Mental Capacity Act (MCA) Directory

The MCA (Mental Capacity Act) Directory has been developed to provide a single space for the sharing of useful information and tools to aid the implementation of the Mental Capacity Act and Deprivation of Liberty Safeguards. Here you will find publications, videos, and academic research that professionals across Health and Social Care may find useful in their day-to-day practice.

Social work expertise, best interests and the court of protection

Purpose: The purpose of this paper is to consider the role of social work professional evidence in mental capacity law, specifically Court of Protection proceedings. The authors analyse how social workers perform as evidence givers in this domain and how social work as a profession is perceived alongside other professions within the context of adult social care decision-making in mental capacity law. Design/methodology/approach: This paper draws on textual evidence from judgments and existing empirical data published elsewhere. The authors consider the contribution of social work professional expertise to best interests decision-making in formal legal proceedings which, in turn, reflects on...

Inclusion under the Mental Capacity Act (2005): a review of research policy guidance and governance structures in England and Wales

Objective: To investigate how people with communication and understanding difficulties, associated with conditions such as dementia, autism and intellectual disability, are represented in research guidance supplementary to the Mental Capacity Act (MCA: 2005) in England and Wales. Methods: A documentary survey was conducted. The sample comprised the MCA Code of Practice (CoP: 2007) and 14 multi‐authored advisory documents that were publicly available on the Health Research Authority website. Textual review of key words was conducted followed by summative content analysis. Results: Representation of people with communication and understanding difficulties was confined to procedural information and position statements that focused mainly...

Assessment of older adults' decision-making capacity in relation to independent living: a scoping review

With a growing global ageing population, approaches to assess and support decision-making are becoming more pertinent. This scoping review aimed to identify and map current knowledge on assessment of older adults' decision-making capacity in relation to independent living. A five-stage scoping review framework was followed. Inclusion criteria were papers on assessment approaches used to evaluate decision-making capacity of older adults, aged 60 years and over for independent living, including studies involving people with cognitive impairment and dementia. Five databases were searched for publications with eligibility criteria from January 2000 to December 2020; 4,118 results were retrieved from sources, resulting in...

Supported decision-making and mental capacity assessment in care homes: a qualitative study

Up to 75% of UK care home residents may lack the mental capacity to make certain decisions (Wade, Clinical Rehabilitation, 2019, 33, 1561-1570). Care home staff need evidence-based tools to help them assess residents’ mental capacity and provide decision-making support (NICE, Decision-making and mental capacity NICE guideline NG108, 2018). The Mental Capacity Assessment Support Toolkit (MCAST) was designed to support multidisciplinary healthcare staff to prepare, complete and document legally compliant mental capacity assessments. MCAST has not yet been trialled in care homes. This study used a descriptive qualitative design to: (a) understand the current challenges faced by care home staff...

COVID-19 and the Mental Capacity Act in care homes: perspectives from capacity professionals

This study explores the experiences of professionals who worked with care home residents with impaired mental capacity in England and Wales during the COVID-19 pandemic. It explores (i) how competing risks were balanced and (ii) how the Mental Capacity Act (MCA) functioned in care homes under pandemic conditions, with particular focus on its associated Deprivations of Liberty Safeguards (DoLS) and Independent Mental Capacity Advocacy (IMCA) systems. Between March and May 2021, an online survey and five focus groups aimed at professionals who worked in or with care homes during the pandemic, were held. The study explored issues pertaining to residents...

'They don't want them to have capacity': multi-agency operationalisation of the Mental Capacity Act 2005 in England with adults who self-neglect

The number of adults who self-neglect and thus fall under the aegis of local authority adult safeguarding procedures in England has increased substantially since the introduction of the Care Act 2014. The requirement for collaborative working between agencies dealing with these adults in a safeguarding context is explicit in government policy and legislation. Decisions made by the multiplicity of agencies that may work with people who self-neglect are largely guided by the Mental Capacity Act 2005 (MCA). The overall objective of this research was to develop a clearer understanding of how the range of agencies that might typically be involved...

A matter of life or death: a rapid review assessment of London's safeguarding adults reviews to inform the future of mental health adult social care under a new Mental Health Act

Safeguarding Adult Reviews (SARs) can be a valuable source of learning to improve mental health care. In light of the government's commitment to reform the Mental Health Act 1983, this report summarises the qualitative learning from 77 SARs published across 24 London boroughs covering the period January 2017 to November 2020. The premise of this report is that the reform of the Mental Health Act will also prompt a 'wake up' of the entire mental health system in London and the rest of England in which parity of social care with health care becomes the 'new normal'. The SARs analysed...

Case law directory

CDC’s case law digest service provides essential updates on the latest judicial decisions affecting disabled children and young people and those with SEN.

[Court of Protection transparency pilot order explained]

This is the transparency order template, and includes explanations and guidance. The Court of Protection is testing a new way of having hearings. For the time being, hearings will be in public, but no-one will be allowed to name the people involved. If individuals want their hearing to be in private instead, they can ask the judge. They will need to explain in writing why their case should be treated differently to the other cases.

Taking wishes and feelings seriously: the views of people lacking capacity in Court of Protection decision-making

The Mental Capacity Act requires that where a person (P) lacks capacity to make a decision her wishes and feelings be taken into account when deciding what is in her best interests. This article considers how the Court of Protection evaluates evidence from P concerning her wishes and feelings. It finds that the Court ignores evidence regarding current wishes and fails to engage with more ambiguous evidence where P desires conflicting outcomes or may be concealing her true feelings. This is unhelpful since it makes the resulting judgment unconvincing to observers. It is legally problematic, since the Court should be...