Mental Capacity Act 2005 overview for Falls Conference

MENTAL CAPACITY ACT 2005 Provides a legal framework for decision making, designed to empower and protect vulnerable adults Paid staff have a legal duty to have regard to the MCA code of practice, it is everyone’s responsibility to make sure they know where one is kept.

TWO SAFEGUARDING CONCERNS Consider what the consequences would be for vulnerable adults receiving health or care services if….. They are able to decide or act for themselves (have capacity) and are not permitted to. They are unable to act or decide for themselves (lack capacity) and no one will do this on their behalf or in their best interests.

WHAT IS LACK OF CAPACITY? According to the Act, a person lacks capacity if: Stage 1 1. They have an impairment or disturbance that affects the way their mind or brain works, and….. 2. The impairment or disturbance means they are unable to make a specific decision at the time it needs to be made.

Stage 2 Is the person able to –Understand, retain, use and weigh information relevant to the decision? –Understand the consequences of making, or not making, this decision? –Communicate their decision by any means (ie speech, sign language)? –Failure on one point will determine lack of capacity

KEY ELEMENTS OF THE ACT 5 Statutory principles A standard way for all staff to assess capacity A list of considerations for when staff need to make a ‘best interest’ decision on behalf of someone who lacks capacity

WHAT KIND OF DECISIONS DOES THE MCA COVER? The type of decisions covered by the Act range from: - Day to day decisions, e.g. what to eat, wear, time to get up - Can they give informed consent? eg to have a bed rail, to share information? - Can they remember to follow instructions? eg to use a call bell - Can they weigh up risk to themselves or others? - More serious decisions like where to live, what to do with their finances, having an operation

WHEN MIGHT YOU BE CONCERNED THAT SOMEONE LACKS CAPACITY? Assessment might be prompted by: The person’s behaviour Their circumstances Concerns raised by someone else Always assess in relation to the specific decision to be made.

MAKING A BEST INTEREST DECISION Encourage participation Find out the person’s views Avoid discrimination Assess whether the person might regain capacity Consult others Avoid restricting the person’s rights

CRIMINAL OFFENCE The Act makes it a criminal offence to ‘ill- treat’ or ‘wilfully neglect’ someone who lacks capacity Ill-treatment can be any kind of action that could cause harm either physical or emotional. It does not actually need to have actually resulted in harm. Wilful neglect is failing to do something you knew, or should have known, you had a duty to do.