The Mental Capacity Act 2005 (MCA) provides a framework to empower and protect people who may lack capacity to make some decisions for their care or living arrangements. Under the MCA, you are required to make an assessment of capacity, if there is any doubt that the person lacks\u00a0 the ability to make these decisions themselves. Ordinary day to day decisions are not included in the Act and a simple record in the care plan is all that is required.<\/p>\n
Key Decisions <\/strong>are di\ufb00erent, they are significant decisions that go beyond a person\u2019s daily routine. It requires the care home sta\ufb00 to make a judgement when to undertake this assessment. The\u00a0 more serious the decision, the more formal the assessment of capacity needs to be. https:\/\/www<\/a>.scie.or<\/u>g.uk\/mca\/practice\/assessing-capacity<\/a><\/p>\n What does the Mental Capacity Act mean for care providers \/ workers? What actions are required.<\/em><\/p>\n <\/p>\n When and Who<\/strong><\/p>\n Guidance for when to conduct an assessment and making a best interests decision is provided in the downloadable link below.<\/p>\n If mental capacity is in doubt then complete the forms. The person making the assessment is the professional responsible for their care. In a care home setting that would be the Registered Nurse or Social Worker but the entire sta\ufb00 team must be trained in understanding the Act as they are involved in constant monitoring and assessment of clients\u2019 mental capacity.<\/p>\n https:\/\/www<\/a>.scie.or<\/u>g.uk\/files\/mca\/directory\/mca-tailored-for-you\/health\/pan-london-<\/a> commissioner-toolkit\/croydon-primary-care-mca-form.docx<\/u><\/p>\n <\/p>\n There are five important principles everyone should follow when using the Act:<\/p>\n https:\/\/www.medicalprotection.org\/uk\/articles\/assessing-capacity<\/a><\/p>\n Another helpful version of the 5 points<\/p>\n (Community Care Inform Adults\u2019 knowledge and practice hub on mental capacity and deprivation of liberty). <\/em>https:\/\/www.communitycare.co.uk\/2016\/07\/01\/five-key-steps-assessing-capacity\/<\/em><\/a><\/p>\n <\/p>\n Except in an emergency when there isn\u2019t time, the MCA lays out a checklist of factors to be considered when you are working out a best interests decision for someone who lacks mental capacity.<\/p>\n These are things to check, to make sure, for example, that you\u2019re not stereotyping the person or making assumptions (like, \u2018no older people should want to go to a football match, they\u2019re better watching it on TV\u2019), and to prompt you to look for the option that restricts the person\u2019s freedoms\u00a0 the least, while meeting the need.<\/p>\n The checklist asks you to consider:<\/p>\n If a care plan is based on the person\u2019s best interests it will comply with the MCA and will provide the evidence that may be asked for by the CQC or in any dispute. For small, everyday decisions, the checklist above will help you to understand what\u2019s important to the individual, what do they\u00a0 love doing or would hate to do.<\/p>\n Sta\ufb00 are protected from liability provided they work according to the care plan, but this must be based on the person\u2019s best interests.<\/p>\n For bigger more complex decisions, such as a change to where they live, it\u2019s a really good idea to use a balance-sheet approach.<\/p>\n A sample form is provided ;-<\/p>\n https:\/\/www<\/a>.scie.or<\/u>g.uk\/files\/mca\/directory\/mca-tailored-for-you\/health\/pan-london-<\/a> commissioner-toolkit\/croydon-primary-care-mca-form.docx<\/u><\/p>\n List the pro\u2019s and con\u2019s of each option, using the wisdom gained from friends and relatives: make sure you give as much weight as possible to what the person actually wants to do, even if they\u00a0 lack mental capacity to make this decision for themselves.<\/p>\n (Information from case law shows that it is necessary for the care provider to demonstrate that\u00a0 they know what is important to their clients.)<\/p>\n You\u00a0 will be acting within the MCA if you do your <\/strong>best to work out what is in the best interests of\u00a0 the person<\/strong>. You\u00a0 need to show that you\u2019ve considered the checklist, rather than just imposing\u00a0\u00a0 your own views about what should happen to the person. To do this, you need to record that\u00a0 you\u2019ve considered the checklist, together with anything else that the person\u00a0 would\u00a0 think\u00a0 important. You need to write down what their wishes and feelings are, and make sure you briefly explain why you\u2019ve eliminated some of the options.<\/p>\n You also need to record how you dealt with any disagreements: it\u2019s only natural that people might have di\ufb00erent views about the person\u2019s best interests.<\/p>\n https:\/\/www.qcs.co.uk\/best-interests-work\/<\/a><\/p>\n The MCA provides a non-exhaustive checklist of factors that decision-makers must work through in deciding what is in a person\u2019s best interests.<\/p>\n Again, it is vital that you record your best interests decision. Not only is this good professional practice, but given the evidence-based approach required by the MCA, you will have an objective record should your decision or decision-making processes later be challenged. https:\/\/www<\/a>.scie.or<\/u>g.uk\/mca\/practice\/best-interests<\/a><\/p>\n A \u201cgood\u201d capacity assessment will include the following:<\/p>\n The CQC may ask for the following evidence:<\/p>\n A Youtube clip <\/strong>demonstrates how this all looks in practice. https:\/\/m.youtube.com\/watch?v=tAQhhHE4shI<\/u><\/p>\n The following CQC publication provides comprehensive guidance as well as specific questions or evidence the CQC will require.<\/p>\n h t t p s : \/ \/ w w w <\/a>. c q c . o r <\/u>g . u k \/ s i t e s \/ d e f a u l t \/ fi l e s \/ d o c u m e n t s \/<\/a> rp_poc1b2b_100563_20111223_v4_00_guidance_for_providers_mca_for_external_publication.pdf<\/u><\/p>\n CQC guidance on making best interest decisions https:\/\/www.qcs.co.uk\/best-interests-work\/<\/a><\/p>\nSummary Box – Quick guide<\/em><\/h1>\n
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5 Principles<\/h1>\n
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The Mandatory Checklist<\/h1>\n
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The Balance Sheet Approach: weighing up the options.<\/h1>\n
Recording how you reached your decision<\/h1>\n
What are \u2018best interests\u2019 ?<\/h1>\n
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Records<\/h1>\n
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Evidence of compliance with the MCA<\/h1>\n
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Further resources<\/h1>\n