Report 70: The Mental Capacity Act (MCA) and care planning
A monitoring checklist
This checklist will help commissioners and contract monitoring staff to easily identify if services are developing Mental Capacity Act compliant care and support plans. Staff might consider incorporating elements of the checklist into their own monitoring forms.
- Evidence of the person’s informed consent to their care and support.
- Evidence of why the person was assessed as lacking the capacity to consent.
Communication and control
- A description of any special communication needs.
- Where the person has limited communication ability, other non-verbal communication methods that the person may use.
- How the person is supported to understand and be involved in decisions about their care and support. This includes the nature of the decision, the options available and the consequences of each decision.
- Information about what is important to that person, their wishes and preferences.
- What the person would like to achieve from their care and support.
- A person’s social history, including any key events or achievements.
- If the person appears to lack capacity to make a specific decision for themselves at the time it needs to be made, an assessment of capacity should be made in relation to that particular decision.
- How the person’s liberty and choices about their care and support are promoted.
- Information about the person’s views.
- How the person was supported to be involved in the decision about their care and support. This includes keeping them informed about any decisions made about them.
- Information against each element of the ‘best interests’ checklist (see the section in this report on Demonstrating best-interests decision-making).
- Details of the options that were considered together with the associated risks and benefits of each.
- A clear explanation of why a particular option was decided upon.
- If restrictions are imposed, when these will be reviewed and how.
- The person or their family/friends are able to tell you how they were involved in developing the care and support plan and that they felt (and feel) listened to.
- The person and their chosen representative are aware of the care and support plan and have seen a copy.
- The care and support plan clearly explains how care and support will be delivered.
- What the person would like to achieve with their care and support, their goals and aspirations for the future.
- What is important to the person about how they live their lives now. For example, what they enjoy doing, their interests, likes and dislikes, who is important to them, who they like to see, where they like to go, their preferred routines (such as when they like to get up and go to bed, whether they like a bath or a shower).
- Details of key life events and dates to assist with chronological orientation.
- How best to support and involve the person in decision-making.
- Essential information for continuity of care and for use in emergencies.
- Roles and responsibilities so that the person receives coordinated care support to meet their needs.
- Where a person lacks capacity to express their choices, how their families and others who are interested in their welfare have been consulted.
- What outcome the person wants and any other options considered.
- The associated benefits and risks of each option.