This questionnaire is designed to help assess compliance with the Mental Capacity Act in general practice and out of hours services. It has been designed by Barnet, Enfield and Haringey CCGs as part of work being undertaken to raise awareness and implementation of the Act.

Findings of a survey of care home managers to look into how successfully the Mental Capacity Act (MCA) was being implemented on the front line of residential care. Respondents answered questions on the five principles of the MCA, and the questions asked how well they lead and supported their staff teams to understand and enact these principles. This research shows how some managers take a range of approaches to MCA implementation. Mentorship, coaching and active, floor-based management seemed to recur in the answers from managers who really wrote confidently about their staff team’s understanding of the MCA. One of the greatest apparent barriers to MCA implementation was information and knowledge not filtering down in homes where managers considered that the MCA, capacity assessments, Best Interests Decisions and DoLS were the concern of managers only, when this should not be the case and all staff should be engaged with, and inform these processes.

The focus of this report is on the MHA and its interface with the MCA, Deprivation of Liberty and the implications of the Supreme Court judgment (P v Cheshire West and Chester Council and P and Q v Surrey County Council [2014] UKSC 19). The latter has made it clearer and easier for providers and decision makers to identify where a person is being deprived of their liberty but has also led to a considerable increase in the numbers of people in England and Wales who are considered to be deprived of their liberty for the purposes of receiving care and treatment. The paper summarises the findings from a survey on the court judgment impacted on AMHP practice and service delivery. They show that there has been significant impact on AMHPs and service providers, but the situation appears to be more challenging for certain local authorities where a large proportion of their Best Interests Assessors for DoLS are drawn from the AMHP service. Landmark changes impacting AMHP practice and the local authorities on behalf of which the professionals act have been made as result of the Cheshire West judgement but there remain barriers and challenges in fully implementing these changes arising from the complex and bureaucratic DoLS framework. The Law Commission has been tasked to look for a framework that is simpler, while still protecting the rights of vulnerable people with mental health problems and those who lack capacity, with final report and draft legislation due to be published in summer 2017.