MCA resources on Advance decision

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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

Advance decision to refuse treatment: patient information leaflet

NHS North Central London Clinical Commissioning Group

Statement form for advance decision to refuse treatment (A4). An advance decision allows a person over the age of 18 to refuse a specific treatment in the future when they lack the capacity to consent to, or refuse, that treatment.

Last updated on hub: 17 September 2020

Mental Capacity Act

NHS England

Information covering the MCA, how its assessed, helping people to make their own decisions, best interests, Lasting Powers of Attorney, the Court of Protection, and professionals' duties under MCA.

Last updated on hub: 16 September 2020

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


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

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

Journal of Social Welfare and Family Law

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 following the practices of other decision-makers under the Mental Capacity Act (MCA). And it is ethically problematic since it undermines P's dignity and does not treat P as an actor whose evidence regarding her wishes and feelings has intrinsic status which the Court must make active efforts to engage with or discount rather than ignore.

Last updated on hub: 10 September 2020

Court of Protection forms and guidance

Her Majesty’s Courts & Tribunal Service

Court of Protection forms including the applications to make decisions on someone's behalf; to become someone's deputy; to authorise a deprivation of liberty; and applications relating to powers of attorney.

Last updated on hub: 10 September 2020

Applications to the Court of Protection: a guide for council staff

Association of Directors of Adult Social Services

This note has been produced to offer guidance to Councils about when the intervention of the Court of Protection may be needed in relation to welfare decisions where a person lacks mental capacity for the decision. Any decision in relation to an application to Court must be informed by the Mental Capacity Act (MCA), the MCA Code of Practice and case law. This is a short summary and overview and not legal advice, which should always be sought in individual situations.

Last updated on hub: 10 September 2020

Future wishes: form

Standex Systems

Future wishes form.

Last updated on hub: 09 September 2020

Comment: advance decisions to refuse treatment (ADRT) forms in dementia

King's College London

A brief review of the Compassion in Dying advance decisions form (plus accompanying guidance notes) and the Alzheimer’s Society form.

Last updated on hub: 09 September 2020

Advance decisions: uncovering what GPs need

Compassion In Dying

Findings of a research project to better understand the knowledge and experience GPs have of advance decisions. Five themes emerged from this study and include: GPs had significant gaps in knowledge about advance decisions and how they can benefit people; GPs imposed a financial barrier by charging for appointments to discuss advance decisions; GPs felt that conversations about death, dying and planning for the end of life would be too upsetting or difficult; GPs had negative preconceptions about refusing treatment; and GPs had practical concerns about the ease and process of supporting a person to make an advance decision.

Last updated on hub: 09 September 2020

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