Safeguarding Adults Mental Capacity Act 2005 Video Tutorial - - PDF document

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Safeguarding Adults ‘Mental Capacity Act 2005’

Video Tutorial Facilitated by: Hilary Spilsbury ERSAB Training Officer

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Safeguarding Adults

For this session, you will need to:

• 1. Download the SCIE MCA Video clip and watch first
• 2. Access to the PowerPoint slides, which accompany this video. You

can either view them as you go along or print them off in advance.

• 3. A pen and a notebook or paper.
• 4. Following the tutorial find out where your organisation holds the

MCA Code of Conduct document – it can also be downloaded for free - www.gov.uk

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Safeguarding Adults

Aims:

To consider the implications and application of the Mental Capacity Act 2005 – video tutorial

Outcomes:

• To have awareness of the principles and legal

responsibilities of the Mental Capacity Act and consider how this knowledge applies in everyday practice

• Be aware of a framework for supporting and involving

people when making decisions

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Safeguarding Adults

Mental Capacity Act 2005 (MCA) introduced in England and Wales in 2007 to:

www.ersab.org.uk Protect the rights of people aged 16 years and over to make their own decisions, as far as they are able Provides a framework for supporting and involving people in making decisions about their own care, treatment and support Make sure any decisions made on behalf of a person who lacks capacity to do so, has regard to their wishes and is made in their best interests

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Safeguarding Adults

www.ersab.org.uk

Safeguarding Adults What is mental capacity?

Mental capacity is the ability to make a decision

• This includes the ability to make a decision that affects

daily life – such as when to get up, what to wear or whether to go to the doctor when feeling ill – as well as more serious or significant decisions

• It also refers to a person’s ability to make a decision that

may have legal consequences – for them or others. Examples include agreeing to have medical treatment, buying goods or making a will

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Safeguarding Adults What is lack of mental capacity?

www.ersab.org.uk Mental capacity can vary over time, depending on the type

• f decision to be

made Anyone can find themselves unable to make a particular decision at a particular time Stage 1 Must be caused by an impairment or disturbance in the functioning of the mind or brain whether temporary

• r permanent

Stage 2 Does the impairment or disturbance mean that the person is unable to make a specific decision when they need to?

Safeguarding Adults

The 5 Core Principles of the MCA

www.ersab.org.uk A person must be assumed to have capacity unless it is established that they lack capacity A person must not be treated as unable to make a decision unless all practicable (do-able) steps to help them to do so have been taken without success A person is not to be treated as unable to make a decision merely because they make an unwise decision An act is done, or decision made, under this Act for or on behalf of a person who lacks capacity, must be done, or made in their best interests Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedoms of action

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Safeguarding Adults

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ASSESSING CAPACITY At a specific time and for a specific decision can a person…..

• 3. Use/weigh the information as part of the decision making process
• 4. Communicate the decision
• 2. Retain the information

To have capacity, a person must be able to do all 4 things

• 1. Understand the information relevant to the decision

P r a c t I c a b l e S t e p s

Safeguarding Adults

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Assessment

• f capacity

Restraint Deprivation

• f Liberty

Best Interests

• Time and decision specific
• Understand + Retain + Use/Weigh + Communicate
• If a person lacks capacity nothing can be done to them

unless it is in their Best Interests

• Includes: Person’s wishes + Consult others + Least

Restrictive options + involving the person

• To protect people from coming to harm who need care

in hospital/care home

• Professional assessment + legal criteria + extra rights

Definition: Use or threat of force to make a person do something they resist or restriction of liberty of movement whether or not the person resists Criteria: Lack capacity + Best Interests + prevent harm to person lacking capacity + Proportionate

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Safeguarding Adults

MCA Case Study John lives in a care home where he is supported with some of his care needs, but is otherwise independent. John has recently seen his GP due to having some swallowing difficulties and staff are concerned that he is at risk of choking

• n lumps of food. John loves to eat chocolate and often has a

chocolate bar (Yorkie) in his bedroom drawer. Staff have worked with John to complete a risk assessment regarding the type and consistency of food that would be safer for him to

• eat. Staff have noticed that John is still eating chocolate in his

room when he is on his own and are worried about the continued risk of choking. Consider the following questions

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Safeguarding Adults

MCA Case Study - John

• Write down how you would

proceed

• What could you do to support

the capacity assessment?

• What makes you think this is not

just an ‘unwise decision’?

• What might be the barriers to

achieving this?

Consider: Safeguarding policy Duty of Care & Training Duty of Candour Six Principles of Safeguarding Types of Abuse Relevant records Reporting VARM – Vulnerable Adults Risk Management Policy

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Safeguarding Adults

Making Decisions for the Future

Advocates Lasting Power of Attorney Court of Protection Advance care plan or statement of wishes and preferences Advance Decision

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Safeguarding Adults

Independent Mental Capacity Advocate (IMCA)

An IMCA must be instructed and then consulted, for people lacking capacity who have no-one else to support them (other than paid staff), whenever:

• an NHS body is proposing to provide serious medical

treatment or

• an NHS body or local authority is proposing to arrange

accommodation (or a change of accommodation) in hospital

• r a care home and
• the person will stay in hospital longer than 28 days, or
• they will stay in the care home for more than 8 weeks.

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Safeguarding Adults

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Safeguarding Adults

Further Information & Resources East Riding Safeguarding Adults Board Website – www.ersab.org.uk (information, operational policy & procedures, concern forms, Newsletter and e learning package) East Riding Safeguarding Children Partnership – www.erscb.org.uk Hull Safeguarding Adults Partnership Board Website – www.safeguardingadultshull.com Care Quality Commission (CQC) – www.cqc.org.uk Care Act 2014 – www.gov.uk – ‘Care and Support Statutory Guidance Manual’ – updated 26 Oct 2018 Equality Act 2010: Guidance - Anti-discrimination law &protected characteristics www.gov.uk Lasting Power of Attorney – www.publicguardian.gov.uk ‘Making Safeguarding Personal’ – Local Government Association (LGA) www.local.gov.uk Mental Capacity Act (MCA) 2005 – Code of Practice 2007. (downloadable or hard copy £15) www.gov.uk – put title in search bar Mental Capacity (Amendment) Act 2019 May 2019 (Deprivation of Liberty Safeguards) Explanatory notes – www.gov.uk – updates will be issued when available National Institute for Health and Care Excellence (NICE) – Decision-making and mental capacity. NICE Guideline 3 October 2018. nice.org.uk/guidance/ng108. www.nice.org.uk Skills for Care – www.skillsforcare.org.uk – Resources to support care, such as MCA, Care Certificate & Safeguarding Social Care Institute for Excellence (SCIE) – www.scie.org.uk - Health & Social Care improvement agency and independent charity ( MCA & SAT e learning packages)

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