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Comment on legislation, case law, and relevant stories relating to Mental Capacity and the care of vulnerable people.

Older lady sat in a community centre, smiling at the camera

Barriers to supported decision-making in practice

Evidence based practice is essential in healthcare, and indeed many other sectors.  It provides proof of impact, or outcome, through careful assessment and comparison in controlled environments. In today’s blog, we will examine a recent systematic review of the field, published in the journal Health Expectations looking particularly at the barriers to supported decision-making that the paper identifies

UK Parliament

New official statistics for DoLS cases, 2022-23

NHS Digital has published national statistics for DoLS cases for the period April 2022 to March 2023. The report reveals that:

  • There were an estimated 300,765 requests for authorisations during 2022-23, up 11% on the previous year
  • There were 289,150 authorisations completed in 2022-23, while 126,100 remain uncompleted as of the end of the year
  • Of all DoLS applications, 56% of applications were not granted, mostly due to either change of circumstances, misapplication (requiring a community DoLS or Inherent Jurisdiction) or not meeting the assessment criteria
  • The statutory 21-day timeframe for authorisations was only met in 19% of cases
Elderly man with head in his hands

Mental Capacity: Is choice the same as freedom?

If an adult in care can only select from a limited number of closed options, then do they really have what we might describe as ‘choice’?

Lucy Series argues that in many ways, we have come on a long way from the outmoded restrictive institutions of old. However, there are many new modern-age deprivations that have risen in their place. For example, many care homes will enforce a certain structure to the day in order to enable the cost-effective provision of meals, activities, and personal care support. In doing so, they are restricting natural choices and freedoms, while also enacting a system of close monitoring.

Mental capacity assessment: female professional assessing elderly gentleman

Important updates to Form COP3 ‘assessment of capacity’

As of July 2023 there is now a new updated COP3 form (‘assessment of capacity’ for Court of Protection Submissions) available on the UK Government website. We have a growing range of blogs around this topic and area able to provide completition of Part B on referral. For a walkthrough guide of the updated document, please visit.

Woman in wheelchair signing consent form

Mental Capacity and informed consent

Consent refers to a person’s voluntary assent to a particular action, decision or interaction. There are many different types of consent. These include:

  • Implied consent – where no verbal or written consent has been given, but an action by the individual in question suggests their agreement. For example, if a patient offers their arm to have their blood pressure taken.  
  • Informed consent – requires an explicit understanding of all the relevant facts, including risks and available alternatives. Usually, information is provided in order to help the person to understand what is proposed and why. This type of consent is often associated with medical procedures in healthcare settings; it is also often formalised with a physical signature on a consent form.
Weighing up a tough decision: Man sat thinking on sofa

Mental Capacity still not well understood

  • Comment

There are several key organisations that exist to protect people’s rights with regards to the Mental Capacity Act and its application. These include the Care Quality Commission (CQC), Office of the Public Guardian (OPG) and Court of Protection (COP). However, while each of these bodies has an important role to play, we should remember that it is every person’s responsibility to raise a concern if a suspected breach of the Act has taken place.