MCA resources on Independent Mental Capacity Advocacy

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“My next patient may lack capacity”

ASIST Advocacy Services

This guidance covers the key principle of the Mental Capacity Act, assessing capacity and inability to consent, best interests decision making for patients, independent mental capacity advocacy, and deprivation of liberty safeguards.

Last updated on hub: 19 September 2020

Advocacy with people with learning disabilities and autistic people, who are subject to seclusion, segregation or restraint

VoiceAbility

Independent advocacy is crucial to make sure a person’s voice is heard and their human rights are protected. This is especially important when a person is subject to compulsory and restrictive powers. Consistent and effective advocacy must be provided to people who most require it, whenever they require it, including to people with learning disabilities, autism or both, who are subject to long term segregation. Improvement to the delivery and commissioning of advocacy is required to achieve this. This briefing highlights the key features of advocacy for people with learning disabilities, autism or both who are in long term segregation, which must be accessible, highly competent, holistic, independent and perceived to be so, connecting, supporting and joined up. The paper also sets out two commissioning options: national commissioning – the model could be specified clearly, activated promptly, its delivery easily monitored, and there would be a clear line of sight on the resources; and local commission – this would allow locally commissioned services to align with most existing statutory provision. Irrespective of the commissioning arrangements, the service must be able to undertake the full range of statutory advocacy duties, rather than referring the person on and requiring that they relate to several advocates. The paper conclude with eight recommendations, including ensuring that advocacy for people in long term segregation is provided on an opt-out basis, to ensure a greater number of people in long term segregation receive the timely advocacy support and representation they need for their voice to be heard and their rights upheld.

Last updated on hub: 05 January 2021

Are you making decisions on behalf of someone you’re looking after? A carer’s guide to the Mental Capacity Act

SITRA

Sitra, the Carers Trust and Care Charts UK designed this booklet to provide support and guidance about decision making for carers of people living with dementia. Carers provided examples of decisions they make with and for the person they care for. The booklet uses their experience to bring alive how carers manage supported decision making to maintain a good quality of home life, whilst keeping the people they care for as independent and safe as possible. It covers the key principles at the heart of the Mental Capacity Act; how to assess capacity; and making decisions on behalf of someone.

Last updated on hub: 14 September 2020

Assessment of mental capacity policy

North East London NHS Foundation Trust

This policy has arisen from the implementation of the MCA 2005 and seeks to give advice and guidance on how and when an assessment of mental capacity should be carried out. It draws a distinction between routine/ongoing assessments of capacity, which is a part of everyday care, and more exceptional occasions, when a formal assessment is necessary. In the latter case a formal, documented assessment is now required by the Trust in defined instances.

Last updated on hub: 17 September 2020

Best interests decision-making matters for clinicians

Disability Matters

A best interests decision making e-learning course. This session explores 'best interests', what it means for disabled people and how best interest decisions are made for disabled people who lack capacity.

Last updated on hub: 06 September 2020

Case study eight: Mrs C – improvements to accommodation

Department of Health and Social Care

A case study focusing on a care home resident needing improvements to their accommodation, explaining how after intervention by an IMCA the decision was made to go ahead with the repair work. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, and shows how IMCAs can act as a powerful support to people who may lack capacity.

Last updated on hub: 16 September 2020

Case study eleven: Mr J – wanting more independence upon moving from a mental health rehabilitation unit

Department of Health and Social Care

A case study focusing on a patient wanting more independence upon moving from a mental health rehabilitation unit. It describes how the patient, supported by an IMCA, was able to move into supported living accommodation where he can be more independent. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, showing how IMCAs can act as a powerful support to people who may lack capacity.

Last updated on hub: 16 September 2020

Case study five: Mrs H – return home with family conflict

Department of Health and Social Care

A case study focusing on patient due to be discharged from hospital while there was disagreement amongst family members about where she should go. It shows how an IMCA intervention ensured that a decision could be made for the patient to be discharged to a 24-hour residential care placement, which was the only place where her complex needs could be met. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, and shows how IMCAs can act as a powerful support to people who may lack capacity.

Last updated on hub: 16 September 2020

Case study four: Mrs Z – acquired brain injury

Department of Health and Social Care

A case study focusing on a patient with an acquired brain injury, needing a best interests decision made as to whether she should have a PEG feed inserted. The case shows how the correct application of the principles of the MCA ensured the least restrictive option was explored and the patient was able to make improvements in eating and drinking so the PEG was no longer needed. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, to show how IMCAs can act as a powerful support to people who may lack capacity.

Last updated on hub: 16 September 2020

Case study nine: Mrs L – challenging capacity assessments

Department of Health and Social Care

A case study describing how a decision had to be made about the permanent care arrangements for a service user temporarily placed in a care home, which appeared to be against her wishes. With IMCA intervention the resident was able to return home with a care package which she was more amenable to. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, showing how IMCAs can act as a powerful support to people who may lack capacity.

Last updated on hub: 16 September 2020

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