Report 70: The Mental Capacity Act (MCA) and care planning
Purpose of this report
A human being is a human being. Behaviours may be erratic, chaotic or self-sabotaging, but people still retain their human rights 
The MCA protects people’s basic human right to live the lives that they choose as far as they are able. Integrating the principles of the MCA into care planning and practice can transform the experience of adults with care and support needs.
This report is not intended as a guide to care planning, commissioning or the MCA. There are already excellent resources available on each of these topics. What it does offer is a starting point for both commissioners and providers to understand and demonstrate how care and support plans can comply with the principles of the MCA.
Despite examples of good practice, there is still considerable uncertainty about what the MCA means for care planning.
Care and support plans can and should:
- consider questions of autonomy and liberty
- encourage staff to maximise people’s capacity to be involved and to make decisions
- respect the right of people, who have capacity, to make unwise decisions.
Commissioners must check that providers are aware of this, and are implementing it – for all people, including those with challenging behaviour or complex needs.
This report aims to encourage and challenge providers to perform care planning differently and better; to think about promoting rights and liberty, promoting people’s capacity to make decisions about their life and their care, and supporting people to be involved in every decision about their care. It also encourages commissioners of residential and domiciliary care services to question and scrutinise care planning to ensure that it meets the requirements of the MCA and delivers human rights.
The report will also be of interest to people who use care services, their families or other caregivers. By setting out the principles of good quality care planning under the MCA, this report tells people what they can expect and what can be achieved.
A note on terminology
The terms ‘capacity’ or ‘lack of capacity’ are used throughout this report to refer to capacity that is specific to each decision at the time that it needs to be made.
How this report was produced
This report was commissioned by the Department of Health (DH) as part of its programme to implement the MCA 2005. The Social Care Institute for Excellence (SCIE) carried out a scope of available research on care planning and the MCA, which forms the basis of this report. Members of an advisory group of users and stakeholders from across the social care sector have also contributed to the content by drawing on their experiences.
What to look for in care and support planning
The report contains examples of evidence to illustrate what MCA-compliant care planning might look like. These examples are intended to be used as prompts. Not all of these prompts will be relevant to every situation, so you will need to pick and mix. Some of the evidence will be found in the care and support plan itself; other evidence may be in the care planning assessment documentation or may be gleaned from conversations with staff, users and/or their relatives/carers.