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 annual report on CQC monitoring of the Mental Health Act (MHA) puts a specific focus on the impact that the COVID-19 pandemic has had on patients detained under the MHA, and on the services that care for and treat them. The findings indicate that: planning for individuals’ discharge from hospital continues to be essential and is particularly important during the pandemic period due to the increased burden on all services, including those in the community; some services showed exemplary practice in the co-production of care with patients, including infection control measures; in many services the physical environment requires modernisation and doing so would have the added positive impact of making infection control easier; some services continued to uphold restrictions on patients’ movement, activities and leave for longer than seemed necessary; many services invested in software to help detained patients to stay connected with their family and other sources of support during the pandemic; detained patients’ access to advocacy services was made more difficult during the pandemic, but such services played an even more crucial role where patients’ lives were more limited by infection control measures; there needs to be careful evaluation of using remote technology should aspects of them continue after the pandemic abates.

Advocacy helps to ensure that individuals are in control of their own lives and are supported to make their own decisions. This good practice guide has been developed to help professionals and advocates to decide on the most appropriate route to take to challenge decisions about an individual’s care. It will help advocates to develop a ‘tool-kit’ of different approaches to get the best possible outcome for people depending on their views and the situation. The guide discusses when it is most appropriate to use informal approaches to challenge decisions; the skills required to be effective when taking this approach, including negotiating and influencing; and using Best Interests meetings. It also looks at using formal routes to challenge decisions through the Mental Capacity Act 2005, Mental Health Act 1983, the Care Act 2014, and through formal complaints processes and judicial review. The guide provides useful case examples and makes reference to relevant sections within Acts and Statutory Guidance to illustrate key points. The guide is relevant for professionals across the health and social care sectors, as well as for friends and family members who are supporting a friend or relative.

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

SCIE Guide on practice guidance on the involvement of Independent Mental Capacity Advocates (IMCAs) in safeguarding adults

This guide aims to support the work of local authority and NHS staff who may need to instruct and work with IMCAs in relation to accommodation decisions and care reviews.

This practice guidance describes the role of Independent Mental Capacity Advocates (IMCAs) and paid representatives in the Mental Capacity Act Deprivation of Liberty Safeguards (MCA DOLS).

An advocate reminds other professionals not to make decision on behalf of people
until incapacity has been established.