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Audit of fidelity of clinicians to the Mental Capacity Act in the process of capacity assessment and arriving at best interests decisions
- Authors:
- SORINMADE Oluwatoyin, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 12(3), October 2011, pp.174-179.
- Publisher:
- Emerald
Two years after the implementation of the Mental Capacity Act (MCA) an audit was carried out with the aim of assessing the fidelity of practices at the Oxleas NHS Foundation Trust, and at the Princess Royal University Hospital Geriatric Department, in terms of assessing mental capacity and the process of arriving at “best interests”. A retrospective review was undertaken of the case records of 68 patients previously determined by clinicians as lacking mental capacity. They had been deemed to lack capacity in at least one of three areas: treatment consenting capacity, capacity to decide place of abode and capacity to manage financial affairs. It proved difficult to locate relevant entries as there were no designated folders for MCA related issues. There were (mostly) minimal entries made about the assessment process, only patchy documentation of the legal criteria used in capacity assessment, and which of the criteria the patient did not fulfil. Clinicians only partially followed the procedure prescribed by the MCA in determining best interests of non-capacitous patients. The authors highlight the need for health care professionals to better adhere to the principles of the MCA. They suggest that health care professionals and the public need to be better informed of the provisions of the MCA.
Pan-London NHS: MCA lead toolkit
- Author:
- NHS LONDON PURCHASED HEALTHCARE TEAM
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2016
- Place of publication:
- London
An objective of the London NHS Commissioner MCA Board is to support commissioners to implement MCA assurance and compliance. This resource brings together a number of tools and documents to support MCA leads to gain MCA assurance. These tools have been compiled into a toolkit for NHS MCA leads in line with the MCA compliance framework, focusing on MCA policies and procedures to provide the correct framework for staff to follow; MCA training and support to translate MCA policies and procedures into practice; and quality assurance mechanisms that check MCA processes are carried out appropriately. (Edited publisher abstract)
Emergency Code of Practice: Coronavirus Act 2020 Mental Capacity (Deprivation of Liberty) (Amendment) Regulations (Northern Ireland) 2020
- Author:
- NORTHERN IRELAND. Department of Health
- Publisher:
- Northern Ireland. Department of Health
- Publication year:
- 2020
- Pagination:
- 18
- Place of publication:
- Belfast
The Coronavirus Act 2020 and temporary Regulations makes amendments to the Mental Capacity Act (Northern Ireland) 2016 and the supporting Regulations. The temporary provisions relax some of the requirements of Deprivation of Liberty Safeguards during the Coronavirus (COVID-19) emergency, to ensure that persons can still be deprived of liberty during the pandemic crisis when staff availability may be significantly reduced. This Code of Practice provides practical guidance on how the amendments operate. Emergency forms and a reporting template for Health and Social Care Trusts have also been created. (Edited publisher abstract)
Best interests decisions study: lay summary
- Authors:
- WILLIAMS Val, et al
- Publisher:
- Mental Health Foundation
- Publication year:
- 2012
- Pagination:
- 10p.
- Place of publication:
- London
The Mental Capacity Act 2005 (MCA) sets out what should happen in England and Wales if someone is unable to make a particular decision themselves. The MCA says that a decision made for someone who lacks capacity must be made in their ‘best interests’. The person making that decision is often a health or social care worker, and they must follow the MCA Code of Practice. This study aimed to find out more about how best interests decisions are being made, how far the Code of Practice is followed, and how helpful it is in real life situations. Information was collected about 385 best interests decisions made in 4 areas of England through an online survey of professionals and workers involved in best interests decisions. Telephone interviews with 68 of the people who responded to the survey, and face-to-face interviews with 25 of these, gave a better understanding of what they had done and why. The findings cover the following areas: triggers for undertaking a best interests process; assessment of capacity; the process of making a best interests decision; including the person lacking capacity and others close to them; the role of Independent Mental Capacity Advocates (IMCAs); recording of best interests decisions and assessment of capacity; the basis of the decision; and outcomes. Recommendations are provided for policy, commissioning, professional education and training, practice management, and future research.
Making best interests decisions: people and processes
- Authors:
- WILLIAMS Val, et al
- Publisher:
- Mental Health Foundation
- Publication year:
- 2012
- Pagination:
- 157p.
- Place of publication:
- London
The Mental Capacity Act 2005 (MCA) sets out what should happen in England and Wales if someone is unable to make a particular decision themselves. The MCA says that a decision made for someone who lacks capacity must be made in their ‘best interests’. The person making that decision is often a health or social care worker, and they must follow the MCA Code of Practice. This study aimed to find out more about how best interests decisions are being made, how far the Code of Practice is followed, and how helpful it is in real life situations. Information was collected about 385 best interests decisions made in 4 areas of England through an online survey of professionals and workers involved in best interests decisions. Telephone interviews with 68 of the people who responded to the survey, and face-to-face interviews with 25 of these, gave a better understanding of what they had done and why. The findings cover the following areas: triggers for undertaking a best interests process; assessment of capacity; the process of making a best interests decision; including the person lacking capacity and others close to them; the role of Independent Mental Capacity Advocates (IMCAs); recording of best interests decisions and assessment of capacity; the basis of the decision; and outcomes. Recommendations are provided for policy, commissioning, professional education and training, practice management, and future research.
Mental Capacity Act: policy, guidance and procedural framework
- Author:
- GATESHEAD SAFEGUARDING ADULTS BOARD
- Publisher:
- Gateshead Council
- Publication year:
- 2013
- Pagination:
- 56
- Place of publication:
- Gateshead
This framework aims to assist professionals, and specifically staff working within Gateshead, to understand their responsibilities under the Mental Capacity Act and to access guidance to assist them in fulfilling them. The document is separated into four main parts: policy – this section outlines the policy structures which underpin MCA practice in Gateshead, including a detailed glossary of terms, the legal context, exploration of the role of the CQC and a discussion of how clear MCA leadership can be structured within individual agencies; considerations for particular agencies – this section examines the impact of the MCA on specific agencies within Gateshead and considers some of the challenges presented; MCA practice and procedural guidance – this section considers specific elements and functions of the MCA, and offers practice and procedural guidance; and DoLS procedural guidance – this section sets out Gateshead’s procedure for the effective operation of the Deprivation of Liberty Safeguards. (Edited publisher abstract)
Mental Capacity Act (Northern Ireland) 2016: Deprivation of Liberty Safeguards: process maps
- Author:
- NORTHERN IRELAND. Department of Health
- Publisher:
- Northern Ireland. Department of Health
- Publication year:
- 2019
- Pagination:
- 8
- Place of publication:
- Belfast
A collection of process maps providing short summaries of workflow for a number of key aspects in relation to the deprivation of liberty processes in Northern Ireland. They process maps cover: the authorisation process for detentions; short-term detentions; discharge from hospital into care home; move from family home into care home; formal assessment of capacity; and best interests considerations. (Edited publisher abstract)
Making best interests decisions: people and processes: appendices A-F
- Authors:
- WILLIAMS Val, et al
- Publisher:
- Mental Health Foundation
- Publication year:
- 2012
- Pagination:
- 337p.
- Place of publication:
- London
The Mental Capacity Act 2005 (MCA) sets out what should happen in England and Wales if someone is unable to make a particular decision themself. The MCA says that a decision made for someone who lacks capacity must be made in their ‘best interests’. The person making that decision is often a health or social care worker, and they must follow the MCA Code of Practice. A study aimed to find out more about how best interests decisions are being made, how far the Code of Practice is followed, and how helpful it is in real life situations. Information was collected about 385 best interests decisions made in 4 areas of England through an online survey of professionals and workers involved in best interests decisions. Telephone interviews with 68 of the people who responded to the survey, and face-to-face interviews with 25 of these, gave a better understanding of what they had done and why. A description of the study and its findings are published in the report ‘Making Best Interests Decisions: People and Processes’. This document contains the appendices to this report and provides further details on the experimental methods and analysis. The appendices cover: the online survey; the telephone survey; interviews; people with dementia; Deprivation of Liberty Safeguards; and the issues discussed in the focus group.
Developing a policy to deal with sexual assault on psychiatric in-patient wards
- Authors:
- LAWN Tara, McDONALD Elizabeth
- Journal article citation:
- Psychiatric Bulletin, 33(3), March 2009, pp.108-111.
- Publisher:
- Royal College of Psychiatrists
Sexual harassment and assault on psychiatric wards is an ongoing concern. A number of incidents have been reported in the media. This paper focuses on a policy drafted to deal with allegations of sexual assaultorrapeonanin-patient psychiatric ward. The paper aimed to produce a practical, easy-to-follow guide for junior doctors and ward staff who may face complex and possibly contentious issues surrounding consent, capacity to consent and police involvement.
Practice guidance on the involvement of Independent Mental Capacity Advocates (IMCAs) in safeguarding adults
- Authors:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE, GORCZYNSKA Teresa, THOMPSON David
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2009
- Place of publication:
- London
This practice guidance covers the involvement of Independent Mental Capacity Advocates (IMCAs) in safeguarding adults. It replaces the Practice guidance criteria for the use of IMCAs in safeguarding adults published by ADASS in 2007. Coverage includes who can be represented by an IMCA, the role of the IMCA, contact with the person at risk, information sharing, the appropriate adult role, IMCA challenging decisions and when the IMCA role ends. It is primarily aimed at professionals who have responsibilities in relation to safeguarding adults and may be involved in safeguarding adults proceedings.