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.

MCA compliance records audit forms, including screening steps.

This audit is to help the CCG gain assurance that the Mental Capacity Act is embedded in commissioned organisations. Commissioners have a duty to ensure that all provider services are delivered in accordance with the provisions of the Mental Capacity Act, and that the rights of those who use the service are promoted and protected. CCGs have a duty to ensure providers of healthcare understand the MCA, apply it and monitor compliance.

This toolkit helps to understand if correct processes are correctly being undertaken in relation to the MCA (2005); to ensure the MCA is being completed and fully documented including the consent form, MCA/determination of best interests form; to provide a base line audit to ensure practice is embedded across services; and to provide robust procedural evidence for internal and external assurance. The tool may be adapted to align to local provider policies and procedural documents.

This is an audit form to test compliance with Mental Capacity Act 2005. It includes questions around current policies and procedures, its content, supporting information and any next steps.

This is an audit form to test compliance with Mental Capacity Act 2005, specifically in relation to staff training.

A template for the MCA/DoLS audit, covering knowledge of Mental Capacity Act and DoLS and knowledge of organisation’s policies and procedures.

This audit tool includes examples of the evidence needed to meet the CQC requirements in the four domains (safe, effective, caring, and well-led).

Findings of an audit on the use of the MCA and Safeguarding Adults procedures across the nine prison and young offender institution healthcare teams in London. The audit reveals that: safeguarding is afforded a high priority by offender healthcare services; the organisational infrastructures for safeguarding (policies, procedures, training, etc) were rated higher than the infrastructures for the Mental Capacity Act (MCA); there are good working relationships between prison authorities and healthcare services around safeguarding, but the role of healthcare staff in safeguarding is limited by the prison context; mental capacity tends to be treated within offender healthcare services as an aspect of safeguarding; knowledge of and practice around the MCA is patchy – senior clinicians tend to have a good grasp of their obligations under the Act and how to apply them, while frontline nursing and other staff generally do not; there is a very weak infrastructure to support practice in relation to the MCA (policies and procedures, training, information, guidance, supervision, records); it is recommended that priority be given to strengthening the infrastructure to ensure that frontline practice in offender healthcare services is compliant with the MCA and the Care Act.