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Case Study

Case studies from the field of Mental Capacity.

Elderly man walking through city using two walking sticks to support his mobility.

What is ‘salient information’?

When conducting a Mental Capacity Assessment it is vital to understand the salient information relevant to this case. Put simply, ‘salient information’ is the relevant information that is required in order for the relevant person to be able to demonstrate capacity for the specific decision being addressed.

To help illustrate this point, we have two case studies that consider two separate decisions: whether to install bed rails, and whether to smoke.

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Patient consulting with doctor

Capacity Assessments: Professionalism, Accountability and Best Practice

A recent case held before the Court of Protection highlighted issues around the way that Mental Capacity Assessments are completed. In her conclusions, Mrs Justice Knowles highlighted the important role played by the Assessor – emphasising the need for accountability in the process, and for the Assessor to take professional measures to establish the salient information relating to the case the case.

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Man in electric wheelchair looking out to the sea

Case study: What do we mean by ‘decision specific’?

We all make many thousands of micro-decisions on a daily basis, from the way we make a cup of tea to what we watch on TV. However, when it comes to decision making, the Mental Capacity Act (2005) is ‘decision specific’. This means that it relates to a specific decision made at a specific time. It does not refer to decision-making more broadly. This raises the question: how specific do we need to be when we assess capacity?

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Retaining information: man looking out of window

When should an RPR make a section 21a application to the Court of Protection?

The role of a Relevant Person’s Representative (RPR) is to be an independent and impartial voice working on behalf of the relevant person under a Deprivation of Liberty Safeguards (DoLS) authorisation. They are there to support inclusion, knowledge, rights and promote the person’s voice within the DoLS process, performing a vital safeguarding role to help monitor its application. As part of this role, an RPR should raise a Section 21a challenge to the Court of Protection if the person they are representing voices an objection to DoLS.

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Manor house on a misty day

Case study: The diagnostic step and the causative nexus

The diagnostic step is a simple but often misunderstood part of the Mental Capacity Assessment. One of the most common errors is to simply list a medical diagnosis without any explanation of how the diagnosis impacts upon decision-making. However, this link – also known as the causative nexus – is the vital point on which the rest of the assessment is based. It is therefore important to understand exactly why the diagnostic step is important and how to document it properly.

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Man sat on a picnic bench, smoking while playing a guitar

Case study: How to document a Mental Capacity Assessment

The way professionals document mental capacity tests can vary greatly across the health and care sectors. In some cases, professionals are not yet using the updated assessment format of Functional and then Diagnostic. More worrying still is that in some cases it’s not just the documentation format that varies, but the quality of the content that is recorded.

In this blog, we examine two example assessments, using the case of Dylan to show the impact documentation can have on the outcomes of an assessment.

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