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Capacity and competence: limitations on choice and action
- Author:
- WILLNER Paul
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(6), 2011, pp.49-56.
- Publisher:
- Emerald
The terms capacity and competence are often used interchangeably. However, they are distinct concepts, and the failure to differentiate them can generate confusion. This aim of this paper is to clarify the application of these terms. The term ‘mental capacity’ refers to the ability to make a decision, while the term ‘competence’ refers to the ability to perform the actions needed to put decisions into effect. Some implications of this distinction as it applies to adults with cognitive limitations are explored. Questions of capacity are governed by legislation, particularly the Mental Capacity Act (MCA); they apply only to people who can be demonstrated to have a ‘mental disorder', and can trigger best-interests decision making and other legal provisions. Questions of competence involve a range of formal and informal assessment procedures, and can apply to anyone; they arise where others possess legal powers to control a person's actions. The MCA protects the rights of people with cognitive limitations to make autonomous decisions where capacity is present. However, where others have the right to set standards of competence, the MCA does not confer rights to perform the actions needed to implement the decisions. Nevertheless, there is some scope for challenging this position; the paper concludes by considering some areas of practice where the MCA can be invoked to promote competence.
Review of compliance: Healthlinc Individual Care Limited: Healthlinc House
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 17p.
- Place of publication:
- London
Healthlinc House was reviewed as part of a targeted inspection programme in hospitals that care for people with learning disabilities. Healthlinc House is an independent hospital providing treatment and rehabilitation for people with learning disabilities. Two essential standards of quality were examined: Outcome 4: People should get safe and appropriate care that meets their needs and supports their rights; and Outcome 7: People should be protected from abuse and staff should respect their human rights. The report includes a summary describing why the review was carried out, the main findings and action required. It also provides detailed findings for the two essential standards and outcomes reviewed. The provider was found to be compliant with both standards. Improvements have were also suggested to maintain compliance.
Review of compliance: Modus Care Ltd: Westbrook Grange
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 21p.
- Place of publication:
- London
Westbrook Grange was reviewed as part of a targeted inspection programme in hospitals that care for people with learning disabilities. Westbrooke Grange is a small hospital setting providing accommodation, assessment and treatment of patients with a mental health disorder and Autistic Spectrum Disorder. Two essential standards of quality were examined: Outcome 4: People should get safe and appropriate care that meets their needs and supports their rights; and Outcome 7: People should be protected from abuse and staff should respect their human rights. The report includes a summary describing why the review was carried out, the main findings and action required. It also provides detailed findings for the two essential standards and outcomes reviewed. The provider was found to meet Outcome 7 but improvements were needed before Outcome 4 was met.
Review of compliance: Tees, Esk and Wear Valleys NHS Foundation Trust: Roseberry Park
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 20p.
- Place of publication:
- London
Roseberry Park in Middlesbrough was reviewed as part of a targeted inspection programme in hospitals that care for people with learning disabilities. It provides 75 beds for the assessment and treatment of patients with a learning disability in a low secure environment. Three essential standards of quality were examined: Outcome 4: People should get safe and appropriate care that meets their needs and supports their rights; Outcome 7: People should be protected from abuse and staff should respect their human rights; and Outcome 9: People should have their medicines at the times they need them, and in a safe way. The report includes a summary describing why the review was carried out, the main findings and action required. It also provides detailed findings for the two essential standards and outcomes reviewed. The provider was met the standard for Outcome 9 but did not meet essential standards Outcome 4 and Outcome 9.
Review of compliance: Partnerships in Care Limited: Hazelwood House
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 21p.
- Place of publication:
- London
Hazelwood House was reviewed as part of a targeted inspection programme of hospitals that care for people with learning disabilities. It provides a low secure hospital service for men with a learning disability and mental health needs and problems with substance misuse. Two essential standards of quality were examined: Outcome 4: People should get safe and appropriate care that meets their needs and supports their rights; and Outcome 7: People should be protected from abuse and staff should respect their human rights. The report includes a summary describing why the review was carried out, the main findings and action required. It also provides detailed findings for the two essential standards and outcomes reviewed. It was found that improvements were needed to meet both essential standards reviewed.
What we think about Westridge Assessment and Treatment Service
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 17p.
- Place of publication:
- London
This easy read report describes the inspection of Westridge Assessment and Treatment Service for patients with learning disabilities. Using words and pictures it describes the reasons for the inspection, what happened when the inspection was carried out and what the hospital was and was not doing well.
Review of compliance: Berkshire Healthcare NHS Foundation Trust: Little House
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 18p.
- Place of publication:
- London
Little House was reviewed as part of a targeted inspection programme in hospitals that care for people with learning disabilities. The service provides short to medium term assessment and treatment for adults with a learning disability and additional complex needs. Two essential standards of quality were examined: Outcome 4: People should get safe and appropriate care that meets their needs and supports their rights; and Outcome 7: People should be protected from abuse and staff should respect their human rights. The report includes a summary describing why the review was carried out, the main findings and action required. It also provides detailed findings for the two essential standards and outcomes reviewed. The provider was found to be meeting with both standards.
What we think about Humber NHS Foundation Trust Townend Court: easy read report
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 15p.
- Place of publication:
- London
This easy read report describes the inspection of Townend Court, which provides support for adults with learning disabilities who require specialist assessment and treatment with 24 hours support within an inpatient facility. Using words and pictures it describes the reasons for the inspection, what happened when the inspection was carried out and what the hospital was and was not doing well.
Review of compliance: Tees, Esk and Wear Valleys NHS Foundation Trust: Church View
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 15p.
- Place of publication:
- London
Church View was reviewed as part of a targeted inspection programme in hospitals that care for people with learning disabilities. It is an 8 bedded unit providing long term care to eight people with a moderate to severe learning disability. Two essential standards of quality were examined: Outcome 4: People should get safe and appropriate care that meets their needs and supports their rights; and Outcome 7: People should be protected from abuse and staff should respect their human rights. The report includes a summary describing why the review was carried out, the main findings and action required. It also provides detailed findings for the two essential standards and outcomes reviewed. The provider was found to be meeting both standards, but to maintain this it was recommended that person centred plans should be reviewed and evaluated.
Review of compliance: Rotherham Doncaster and South Humber NHS Foundation Trust: Learning Disability Assessment and Treatment Unit
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 20p.
- Place of publication:
- London
Rotherham Doncaster and South Humber NHS Foundation Trust Learning Disability Assessment and Treatment Unit was reviewed as part of a targeted inspection programme in hospitals that care for people with learning disabilities. The Unit provides assessment and treatment interventions for 10 adults with a primary diagnosis of learning disabilities and associated health care needs. Three essential standards of quality were examined: Outcome 4: People should get safe and appropriate care that meets their needs and supports their rights; Outcome 7: People should be protected from abuse and staff should respect their human rights; and Outcome 21: Records. The report includes a summary describing why the review was carried out, the main findings and action required. It also provides detailed findings for the essential standards and outcomes reviewed. The provider was found to be meeting the essential standard for Outcome 4 and 7, but was not meeting essential standard Outcome 21. Improvements are suggested.