacks capacity should be the least restrictive of their basic rights and freedoms
How is mental capacity assessed?
The MCA sets out a 2-stage test of capacity:
1) Does the person have an impairment of their mind or brain, whether as a result of an illness, or external factors such as alcohol or drug use?
2) Does the impairment mean the person is unable to make a specific decision when they need to? People can lack capacity to make some decisions, but have capacity to make others. Mental capacity can also fluctuate with time – someone may lack capacity at one point in time, but may be able to make the same decision at a later point in time.
Where appropriate, people should be allowed the time to make a decision themselves.
The MCA says a person is unable to make a decision if they can’t:
The MCA says a person is unable to make a decision if they can’t:
understand the information relevant to the decision
retain that information
use or weigh up that information as part of the process of making the decision
Helping people make their own decisions
Before deciding a person lacks capacity, it’s important to take steps to enable them to try to make the decision themselves. how can this be done
For example:
does the person have all the relevant information they need?
have they been given information on any alternatives?
could information be explained or presented in a way that’s easier for them to understand (for example, by using simple language or visual aids)?
have different methods of communication been explored, such as non-verbal communication?
could anyone else help with communication, such as a family member, carer or advocate?
are there particular times of day when the person’s understanding is better?
are there particular locations where the person may feel more at ease?
could the decision be delayed until they might be better able to make the decision?
s the decision in their best interests?
It says you should:
encourage participation – do whatever’s possible to permit or encourage the person to take part
identify all relevant circumstances – try to identify the things the individual lacking capacity would take into account if they were making the decision themselves
find out the person’s views – including their past and present wishes and feelings, and any beliefs or values
avoid discrimination – don’t make assumptions on the basis of age, appearance, condition or behaviour
assess whether the person might regain capacity – if they might, could the decision be postponed?
It’s vital to consult with others for their views about the person’s best interests.
Finding the least restrictive option
Before you make a decision or act on behalf of someone who lacks capacity, always question if you can do something else that would interfere less with their basic rights and freedoms.
Advance statements and decisions
This could include:
how they want any religious or spiritual beliefs they hold to be reflected in their care
where they would like to be cared for – for example, at home or in a hospital, nursing home or hospice
how they like to do things – for example, if they prefer a shower instead of a bath, or like to sleep with the light on
concerns about practical issues – for example, who will look after their pet if they become ill
Lasting Powers of Attorney
An EPA made before the Mental Capacity Act came into force on October 1 2007 remains valid.
Powers of attorney can be made at any time when the person making it has the mental capacity to do so, provided they’re 18 or over.
Both an EPA and LPA must be registered. An LPA can be registered at any time, but a personal welfare LPA will only be effective once the person has lost the capacity to make their own decisions.
When acting under an LPA, an attorney (the appointed person) must:
make sure the MCA’s statutory principles are followed
check whether the person has the capacity to make that particular decision for themselves – if they do, a personal welfare LPA can’t be used and the person must make the decision
In addition, the Court of Protection will be able to appoint deputies who can also take decisions on health and welfare and financial matters if the person concerned lacks the capacity to make a decision.
They’ll come into action when the court needs to delegate an ongoing series of decisions rather than one decision.
If the person concerned already has an LPA appointed, they won’t normally need a deputy as well.
The Office of the Public Guardian registers LPAs and EPAs, and supervises court-appointed deputies.
It provides evidence to the Court of Protection and information and guidance to the public.
The Public Guardian works with a range of agencies, such as the financial sector, police and social services, to investigate concerns.
Professionals’ duties under the Mental Capacity Act
The Mental Capacity Act applies to all professions – doctors, nurses, social workers, occupational therapists, healthcare assistants, and support staff.
These staff and their employers have a duty to ensure they know how to use it.
Most trusts and local authorities will have a Mental Capacity Act lead who provides specialist advice on how the Act works.
5 rules
- Assume capacity
- Support
- Unwise decisions
- Best interests
- Restriction and restraint
capacity must be assessed on what
Decision specific
