Mental capacity Act & DOLS

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Mental capacity Act & DOLS

  1. 1. Elevate Training & Development © www.SocialWorkProcesses.co.uk
  2. 2.  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 ways 1. People 16+ who are unable to make all or some decisions for themselves 2. Support to those who are 18+ who have capacity and choose to place for their future Elevate Training & Development © www.SocialWorkProcesses.co.uk
  3. 3. The Mental capacity Act (MCA) 2005 applies to everyone involved in the Care, 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  4. 4. The MCA also provides support and guidance for less formal carers Elevate Training & Development © www.SocialWorkProcesses.co.uk
  5. 5. The MCA 5 statutory principles are the benchmark and must underpin all acts carried out and decisions taken in relation to the Act Elevate Training & Development © www.SocialWorkProcesses.co.uk
  6. 6. Anyone caring for or supporting a person who may lack capacity could be involved in assessing capacity and must follow the two stage test Elevate Training & Development © www.SocialWorkProcesses.co.uk
  7. 7. The MCA is to empower those in health and social care to assess capacity themselves rather than rely on expert testing Elevate Training & Development © www.SocialWorkProcesses.co.uk
  8. 8. Understanding and using the MCA supports practice for example the application of the Deprivation of Liberty Safeguards Elevate Training & Development © www.SocialWorkProcesses.co.uk
  9. 9. All professionals have a duty to comply with the Code Of Practice Elevate Training & Development © www.SocialWorkProcesses.co.uk
  10. 10. If capacity is lacking follow the checklist described in the Code to work out the best interests of the individual concerned Elevate Training & Development © www.SocialWorkProcesses.co.uk
  11. 11. The Act is underpinned by five key principles (Section 1, MCA) Elevate Training & Development © www.SocialWorkProcesses.co.uk
  12. 12. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  13. 13. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  14. 14. Principle 3: Unwise decisions - People have the tight to make decisions that others might regard as unwise or eccentric Elevate Training & Development © www.SocialWorkProcesses.co.uk
  15. 15. Principle 4: Best Interests - Anything done for or on behalf of a person who lacks mental capacity must be done in their best interests Elevate Training & Development © www.SocialWorkProcesses.co.uk
  16. 16. 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. Elevate Training & Development © www.SocialWorkProcesses.co.uk
  17. 17. Sections 2 – 4 MCA Under 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  18. 18. Sections 2 – 4 MCA You should also ensure that the more serious the decision that is required the more formal the assessment process should be Elevate Training & Development © www.SocialWorkProcesses.co.uk
  19. 19. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  20. 20. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  21. 21. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  22. 22. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  23. 23. Stage 1 Is there an impairment of or disturbance in the functioning of a person’s mind or brain? If so..... Elevate Training & Development © www.SocialWorkProcesses.co.uk
  24. 24. Stage 2 Is the impairment of or disturbance sufficient that the person lacks the capacity to make a particular decision? Elevate Training & Development © www.SocialWorkProcesses.co.uk
  25. 25. 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 them 2. Retain that information long enough to be able to make a decision 3. Weigh up the information available to make the decision 4. Communicate their decision Elevate Training & Development © www.SocialWorkProcesses.co.uk
  26. 26. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  27. 27. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  28. 28. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  29. 29. When a person is assessed as lacking capacity then the person who acts on their behalf is known as the “Decision-Maker” Elevate Training & Development © www.SocialWorkProcesses.co.uk
  30. 30. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  31. 31. The “Decision-Maker” must make decisions which are in the best interest of the person who is said to be lacking in capacity Elevate Training & Development © www.SocialWorkProcesses.co.uk
  32. 32. The “Decision Maker” makes decisions to do with regard to treatment, care or accommodation needs Elevate Training & Development © www.SocialWorkProcesses.co.uk
  33. 33. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  34. 34.  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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  35. 35. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  36. 36. 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 Elevate Training & Development © www.SocialWorkProcesses.co.uk
  37. 37. The Public Guardian Elevate Training & Development © www.SocialWorkProcesses.co.uk
  38. 38. Independent mental capacity advocates (IMCA) Elevate Training & Development © www.SocialWorkProcesses.co.uk
  39. 39. Advance decisions to refuse treatment Elevate Training & Development © www.SocialWorkProcesses.co.uk
  40. 40. A criminal offence Elevate Training & Development © www.SocialWorkProcesses.co.uk

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