Mental capacity Act & DOLS
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Transcript of Mental capacity Act & DOLS
Mental Capacity Act 2005
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Mental Capacity act 2005 has been in force since 2007
Primary purpose to promote and safeguard decision making within a legal framework
This is done in 2 ways1. People 16+ who are unable to make all or
some decisions for themselves2. Support to those who are 18+ who have
capacity and choose to place for their future
Key messages
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The Mental capacity Act (MCA) 2005 applies to everyone involved in theCare, Treatment, Support
- Of people who are 16+ who are unable to make decisions for themselves
- Of people who are 18+ who have capacity and choose to plan for their future
Key messages
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The MCA also provides support and guidance for less formal carers
Key messages
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The MCA 5 statutory principles are thebenchmark and must underpin all acts
carriedout and decisions taken in relation to the Act
Key messages
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Anyone caring for or supporting a person whomay lack capacity could be involved in
assessingcapacity and must follow the two stage test
Key messages
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The MCA is to empower those in health andsocial care to assess capacity themselves
ratherthan rely on expert testing
Key messages
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Understanding and using the MCA supportspractice for example the application of the
Deprivation of Liberty Safeguards
Key messages
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All professionals have a duty to comply with the
Code Of Practice
Key messages
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If capacity is lacking follow the checklistdescribed in the Code to work out the best
interests of the individual concerned
Key messages
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The Act is underpinned by five key principles (Section 1, MCA)
5 Key Principles
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Principle 1: A presumption of capacity
– Every adult has the right to make their own decision and must be assumed to have
capacity to do so unless is it proved otherwise
5 Key Principles
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Principle 2: Individuals being supported to make their own decisions
- A person must be given all practicable help before anyone treats them as not being
able to make their own decisions
5 Key Principles
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Principle 3: Unwise decisions
- People have the tight to make decisions that others might regard as unwise or eccentric
5 Key Principles
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Principle 4: Best Interests
- Anything done for or on behalf of a person who lacks mental capacity must be done in
their best interests
5 Key Principles
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Principle 5: Less Restrictive option
- Someone making a decision or acting on behalf of a person who lacks capacity must consider whether it is possible to decide or
act in a way that would interfere less with the person's rights & freedoms of action, or
whether there is a need to decide or act at all.
5 Key Principles
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Sections 2 – 4 MCAUnder the act you are required to carry out an assessment of capacity before carry out
any care or treatment having taken into account the 5 key principles
Assessment of capacity
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Sections 2 – 4 MCAYou should also ensure that the more serious
the decision that is required the more formal the assessment process should be
Assessment of capacity
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Workers are required to be aware of when there is a need for capacity to be assessed
- Someone’s mind or brain is affected by illness or disability
- Lack of capacity might not be a permanent condition
Assessment of capacity
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Workers are required to be aware of when there is a need for capacity to be assessed
- Assessments of capacity should be time and decision specific
Assessment of capacity
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Workers are required to be aware of when there is a need for capacity to be assessed
- Assessments of capacity should not be based on age, appearance, condition or behaviour alone
Assessment of capacity
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The MCA has a 2 stage functional test of capacity which helps to decide whether a person has the capacity to make a specific
decision
The test to assess capacity
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Stage 1
Is there an impairment of or disturbance in the functioning of a person’s mind or brain?
If so.....
The test to assess capacity
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Stage 2
Is the impairment of or disturbance sufficient that the person lacks the capacity to make
a particular decision?
The test to assess capacity
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The MHA states the a person is unable to make their own decision if they cannot do
one or more of the following 4 things:
1. Understand information given to them2. Retain that information long enough to be
able to make a decision3. Weigh up the information available to
make the decision4. Communicate their decision
The test to assess capacity
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Communicate their decision – this can be written, verbal, sign language or muscular movement including squeezing a hand or
blinking an eye
The act is clear that communication methods must be fully explored before deciding on
lack of capacity which is only based on inability to communicate
The test to assess capacity
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The act is clear that communication methods must be fully explored before deciding on
lack of capacity which is only based on inability to communicate
In addition you must involve family, friends, carers and professionals to fully explore
communication
The test to assess capacity
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The MCA states that you should base the outcome of your assessment on the balance
of probabilities
– meaning it is more likely than not that the person lacks capacity
- Your records should clear show how you came to this outcome in this particular
decision
The test to assess capacity
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When a person is assessed as lacking capacity then the person who acts on their behalf is known as the “Decision-Maker”
Best interest decision - making
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The “Decision-Maker” is usually someone who is involved with the persons ongoing care on a day to day basis, they maybe a
professional or a carer, a social worker or a nurse
Best interest decision - making
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The “Decision-Maker” must make decisions which are in the best interest of the person
who is said to be lacking in capacity
Best interest decision - making
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The “Decision Maker” makes decisions to do with regard to treatment, care or
accommodation needs
Best interest decision - making
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There is an non exhaustive checklist of factors that “The Decision-Maker” must work through in deciding what is in the
person’s best interest
Best interest decision - making
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Attorneys appointed under Lasting Powers of Attorney (LPAs)
Court of Protection and Deputies The Public Guardian Independent mental capacity advocates
(IMCA) Advance decisions to refuse treatment A criminal offence
MCA New roles, bodies & powers
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Attorneys appointed under Lasting Powers of Attorney (LPAs)
- this allows people over the age of 18 to formally appoint a person or person who can look after their needs including health, welfare and financial decisions if at sometime they are not able to due to lack of capacity
MCA New roles, bodies & powers
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Court of Protection and Deputies
- A new court and public official created to protect people who lack capacity and to be responsible for supervising those that make decisions on that persons behalf.
- The court can appoint Deputies to those who are deemed to have ongoing lack of capacity for example
MCA New roles, bodies & powers
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The Public Guardian
MCA New roles, bodies & powers
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Independent mental capacity advocates (IMCA)
MCA New roles, bodies & powers
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Advance decisions to refuse treatment
MCA New roles, bodies & powers
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A criminal offence
MCA New roles, bodies & powers
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