Using the Mental Capacity Act

This video explains the MCA and how it can protect the right to make choices. For people who need the MCA, their carers, and others.

• Video transcript Open

  OOV

  Making everyday decisions about our own lives is something most of us take for granted where I’m going what I want to do spending money or just looking after myself.

  OOV  (WORDS ON SCREEN)

  But what happens if there’s a time when we find it more difficult to make decisions or if people think we can’t make them.  What happens then?  This is what the Mental Capacity Act is all about.

  Larry Gardiner

  The Mental Capacity Act essentially protects my freedom and my dignity

  Dorothy Runnicles

  Well it’s based on five principles

  Sue Jardine

  It’s about being able to support vulnerable people and their families

  Janice Williams

  It’s very protective you have to be given support to make your decisions and the thing I really like is the fact that they allow for the fact that you could make unwise decisions.

  Dorothy Runnicles

  It’s basically about human rights giving all people the right to have a voice to express a preference

  OOV

  The Mental Capacity Act supports anyone aged sixteen and over. It’s made up of five key principles and some groups are adapting the language to suit their own needs

  Rosa, Taking Part Advocacy

  We are making an easy read version of the five rules of the Mental Capacity Act.  Capacity means I can make my own decision and understand what it means to me.  One, two and three is all about me

  Clair, Taking Part Advocacy

  Start by thinking I can make a decision

  Pete, Taking Part Advocacy

  Do all you can to help me make my decision

  Stuart, Taking Part Advocacy

  You must not say that I lack capacity just because my decision seems unwise

  Rosa, Taking Part Advocacy

  4 and 5 you do with me if I lack capacity. Capacity!

  Clair, Taking Part Advocacy

  Use a Best Interest Checklist for me

  Rosa, Taking Part Advocacy

  If I can’t make a decision

  Pete, Taking Part Advocacy

  You must check the decision made does not stop my freedom more than needed

  OOV

  The Mental Capacity Act is there to support us all and the first of the 5 important principles is to assume everyone has the capacity to make their own decisions

  Anita Puri

  My name is Anita Puri and this is my mum Santosh Anand ‘Mammy tell them your name?’ (urdu)

  Santosh Anand

  Santosh Anand

  Anita Puri

  My mum has been recently diagnosed with dementia and I’m her main carer.  It’s just been a bit of a shock being diagnosed with dementia so we are trying to come to terms with that and trying to plan things for the future.  Mental Capacity Act is to assume everybody has the capacity until it’s proven that they don’t have the capacity.  My mum still makes decisions for herself we encourage that she continues to make her own decisions about herself.

  Dorothy Runnicles

  My name is Dorothy Runnicles I’ve been fortunate enough to be trained as a Social Worker and as an Academic and I’ve worked, I’ve had family, my own family, so I’ve had lots of life experiences on the way to this 91st birthday which is coming up.  Very often even as an age group you’re judged as not having capacity to deal with or participate or share in decision making which is affecting you, you don’t  expect to be told that you don’t have a view and that your view is not important or to be ignored.  That’s why capacity through the Mental Capacity Act and it’s effect on older people is so important because it assumes if you do have capacity it may vary as you grow older, it may vary from day to day and it assumes that you still have a point of view and the control of our life should be retained and it can happen.

  OOV

  The second principle of the Mental Capacity Act is about giving the right support to people to help them make their own decisions.

  Clair, Taking Part Advocacy

  My name is Clair I live on a farm and also I’ve got a job.  The Mental Capacity Act has supported me to catch a bus from home to the bus station and to get to work.  At first my mum and dad they was just worried about me as they always liked to protect me and take me to places I said ‘hard fire’ I would like to go and do them myself. 

  OOV

  Doing a risk assessment in Clair’s own words is a good way of supporting someone to make sense of information so that they can make a decision.

  Clair, Taking Part Advocacy

  I’ve done myself a transport centred plan risk assessment I designed it and I had a little help and its all come in my own words.  This has helped me make a decision it’s what’s good and not so good. 

  Spending time to know the right bus stop. People I am working with knowing when I arrive. 

  This really helped my mum and dad and also me its helped me spread my wings and now it’s brilliant that I can catch the bus.

  OOV

  And whenever necessary support people to speak for themselves by using advocates or representatives

  Larry Gardiner

  My name is Larry, Larry Gardiner, I’m 63 born in 1952.  I have altered states of consciousness and funny turns I call them my funny turns.  At the moment in the present situation the kind of support that’s necessary for me to assert the rights that the Mental Capacity Act gives me and to assert the presumption about my capacity to make a decision, often it actually needs an advocate to partner with me to back me up so if you ask me to make a decision and I just can’t make one or if you ask me to make a decision and I don’t understand the requirement to make a decision, so I don’t know that one is necessary, then I think you can assume that somebody needs to make a decision in my best interest.

  OOV

  Principle 3 of the Mental Capacity Act is also very important it states that what might seem like an unwise decision does not necessarily indicate a lack of capacity.  An example of this is when people have relationships which some find difficult to support or accept.

  Marlene, Taking Part Advocacy

  This is Michael Ratcliffe my husband

  Michael, Taking Part Advocacy

  And this is Marlene my wife.

  Marlene, Taking Part Advocacy

  We’ve been together nearly 29 years

  Michael, Taking Part Advocacy

  Marlene do you remember when we first got together

  Marlene, Taking Part Advocacy

  Yes I can

  Michael, Taking Part Advocacy

  And they asked us to come into the office because they were worried about our relationship

  Marlene, Taking Part Advocacy

  Yes

  Michael, Taking Part Advocacy

  Can you remember what they were worried about?

  Marlene, Taking Part Advocacy

  They thought I was going to get pregnant

  Michael, Taking Part Advocacy

  What did you think of it?

  Marlene, Taking Part Advocacy

  I think they didn’t treat us like adults

  Michael, Taking Part Advocacy

  But I think people still don’t take relationships with people with Learning Disabilities like us seriously enough, it annoys me, and I’m trying to think of a polite word, it really does annoy me when people do that.  So do you think people understand what the Mental Capacity Act is?

  Marlene, Taking Part Advocacy

  No

  Michael, Taking Part Advocacy

  It gives you the power to make your own decisions and it also gives you the right to make mistakes, the act actually helps us to make a decision as long as people know what the act is about.

  Larry Gardiner

  In the whole of my life I don’t think there’s ever been a moment when it wasn’t possible for me to make a decision, I might have made one that nobody agreed with, I’ve been given medication against my will and now if a clinician says ‘I think we’d like you to try these medicines and these are our reasons’ if I don’t agree with them prescribing this medicine and if I don’t want to take it I’m free not to take it just in the same way that you are.  I have the right, I have that right.

  OOV

  At times it might be felt that someone doesn’t have the capacity to make a decision, when this happens a mental capacity assessment is done, this involves two key parts.  The first is to determine whether the person can make the actual decision and the time and the second assesses whether if they can’t make the decision, this is due to something affecting their mental ability through a long-term condition such as dementia or a learning disability or perhaps temporarily such as unconsciousness or drunkenness.  In these cases Principle 4 of the Mental Capacity Act states that any decision should always be taken in the best interests of the person.

  Sue Jardine

  The Best Interests Decision is a decision that in our situation was made because my mum didn’t have capacity and the decision that was being made was about her care, so whether she could stay at home or whether she would need to go into residential care.  The best interest meeting is a meeting where it brings all the different parties together who are involved in the care of an individual.  Being in a best interests meeting was really useful because obviously for a family it’s very emotive and we have our reasons and wishes which may be contrary to the individual themselves so in the case of my mum we know even though she wanted to stay in her own home, it was increasingly more difficult to enable that to happen.  We feel reassured that the decision has been made in my mum’s best interest and it’s helped us, it’s quite a relief really, knowing that she is actually in a care home. She’s settled into a care home very well.

  OOV

  Principle 5 of the Mental Capacity Act requires us to look for less restrictive ways of meeting someone’s best interest and this could mean challenging decisions taken by professionals. 

  Liz McNichol

  I’m Liz McNichol I’ve been mam’s carer for the last six years.  When it was coming to the end of me looking after mam, mam was wandering, she was putting her coat on and going out and taking herself for walks and we don’t know where she was going, it was really frightening.  They diagnosed her with vascular dementia.  I’d always promised mam that I wouldn’t put her in a care home, mam was frightened of care homes, but when I had taken her up to the bungalows at Independent Living Bungalows she loved it and she said she could feel herself wanting to live there, being looked after and getting care .

  OOV

  The first Social Worker decided that because of her dementia Liz’s mum needed a capacity assessment as they felt she may not have the capacity to make the decision about where she wanted to live.

  Liz McNichol

  The process was mam had to have a capacity assessment but the Social Worker said she failed the test.

  OOV

  This led to the Social Worker advising that Liz’s mum should go into a residential care home and not into the Independent Living Bungalows, this wasn’t what Liz felt her mum wanted, feeling that it was a more restrictive choice and not in her mum’s best interest.

  Liz McNichol

  We had to fight through the courts and it was hard.  As soon as we had the right support it was great, the second social worker was brilliant. The end was the judge, she had the Best Interests Decision stating that she could go into the bungalows then.  That was great because then we knew things were starting to move forward.  The main thing is mam being happy and content that’s all we’ve ever wanted.

  OOV

  The Mental Capacity Act also supports people to think ahead and plan for the future.

  Dorothy Runnicles

  Older people are quite often fearful of acknowledging that they are having to face incapacities.  To older people my first piece of advice is get ready for older age in any way you can now, don’t pretend that you’re not going to get old and you’re not going to need help, guidance, trusted friends, professionals who really care about what’s happening to you.

  OOV

  One way of planning for the future is to set up Lasting Powers of Attorney, often known as an LPA.  There are two types of LPA that can safeguard who can take decisions on your behalf. A Health and Welfare LPA allows someone you trust to take decisions about your health and welfare such as going into a care home or receiving medical treatment.  A Finance and Property LPA allows someone to take decisions about your money and finances on your behalf. 

  Pamela Holmes

  I think it’s an opportunity that people should think about seriously, if they should lose capacity and be unable to make decisions about their financial situation, why not now, early on, when everything is completely calm and straightforward just sort that out and what an LPA gives you the opportunity to do is to ask people that you trust to have some say over your financial matters.  Having an LPA gives me the confidence that if there comes a time when I no longer have capacity, that my financial affairs and property and so on, everything from depositing a cheque, paying a bill, through to, I don’t know, selling a house, will be able to be taken forward by the people that I have put in charge of my financial affairs and it won’t be difficult for them they will just be able to take it forward and it won’t be a stress.  I presume when I, if I lost capacity, it would be an uncomfortable position for people around me and at least this won’t be difficult for them.  I think taking out an LPA to some extent is a sort of  generous gesture to those around you because it may not affect me directly by that point I won’t really know, I think, if the LPA needed to be used, but I hope it will make things more comfortable for people around me.

  OOV

  Taking out an advanced decision about any medical treatment you may not want to receive in the future is another way of protecting yourself about any decisions taken on your behalf.

  Janice Williams

  An Advanced Decision to Refuse Treatment at the end of your life is a document where you can say what you don’t want to happen at the end of your life under different sets of circumstances.  You can put all the circumstances you like and you can say ‘yes, that’s ok’ or ‘no, that’s not ok’. So at least my wishes are laid down even if that means my life is shortened.  I’d rather have a shorter life in a happier and more comfortable state that a longer life.  That’s my choice.  Well, you can do it anytime, I wish I’d done it earlier and it’s important to do it while you can, you have to do it while you are of sound mind.  I’ve put all my children’s details in because it needs to be clear who to contact in the event of things going horribly wrong, it makes it easier for them to make the best choices for me.  Under the Mental Capacity Act you have to act in the best interests of the person that no longer has capacity and I will have given them as much guidance as I can as to how I see my best interests, so their decisions should be easier and smoother.  Once it’s done, then I think there’s a lot of peace of mind that comes from that.  

  OOV

  Life can be unpredictable and planning ahead can make taking difficult decisions in the future much easier.

  Anita Puri

  The future is scary for us and we are all going to sit down as a family and we are going to talk about Lasting Power of Attorney, any advanced decisions and then I would know once she doesn’t have the capacity then I know I’m fulfilling her wishes.  I think very few people understand what the Act is about and how it can have an impact on their day to day life and can help them make decisions on a long-term basis as well, that’s why I think it’s very very important before its too late. 

  OOV

  The Mental Capacity Act is there for everyone.  Make sure it supports you when you need it.