Mental Capacity Act workbook

Six scenarios for training

Commissioned by, and hosted here on the MCA Directory on behalf of, the members of the NHS Eastern Region Safeguarding Adult Forum facilitated by Eleanor Sherwen & Sarah Robinson.

View here online or order a DVD or workbook

This resource promotes best practice in the use of the Mental Capacity Act 2005 and where appropriate the Deprivation of Liberty Safeguards (2009), particularly in the context of situations involving health related decisions.

This learning resource provides a series of short film scenarios that will challenge the viewer to consider the ethical issues in any given situation, and to encourage debate about potential decision making outcomes. It is the intention that these scenarios illustrate everyday situations, and whilst they may not demonstrate perfect practice, the aim is that they promote discussion and debate.

Trevor

An 82 year old gentleman with a gangrenous lower leg following an accident at home, now refusing amputation to his leg. The dilemma for the professionals involved in this situation is whether the gentleman has capacity and whether amputation of his limb is required.

Susie

A lady in her sixties who needs renal dialysis. The dilemma for the professionals involved in this situation is whether Susie has capacity or not. If she hasn't, should she have dialysis in her best interests to save her life, despite her recent attempt to end her own life?

Teresa

A lady who is accommodated in a care home. Teresa is determined to go home despite the identified risks. She is currently subject to DoLS. The dilemma for the professionals involved in this situation is whether it is in Teresa's best interests to return home. Can the relevant community support reduce the risk to an acceptable level or would this be neglect?

Darren

A young man with a learning disability who potentially needs dental treatment. The dilemma for the professionals involved in this situation is who should assess Darren's capacity to make decisions about his dental treatment? If treatment in hospital were necessary using the MCA, would any restraints meet the threshold for DoLS?

Isabella

A young female student with cerebral palsy who has collapsed and been taken to hospital late at night. She is unconscious. The dilemma for the professionals involved is who should they consult when there is no immediate next of kin? Potentially if Isabella needs serious medical treatment does this fall within the doctors' duty of care regardless of the MCA? Should issues such as DNACPR be considered?

Arthur

A retired postman living in poor circumstances, he has had a fall but is refusing to let the ambulance crew take him to hospital. He appears to be under the influence of alcohol. The dilemma for the professionals involved in this situation is should they leave Arthur where he is based, on a presumption of capacity, or should his mental capacity be formally assessed?