Mental Capacity Act 2005
What are we doing?
Discussing the principles of the Act
Exploring what is meant by the term ‘Best
Completing the Capacity Assessment
Practicing alternative scenarios
Recording our Assessments
Sharing our record keeping with each
How we will know that
learning has taken place?
We will be able to complete a Capacity
Assessment by using the checklist
We will be able to record the Assessment
We will be able to plan care for a person
who lacks capacity.
What do you know about the
Think about when we
might use it?
Consider what we
might use it for?
What does it help us
Who can determine
How do we actually
Principles of the Act
A person must be assumed An act done, or decision
to have capacity unless it is made, under this Act for or
established that he lacks on behalf of a person who
capacity lacks capacity must be
A person is not to be done, or made, in his best
treated as unable to make interests.
a decision unless all Before the act is done, or
practicable steps to help the decision is made,
him to do so have been regard must be had to
taken without success. whether the purpose for
A person is not to be which it is needed can be
treated as unable to make as effectively achieved in a
a decision merely because way that is less restrictive
he makes an unwise of the person's rights and
decision. freedom of action.
What is meant by ‘Best
What can you choose If you were
for yourself? incapacitated who
How do you make would you like to
those choices? choose for you?
What would you hate How should we
for others to choose protect you from
for you? other people making
What do you take for
choices you would
Does the service-user
Enough information should be
given for the person to make a
decision, including alternatives. It
should be explained in a way they
The amount of information to be
given should be proportional to
the complexity of the task.
HOW WILL YOU KNOW THEY HAVE
What can you
see in this
How about these?
What factors can get in the way of
Can they retain the
There is no legal
guidance on amount
of information that has
to be retained, or for
how long. It is useful
to ask the service-user
to explain how they
reached their decision.
Can they make a
Can the service-user weigh
up the pros and cons and
reach a balanced decision.
Their decision can be
against advice, but it is
whether they have used a
balanced process in their
Can they communicate
that decision to you?
Can you determine
evidence of them making
the decision of their own
free will, without
If all four are answered
yes then regardless of
outcome the person is
deemed to have capacity
Try it out yourselves
In two’s practice Could they spend all
assessing your their life savings on
partner. an Audi A7 Sport
Ask them questions back, rather than
and determine putting the deposit
whether they have on a house?
capacity Could they decide
whether to have a
Completing the paperwork
What else to
Family and carer
RECORDING THE ASSESSMENT
Myself and the ward manager have spent time with Joe blogs to ascertain
whether he has the capacity to spend his life savings on a new car. He was
unable to recall the content of the conversation and had to be reminded of
the question that we posed on several occasions; his short term memory is
extremely impaired and his recall is poor.. He was unable to communicate
back to us a rational for wanting the car and he did not appear to
understand the consequences of his spending in terms of his future
security. He appeared to have no barriers to communication in terms of
language or hearing and so we believe that his capacity to make this
decision is impaired due to his cognition. We completed a MMSE as part of
the assessment and he scored 19 out of 30.He was not orientated to time
and place and his recall was poor. He will be unable to drive due to these
impairments at the present time and so our recommendation was that it
was in his best interest that this particular purchase is deferred. We have
completed the best interest assessment and we felt that because his
capacity may only be impaired temporarily that we will diary forward to
discuss this again within the time frame specified.
Myself and the ward manager spent time with Joe
today as several staff have approached us stating
Joe’s intention to purchase an Audi. He is aware that
due to the expense of this purchase that his savings
will be depleted and he understands that the costs of
insurance and petrol will be prohibitive, which is why
he is looking for a second hand model to limit
depreciation. He understands that he will have no
money left to put towards his future but he has
decided not to return to University in September and
instead move in with his friends locally until he finds a
job. He was able to articulate his needs and he
appears to have thought about all the potential
benefits and problems with such an expensive
purchase. We feel that this has been considered and
communicated to us thoroughly and that Joe has
capacity to make this decision at this time. We have
completed a best interest assessment for his notes.
be viewed this
Refusing treatment Mental capacity Act 2005
Breaking confidentiality ukpga/2005/9/contents
What have we learned?