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Inclusion under the Mental Capacity Act (2005): a review of research policy guidance and governance structures in England and Wales
- Authors:
- RYAN Hayley, et al
- Journal article citation:
- Health Expectations, 24(1), 2021, pp.152-164. Online only
- Publisher:
- Wiley
Objective: To investigate how people with communication and understanding difficulties, associated with conditions such as dementia, autism and intellectual disability, are represented in research guidance supplementary to the Mental Capacity Act (MCA: 2005) in England and Wales. Methods: A documentary survey was conducted. The sample comprised the MCA Code of Practice (CoP: 2007) and 14 multi‐authored advisory documents that were publicly available on the Health Research Authority website. Textual review of key words was conducted followed by summative content analysis. Results: Representation of people with communication and understanding difficulties was confined to procedural information and position statements that focused mainly on risk management and protection. Whilst a need to engage potential participants was recognized, guidance provided was imprecise. Conclusions: Tensions exist between the protection versus empowerment of people with communication and understanding difficulties in research. The development of structured, evidence‐based guidance is indicated. Patient or public contribution: People with communication and understanding difficulties and carers participated in a working group to explore, discuss and interpret the findings. (Edited publisher abstract)
National Mental Capacity Forum: Chair's annual report 2017
- Author:
- FINLAY Baroness
- Publisher:
- Great Britain. Her Majesty's Government
- Publication year:
- 2018
- Pagination:
- 41
- Place of publication:
- London
Annual report of the Chair of the National Mental Capacity Forum, covering the Forum’s work over the year, the Chair’s priorities for the coming year, and details of Forum members. Each chapter describes the achievements and ongoing work against the four priorities for 2017: Improving understanding; Hearing the voice of the person; Supporting carers; and Reducing and preventing exploitation. Achievements include the development of guidelines and training material for front line staff in the financial and banking sector and increased awareness of fraud and scam and the risks for people ‘in vulnerable circumstances.’ The report includes illustrative good practice examples of initiatives relevant to the implementation of the Mental Capacity Act. (Edited publisher abstract)
Service evaluation of a Specialist Memory Clinic for adults with ID in South Wales
- Authors:
- BAYLEY Amanda, AMOAKO Annika, EL-TAHIR Mohamed Omer
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 11(4), 2017, pp.145-154.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to discuss the findings of a service evaluation project of the Specialist Memory Clinic for people with intellectual disabilities in South Wales using the Dementia guidelines published by the British Psychological Society and the Royal College of Psychiatrists (BPS/RCPsych, 2015). Design/methodology/approach: Clinical audit using case notes of patients attending Memory Clinics during 2011 and 2015 benchmarked against best practice guidelines; carers feedback from Memory Clinic attendance; and evaluation of the training sessions to carers. Findings: Audit findings show full compliance with standards (100 per cent) except for the baseline assessment for people with Down syndrome. Carer’s evaluation and feedback was positive and constructive. Training evaluation indicates improvement in knowledge and positively received sessions. Research limitations/implications: The small number of people included and possibility of high motivated team may affect the service evaluation result. Practical implications: It is possible for the Community Learning Disability team to meet the standards published (BPS/RCPsych, 2015) through multidisciplinary working. Originality/value: Initial service evaluation completed after published guidelines for Dementia care by the BPS/RCPsych (2015). (Publisher abstract)
Mental capacity and deprivation of liberty: summary
- Author:
- LAW COMMISSION
- Publisher:
- Law Commission
- Publication year:
- 2017
- Pagination:
- 29
- Place of publication:
- London
Summary of the Law Commission's final report into the review of the Mental Capacity and Deprivation of Liberty Safeguards (DoLS), which considered how the law should protect people who need to be deprived of their liberty in order to receive care or treatment and lack the capacity to consent to this. The review proposes that the DoLS should be replaced by a new scheme, the Liberty Protection Safeguards. This summary provides an overview of the recommendations and the case for reform. It outlines how the new system would operate, with a detailed explanation of some of the key aspects of the new scheme, including its scope, who they would apply to, and conditions for authorisation. (Edited publisher abstract)
Guide to the Mental Capacity Act 2005: Part 2
- Authors:
- GRIMSHAW Catherine, CURRAN Christopher
- Journal article citation:
- Openmind, 140, July/August 2006, pp.24-25.
- Publisher:
- MIND
The 2005 Mental Capacity Act is due to come into force in April 2007. This article summarises some of the main issues in the Act to guide practitioners, ensure compliance with the lat and to reflect good practice. The article looks briefly at: assessments of capacity; maximising capacity; advance decisions; confidentiality and disputes.
Case report: an unusual case of post-stroke psychosis in a 71-year-old lady with a learning disability
- Authors:
- LEEDS Lesley, SRINIVASAN Janaki
- Journal article citation:
- British Journal of Learning Disabilities, 39(4), December 2011, pp.292-294.
- Publisher:
- Wiley
Stroke is a major health concern, and can lead to psychiatric problems, and people with a learning disability are just as likely as people in the general population to be at risk of cerebrovascular disease, due to the presence of undetected or undertreated vascular risk factors. However, it is often difficult to tell whether someone with a learning disability has had a stroke, especially if they seem well. When people with a learning disability are presenting with additional cognitive impairment, it is important to consider a range of conditions that may account for this. Stroke is a major cause of cognitive impairment in older people, affecting at least one-third of stroke survivors. However, post-stroke psychosis is rare following stroke, and, as can be seen from the case of ‘May’, a 71 year-old lady with a learning disability, individuals can make a good recovery with appropriate assessment and intervention. The article concludes that it is important that a diagnosis of dementia is given only after all other potentially treatable conditions have been excluded, and there is deterioration in condition that defies other explanations.
Can clinicians and carers make valid decisions about others' decision-making capacities unless tests of decision-making competence and capacity include emotionality and neurodiversity?
- Authors:
- MACKENZIE Robin, WATTS John
- Journal article citation:
- Tizard Learning Disability Review, 16(3), 2011, pp.43-51.
- Publisher:
- Emerald
This paper offers academic criticism and explanation for the lack of knowledge of many of those involved in capacity assessments, especially non-professionals such as carers of the learning disabled. It suggests that current guidance for capacity assessments do not take into account issues of emotionality. The Mental Capacity Act 2005 Code of Practice suggests that healthcare professionals and carers may undertake assessments of decision-making capacity, yet the guidance it provides for their doing so overlooks salient issues. Many of those involved in the daily lives of those, who may lack decision-making capacity such as the learning disabled, demented, mentally ill and neurodiverse, must decide whether to respect their decisions as competent, or to disregard the decisions on the grounds of incompetence and to act in the person's best interests. Many will lack training in their clinical and legal responsibilities and liabilities. It is therefore vital that they are protected by an increased knowledge of mental capacity legislation and practice.
Housing with capacity: the Mental Capacity Act explained
- Author:
- WILLIAMSON Toby
- Journal article citation:
- Housing Care and Support, 9(4), December 2006, pp.13-19.
- Publisher:
- Emerald
The Mental Capacity Act 2005 comes into effect in England and Wales 2007. The Act contains principles, procedures and safeguard to empower people to make decision for themselves wherever possible, but also to ensure that decision made on their behalf if they lack the mental capacity to make decision themselves are done in their best interests. The Act will apply to anyone working in the supported housing field or residential care where residents may lack the capacity to make decisions as a result of illness, injury or disability. This article gives an overview of the Mental Capacity Act and its relevance to the field of supported housing.
Mental health: victims and witnesses with mental health conditions and disorders
- Author:
- GREAT BRITAIN. Crown Prosecution Service
- Publisher:
- Crown Prosecution Service
- Publication year:
- 2019
- Place of publication:
- London
Revised guidelines for prosecutors on dealing with victims and witnesses with mental health conditions. It provides information on: the Crown Prosecution Service seeking relevant information about any mental health condition the victim or witness has; the use of expert reports on a victim or witness; consideration of whether a person is competent to give evidence; and providing support for victims and witnesses. The guidance is relevant to victims and witnesses with: a mental disorder, as defined by the Mental Health Act 2007; a learning disability; a learning difficulty; Autism Spectrum Disorder; an acquired brain injury; dementia; or other mental health, cognitive or neuro-diverse conditions. (Edited publisher abstract)
Mental capacity and deprivation of liberty
- Author:
- LAW COMMISSION
- Publisher:
- Stationery Office
- Publication year:
- 2017
- Pagination:
- vii, 259
- Place of publication:
- London
Final report from the Law Commission's review of the Mental Capacity and Deprivation of Liberty Safeguards (DoLS), which considered how the law should protect people who need to be deprived of their liberty in order to receive care or treatment and lack the capacity to consent. The review found that DoLS were overly technical and legalistic, often failed to achieve any positive outcomes for the person concerned or their family, and could not deal with the increased numbers of people considered to be deprived of their liberty following the Cheshire West ruling. The report provides recommendations for the reform of the legal framework and proposes that the DoLS should be replaced by a new scheme, the Liberty Protection Safeguards. The proposed scheme would cover a broader group of people, including any setting that might give rise to a deprivation of liberty and would also cover 16 and 17-year-olds. A draft Bill attached to the report provides details of the new scheme. The draft Bill also includes amendments to other parts of the Mental Capacity Act to provide increased protection for people whose rights to respect for their private and family life and their home, whether or not they risk being deprived of their liberty. The Law Commission also recommended that the Liberty Protection Safeguards should be accompanied by the publication of a new Code of Practice covering all aspects of the Mental Capacity Act. An impact assessment and a summary of the report are published alongside the final report. (Edited publisher abstract)