This guidance is intended to provide support in carrying out and recording formal capacity assessments and is not intended as a substitute for the Code of Practice. The documents covers: recording mental capacity assessment activity; principles of the mental capacity act 2005; when to assess capacity and who should carry out the assessment; assessments as part of needs or risk assessments and day to day decisions; capacity to agree to social care decisions; identifying the decision maker; advance statements and preferred place of care statements; capacity assessments; best interests decisions; independent mental capacity advocates; unwise decisions, duty of care, the role of the Court of Protection and inherent jurisdiction; and the role of the Court of Protection.

A mental capacity assessment and best interests determination form. The document includes a summary of key steps in assessing capacity, the principles of assessing capacity, what demonstrates decision-making capacity and considerations for the determination of an individual’s best interests.

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.

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.

Sets out key key principles and considerations for making Best Interests decisions.

A flowchart outlining the procedure for checking compliance to the Mental Capacity Act and Deprivation of Liberty Safeguards on admission to residential care.

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.

A case study focusing on the tender process for new provider of Mr J’s supported living accommodation and the role played by the IMCA in ensuring the selection of the provider from the shortlist was done by the families of the residents with support from the Council’s commissioning unit. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, to show how IMCAs can act as a powerful support to people who may lack capacity.

A case study focusing on a patient for whom an inadequate capacity assessment was carried out. Following IMCA intervention, it was discovered that lack of capacity had been assumed and the IMCA set about undertaking an accurate capacity assessment. The patient, however, passed away before this could be completed. The case study has been drawn together by the Department of Health, the Care Quality Commission, and POhWER, a major provider of advocacy services, and aims to show how IMCAs can act as a powerful support to people who may lack capacity.

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