Mental Capacity Act (MCA) Directory

An easy read booklet explaining what DoLS is, including a number of examples showing the right approach.

This factsheet is aimed at service users and is about making sure people are safe in hospital and get the medical care they need. It includes illustrative examples of making decision about capacity and deprivation of liberty.

This flowchart describes the process of assessing capacity and best interests decision making for health and social care interventions.

This document is part of a series of brief guides to help all health and social care professionals navigate through and apply the principles of the Mental Capacity Act for decisions regarding treatment and care. It sets out alternative decision-making approaches in the event that a person does not have mental capacity to give consent to a proposed treatment. It looks at the role of advance decisions to refuse treatment, lasting powers of attorney for health and welfare and discusses situations where the Court of Protection may need to be involved. The guide also covers advance care plans, independent mental...

Mental Capacity Act 2005: assessment of capacity form

This diagram provides step by step guidance to understanding the principles of consent and mental capacity prior to undertaking care, examination or treatment. The steps are applicable to patients aged 16 and over.

Findings of a survey of care home managers to look into how successfully the Mental Capacity Act (MCA) was being implemented on the front line of residential care. Respondents answered questions on the five principles of the MCA, and the questions asked how well they lead and supported their staff teams to understand and enact these principles. This research shows how some managers take a range of approaches to MCA implementation. Mentorship, coaching and active, floor-based management seemed to recur in the answers from managers who really wrote confidently about their staff team’s understanding of the MCA. One of the...

This case concerns leave under Section 17 MHA 1983 and DoLS. AB, a 34 year old woman, had a serious and life threatening cardiac condition, the recommended treatment for which was surgery. She lacked the capacity to make decisions as to her medical treatment (and to conduct proceedings in relation to her medical treatment). The local health board made an application to the Court of Protection for declarations and decisions in relation to AB’s capacity and best interests as regards heart surgery, as well as (prior) dental surgery to remove her lower teeth. The intention was that AB would be...

D was a 16-year-old boy who had been diagnosed with ADHD, mild learning disability, Asperger’s syndrome and Tourette’s syndrome. He had previously been detained in a psychiatric unit but was discharged to a residential home. The residential unit was funded by the local authority with his parent’s consent under section 20 of the Children Act 1989. All parties agreed that D was deprived of his liberty. The issue was whether D’s parents were able to consent on his behalf and whether the arrangements were imputable to the State. The local authority argued that the effect of the parents’ consent under...

Maria Ferreira, a woman with Down’s syndrome, died in an intensive care unit after she dislodged a tube with her mittened hand. An inquest was to be held but whether a jury was required depended upon whether she died in “state detention” under sections 7 and 48 of the Coroners and Justice Act 2009. A key issue, therefore, was whether “state detention” equated to “deprivation of liberty” under Article 5(1) ECHR and the relevance of the Supreme Court’s decision in Cheshire West. The Court of Appeal concluded Ms Ferreira was not in state detention.

These test cases related to a class of cases in which a welfare order was sought by local authorities to authorise P’s deprivation of liberty under the Re X streamlined procedure. The court considered five cases, JM, AMY, JG, MM and VE, where there was no family member or friend who could act as litigation friend in applications by the local authority to authorise a deprivation of liberty. That was no longer the position in VE and the test cases referred to the remaining four. These cases provide practical guidance as to the procedure to be followed in applications made...

This case related to conditional discharge of restricted patients and deprivation of liberty. It confirms that it is entirely possible for a person lacking capacity as to residence/care to be given a conditional discharge from detention under the MHA 1983 if the conditions amount to an objective deprivation of their liberty, so long as that deprivation of liberty is authorised in advance either by the Court of Protection (for supported living placements etc) or DoLS (care homes or hospitals).