This guideline covers decision-making in people 16 years and over who may lack capacity now or in the future. It aims to help health and social care practitioners support people to make their own decisions where they have the capacity to do so. It also helps practitioners to keep people who lack capacity at the centre of the decision-making process. It includes recommendations on supporting decision-making, advance care planning, assessing mental capacity to make specific decisions at a particular time, and best interests decision-making. The guideline should be read in conjunction with the Mental Capacity Act 2005. It does not cover Deprivation of Liberty Safeguards processes.

This quality standard covers decision making in people aged 16 and over, who use health and social care services and may lack capacity to make their own decisions (now or in the future). It aims to support implementation of the aims and principles of the Mental Capacity Act 2005 and relevant Codes of Practice but it is not a substitute for these. The standard covers: supported decision making; advance care plans; assessment of capacity; and best interests decision making.

On the 13th March 2014, the House of Lords Select Committee on the Mental Capacity Act reported that the implementation of the Mental Capacity Act had not met expectations, suffered from a lack of awareness and the rights conferred by the Act have not been realised. This report provides the Government response to the 29 recommendations of the House of Lords, together with inputs received from a wide variety of stakeholders. It also sets out a a system-wide programme of work for the period of 2014 to 2015 and beyond. The work programme aims to improve oversight and monitoring by strengthen the implementation of the Mental Capacity Advisory Board and consider establishing a new independent chaired Mental Capacity Advisory Board; to raise awareness about the Act and improve its implementation; make changes to the Deprivation of Liberty Safeguards; and increasing the level of awareness and understanding of Lasting Powers of Attorney; and making changes to the Court of Protection.

This code of practice provides guidance to mental health professionals and other practitioners on how they should carry out their duties under the Mental Health Act. As well as providing guidance for professionals, the revised code of practice also guides patients, their families and carers on their rights. Chapters are grouped into seven areas: Using the Act; Protecting patient’s rights and autonomy; Assessment, transport and admission to hospital; Additional considerations for the needs of specific patients; Care, support and treatment in hospital; Leaving hospital; and additional information for professional with specific responsibilities under the Act. Subjects covered in individual chapters include: the nearest relative; independent mental health advocates; mental capacity and deprivation of liberty; detention in hospital; police community treatment orders; guardianship; after care; and care programme approach. The code of practice will come into force on 1 April 2015, depending on Parliamentary approval.

Practice guidance developed to help embed the Mental Capacity Act (MCA) throughout the commissioning process in adult social care. The guidance provides good practice principles which will allow for MCA compliant commissioning, benchmarking and quality assurance with providers. The MCA is built on five guiding principles to ensure a person centred approach to decision making. These principles provide a framework for social care commissioners when commissioning services for people who may be unable to make some, or all decisions, about their care. This guide provides a general overview of the MCA and commissioning MCA compliant services. It then provides a list of areas to question for: each of the five guiding principles of the MCA; Lasting Power of Attorney; Advance decisions to refuse treatment; Independent Mental Capacity Advocate; and for audit and governance. A suggested template for commissioning activity with an MCA focus is also included.

This note provides an overview of the Department of Health and Social Care (non-statutory) guidance ‘Adult social care: our COVID-19 winter plan 2020 to 2021’. It discusses the key issues for local authorities, and in particular the interplay with the wellbeing principles of the Care Act 2014, including managing a potential conflict in terms of the wellbeing of both care home residents and those in the community with care and support needs as regards prevention of C-19. It also looks at the implications of the winter plan for the right to respect for family and private life, addressing the tension between the imperative to protect the health of social care users (and the social care workforce) and the need to respect the family life and private life rights of those who might be subject to protective restrictions. Finally, it explores the impact of the winter plan on deprivation of liberty safeguards, in particular in relation to testing and 14-day isolation requirements.

This framework incorporates and links to a number of other competence standards, for example the National Safeguarding Competence Framework and the BIA capabilities. It is divided by staff group and is focused on what different groups need to demonstrate under each of the 5 principle areas. These statutory principles are: presumption of capacity; helping the person to make their own decision; the right to make unwise decisions; best interests; and less restriction. The MCA is relevant to any staff of any public service, whether directly delivered by statutory agencies (e.g. Local Authority, NHS, Police, Fire service, etc.) or via third sector care providers (e.g. private or charitable organisations providing health, social care or other public service support services).

These materials have been created to help support health and social care professionals working with individuals whose decision-making capacity is limited, fluctuating, absent or compromised. Demographic changes mean there are increasing numbers of people living with conditions which may impact on their decision-making capacity, and as such it is vital that professionals are confident in their understanding use of the Mental Capacity Act 2005. This tool brings together information from a range of professionals working in the field of mental capacity to provide a comprehensive guide to practice. It is part of a wider research project funded by the Burdett Trust for Nursing. Sections include: 1. Reflecting on values and bias in mental capacity decision-making; 2. The history and current context of mental capacity legislation and policy; 3. The concept of mental capacity; 4. Best interests; 5. Supported decision making; 6. Deprivation of liberty: human rights; 7. MCA in clinical decisions for care and treatment; 8. MCA and the Office of the Public Guardian (OPG) role.

This report looks at some of the common issues and complaints investigated by the Local Government and Social Care Ombudsman concerning people who lack mental capacity and the Deprivation of Liberty Safeguards (DoLS) system. The report includes individual case studies to show the impact on people when things go wrong. It estimates that 20 per cent of the 1,212 adult social care complaints investigated by the Ombudsman in the year 2016/17 concerned mental capacity or DoLS. Common issues included: not completing, or delays in carrying out, mental capacity assessments; poor ‘best interests’ decision making; disagreements with the process and failure to involving families; delay in obtaining DoLS authorisations; and failure to carry out full assessments before applying for DoLS. Drawing on the results of investigations, the report provides good practice points to help social care professionals get it right firs time when working with people who may lack mental capacity. It also provides a list of questions to help councillors scrutinise their own authorities.

This Act amends the Mental Capacity Act 2005 in relation to procedures with which a person may be deprived of liberty where the person lacks capacity to consent. It includes amendments of authorising of arrangements enabling care and treatment which give rise to a deprivation of liberty; and Section 42 of the Mental Capacity Act 2005 code of practice in relation to Deprivation of liberty. The legislation provides for the repeal of the Deprivation of Liberty Safeguards (DoLS) and their replacement with a new scheme called the Liberty Protection Safeguards (LPS).

The Committee’s key finding in this evidence-led inquiry is that the Mental Capacity Act 2005 is not widely implemented. To address this, the Committee recommends that responsibility for implementing the Act be given to an independent body. The Committee’s second key finding is that the Deprivation of Liberty Safeguards are not fit for purpose. The Committee recommends that they be replaced with new provisions. This report considers: whether the Act is working as intended in respect of the Act’s five core principles; how to address poor implementation of the Act; advocacy and advance planning; whether the Court of Protection is appropriate (or should there be a Mental Capacity Tribunal instead); and criminal law provisions under Section 44 of the Act. It summarises and refers to cases of unlawful detention under the Act (Steven Neary), and the deprivation of liberty of an autistic man with a profound learning disability, HL at Bournewood Hospital for 32 years. It includes as a good practice example, the work by Jim Blair, a learning disability nurse consultant who explained adjustments made for effective treatment and outcomes for adults with learning disabilities appropriate to their needs. The Committee makes recommendations to Government to: work with regulators and professional bodies to ensure the Act is given a higher profile in training, standard setting and inspections; increase staff resources at the Court of Protection to speed up handling of non-controversial cases; and reconsider the provision of non-means tested legal aid to those who lack capacity, especially in cases of deprivation of liberty. Local authorities should use their discretionary powers to appoint Independent Mental Capacity Advocates more widely than is currently the case. The Government should act on the poor levels of awareness and understanding of Lasting Powers of Attorney and advance decisions to refuse treatment among professionals in the health and social care sectors. The Government should also review the criminal law provision for ill-treatment or neglect of a person lacking capacity, to ensure that the Act is fit for purpose. The Committee recommends that the House of Lords seek an update from the Government twelve months from now to find out what they have done in response to their key recommendations. An easy read version is also available.

SCIE guide to support the commissioning of the Independent Mental Capacity Advocate (IMCA) service