16/04/2020 Safeguarding Adults ‘Mental Capacity Act 2005’ Video Tutorial Facilitated by: Hilary Spilsbury ERSAB Training Officer www.ersab.org.uk 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 www.ersab.org.uk 1
16/04/2020 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 www.ersab.org.uk Safeguarding Adults Mental Capacity Act 2005 (MCA) introduced in England and Wales in 2007 to: 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 www.ersab.org.uk 2
16/04/2020 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 www.ersab.org.uk 3
16/04/2020 Safeguarding Adults What is lack of mental capacity? Mental capacity can Stage 1 vary over time, Must be caused by an depending on the type impairment or disturbance in the of decision to be functioning of the mind or made brain whether temporary or permanent Stage 2 Anyone can find Does the impairment or themselves unable to disturbance mean that make a particular the person is unable to decision at a particular make a specific decision time when they need to? www.ersab.org.uk Safeguarding Adults The 5 Core Principles of the MCA 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 www.ersab.org.uk 4
16/04/2020 Safeguarding Adults ASSESSING CAPACITY P r At a specific time and for a specific decision a can a person….. c t 1. Understand the information relevant to the decision I c a 2. Retain the information b l e 3. Use/weigh the information as part of the decision making process S t 4. Communicate the decision e p s To have capacity, a person must be able to do all 4 things www.ersab.org.uk Safeguarding Adults • Assessment Time and decision specific • of capacity Understand + Retain + Use/Weigh + Communicate • If a person lacks capacity nothing can be done to them unless it is in their Best Interests Best • Includes: Person’s wishes + Consult others + Least Interests Restrictive options + involving the person 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 Restraint Criteria: Lack capacity + Best Interests + prevent harm to person lacking capacity + Proportionate • To protect people from coming to harm who need care Deprivation in hospital/care home of Liberty • Professional assessment + legal criteria + extra rights www.ersab.org.uk 5
16/04/2020 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 on 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 www.ersab.org.uk Safeguarding Adults MCA Case Study - John Consider: • Write down how you would Safeguarding policy proceed Duty of Care & Training Duty of Candour • What could you do to support the capacity assessment? Six Principles of Safeguarding Types of Abuse • What makes you think this is not Relevant records just an ‘unwise decision’? Reporting • VARM – Vulnerable Adults What might be the barriers to achieving this? Risk Management Policy www.ersab.org.uk 6
16/04/2020 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 www.ersab.org.uk 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 or 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. www.ersab.org.uk 7
16/04/2020 Safeguarding Adults www.ersab.org.uk 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) www.ersab.org.uk 8
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