Background

An objective of the London NHS Commissioner MCA Board is to support commissioners to implement MCA assurance and compliance. MCA leads have identified a number of tools/documents to support them to gain MCA assurance. These tools have been compiled into a toolkit for NHS MCA leads in line with the MCA compliance framework shown below

The MCA framework outlines what is required to ensure MCA compliance from a provider and commissioner perspective.

It is important that providers have:

• MCA policies and procedures in place that provide the correct framework for staff to follow.
• MCA training and support to translate MCA policies and procedures into practice.
• Quality assurance mechanisms in place that check MCA processes are carried out appropriately.

Good practice provider MCA training and support and quality assurance should involve service users. For example, service users should be provided with information to understand the MCA and feedback about their experience should be collected.

CCGs have a responsibility to ensure they commission healthcare that is compliant with the MCA for service users in the CCG’s area. The MCA framework shows how this can be achieved through the contract monitoring process, where commissioners assess the quality of providers’ MCA policies, procedures, training and assurance mechanisms. If any areas require improvement, commissioners should support providers to reach acceptable standards of MCA compliance.

Commissioners need to be trained to understand what providers should be doing regarding the MCA and commissioners’ role to monitor this. Networking involves commissioners sharing issues and best practice as well as keeping updated on any changes in legislation taking place.

Commissioner training

Checklists

• Commissioner MCA responsibilities checklist
• Commissioner MCA training checklist

Case studies

• Case study: hypothetical example
• Case study: 69 year old male
• Case study: 35 year old woman
• Case study: 79 year old woman
• Case study: mature woman with severe physical and learning disabilities
• Case study: 89 year elderly lady
• Case study: 64 year old gentleman
• Case study: man in his late 40’s

Contract monitoring

Frameworks

• Bromley MCA quality framework
• Bromley MCA quality assurance framework for contract monitoring and procurement

MCA CQUINs

• Barts Health
• St Christophers

Policies and procedures

Care homes

• Policy Template for Care Homes

Acute

MCA policy examples for Acute providers

• Barts Health NHS Trust: Corporate policy – Safeguarding adults at risk of harm. Includes Mental Capacity Act; Deprivation of Liberty and prevent
• NELFT NHS Foundation Trust: Assessment of mental capacity and determination of best interests
• NELFT NHS Foundation Trust: Assessment of mental capacity policy

Provider training

Checklist

• Provider MCA training quality standards checklist

Support

Good practice MCA implementation/awareness support documents

Barnet, Enfield and Haringey CCGs

• Mental Capacity Assessment Form for Vision
• Mental Capacity Assessment Form for EMIS
• Mental Capacity Assessment Tool Guidance
• A4 Patient information leaflet: Advance Decision to Refuse Treatment
• A4 Patient information leaflet: Advance Statement for Mental Health
• A4 Patient information leaflet: Lasting Power of Attorney (LPA)
• A4 Patient information leaflet: Preferred Priorities for Care
• A5 Patient information leaflet: Advance Decision to Refuse Treatment
• A5 Patient information leaflet: Advance Statement for Mental Health
• DL Patient information leaflet: Lasting Power of Attorney (LPA)
• A4 Patient information leaflet: Advance Decision to Refuse Treatment - Frequently Asked Questions
• A4 Patient information leaflet: Lasting Power of Attorney - Frequently Asked Questions

Barts Health

• Five key principles of the Mental Capacity Act (MCA) mousemat
• Briefing on: Outcome of MCA-DoLS awareness week, November 2015
• Case study for learning: A patient with learning disabilities needing specialist treatment
• Mental Capacity Act and Deprivation of Liberty Safeguards Champion: Role description
• Mental Capacity Act and Deprivation of Liberty Safeguards Crossword
• Presentation/screensaver: MCA-DoLS awareness week, November 2015
• Poster: Mental Capacity: What’s it all about?
• Poster: My patient is ‘on DoLS’: What’s it all about?
• Poster: Mental Capacity Act: What’s it all about?
• Powerpoint presentation: Mental Capacity Act and DoLS

Croydon CCG

• Mental Capacity Act & Deprivation of Liberty safeguards project poster
• GP Practice Mental Capacity Act self-assessment tool
• Primary Care: Mental Capacity Act & Deprivation of Liberty Quick Guide – Contacts and Sources of Guidance
• Mental Capacity Assessment and Best Interest Decision Making Form

Camden and Islington Foundation Trust

• Advanced Planning Information & Useful Links
• Guide to the Mental Capacity Act 2005 (flashcards)
• Informed Consent to Voluntary Admission
• Mental Capacity Act 2005 Information Leaflet
• Record of Informed Consent for Voluntary Admission/Stay in Mental Health Units

NHS London

• Safeguarding adults - prompt cards

NELFT NHS Foundation Trust

• Deprivation of Liberty Safeguards (DoLS) - Guide for family and carers
• Deprivation of Liberty Safeguards (DoLS) - Guide for family and carers (leaflet)
• Case study – 89 year elderly lady
• Case study – 64 year old gentleman
• Case study – man in his late 40’s

Quality assurance

Audit tools

• Bromley CCG: Policy procedures – Audit to test compliance with Mental Capacity Act 2005
• Bromley CCG: Training policies – auditor’ use
• Bromley CCG: Training for staff – Audit to test compliance with Mental Capacity Act 2005
• Bromley CCG: File audit to test compliance with Mental Capacity Act 2005
• Bromley CCG: Pre-training audit
• Barnet, Enfield and Haringey CCG: Mental Capacity Act (MCA) 2005 questionnaire for General Practice and Out of Hours Services
• Barnet, Enfield and Haringey CCG: Mental Capacity Act 2005 audit tool