The Mental Capacity Act in practice.
In our last blog, we outlined some of the key differences between Next of Kin (NOK) and Lasting Power of Attorney (LPA). In this follow-up blog, we will explore a few recent examples of misuse of LPA, and lessons we can learn going forward.
According to UK consumer rights organisation Which?, the Power of Attorney system is in ‘desperate need of improvement’. This is because many people don’t understand how the system works, and it can also be difficult to put vital Lasting Power of Attorney (LPA) arrangements in place.
In our last blog, we considered the complex case of ‘P’ – an individual being assessed for mental capacity with respect to their change in accommodation, as well as their wish to take responsibility for managing their inheritance.
The case study highlighted several major issues in the way the original mental capacity assessment had been completed, including concerns around the lack of support to help P communicate autonomously, and the lack of documentation around P’s condition and capacity.
In this blog, we will work through an example mental capacity assessment for an individual making a complex decision. This case study is based on a real-life example reviewed in the wake of the Covid pandemic. At each stage we will present the information as it was presented to us, followed by specific comment relating to the assessment process and steps that could and in some cases should have been taken to improve the quality of outcomes.
When assessing someone for their capacity to make a specific decision, it is important that they are able to demonstrate that they can sufficiently ‘weigh up’ the decision and so form a reasoned judgement – whether we agree with their final decision or not.
When it comes to Mental Capacity Assessments, ‘retention’ refers to an individual’s ability to recollect relevant information relating to a specific decision. However, in assessing for retention, it is also important to take into account the second principle of the Mental Capacity Act, which states that we should actively support capacity wherever possible. Therefore, as assessors, we should provide sufficient support to enable retention where possible – be it through labelled items, social stories, easy read guides or so on.
At its most basic level, ‘understanding’ refers to ‘comprehension’ or ‘insight’ – the ability to apply knowledge to a specific topic or situation. However, in terms of the criteria for Mental Capacity Assessments, these definitions are perhaps a little broad. This is because when we test for capacity, we are not looking for an in-depth understanding of a specific topic, but rather an ability to ‘grasp’ the concept within the context of the individual’s own situation.
The Mental Capacity Act (2005) is built around five key principles. To ensure best practice, it is useful to attach a copy of the five principles to any Mental Capacity Assessment, to be reviewed prior to the assessment in order to ensure the assessment is only completed if necessary and that appropriate support is put in place, while also respecting the individual and their Rights
There are many different forms of communication, both verbal and non-verbal in nature. While many of us will take communication for granted, others need a little more support. Thankfully there are a range of relatively low-tech aids available to support those with complex communication needs. These include Makaton, PECS and Talking Mats – all of which are put to good use across education and healthcare settings to promote inclusion and person-centred care.
There is a range of information available online to support matters surrounding the Mental Capacity Act (2005). Many of these resources are free to access and also include accessible guides for those we work alongside. In this blog, we share some of our favourite resources with you to explore.