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The impact of the Mental Capacity Act 2005 on social workers' decision making: a report for SCIE
- Authors:
- McDONALD Ann, DAWSON Carol, HEATH Becky
- Publisher:
- University of East Anglia
- Publication year:
- 2008
- Pagination:
- 55p.
- Place of publication:
- Norwich
Social workers in Norfolk, working with people with dementia, were asked to describe their casework and recording and to reflect upon the impact that the coming into force of the Mental Capacity Act 2005 had upon their practice. The cases in this research all related in some way to residential care, and most concerned capacity to make the decision to enter or remain in residential care. They concerned very vulnerable older people, their families and other professional supporters. The Act had had a significant impact in the way in which decision-making was structured, though not all cases were amenable to a clear-cut solution. Relationships with family members and other professionals, the availability of resources and the impact of training all played a part in influencing outcomes. Professionally, the social workers involved seemed to have developed greater professional confidence in their assessment and decision-making skills within the structure provided by the Mental Capacity Act. Mental capacity had become a topic that was discussed with other agencies, and integrated into the care management process.
The impact of the 2005 Mental Capacity Act on social workers' decision making and approaches to the assessment of risk
- Author:
- McDONALD Ann
- Journal article citation:
- British Journal of Social Work, 40(4), June 2010, pp.1229-1246.
- Publisher:
- Oxford University Press
While there is no body of law relating directly to older people, the 2005 Mental Capacity Act in England and Wales has introduced a statutory system for assessment and substituted decision making for people lacking the capacity to make independent decisions, including decision making by older people with dementia. This paper, based on research into the early impact of the Act on social work practice, identifies three distinct types of approach to risk emerged: legalistic; actuarial; and rights-based. These three types of social work practice are discussed in the context of modernist assumptions of rationality and self-interest, the demands of a risk society for proficiency at decision making, and the relationship between moral and legal dialogue where social workers intervene when capacity is challenged. The author highlights how the outcomes are relevant to the changing context of social work with people with dementia, the introduction of individual budgets replacing directly provided services and the development of a National Dementia Strategy. The author argues that, although risk-based and actuarial types currently govern practice, rights-based approaches are necessary to support older people in making choices, counteract stereotypes and promoting well-being.