Mental Capacity is a field full of jargon and complex terms. To help you better understand it, please browse our glossary of terms.
Best Interest – A Best Interest decision is made when an individual is deemed to lack capacity for a specific decision. This decision maker is usually the individual’s daily carer or care team, though may be a healthcare professional in the case of more complex decisions. The Best Interest decision should be included in the individual’s care plan and reviewed at regular intervals. For more details, see our guide to the Mental Capacity Act.
Court of Protection (CoP) – Responsible for protecting individuals who are under the Mental Capacity Act. The CoP supervises those responsible for making decisions for anyone under the Act and can allocate a deputy to an individual if they are unable to assign a Lasting Power of Attorney.
Deprivation of Liberty Safeguards (DoLS) – A statutory safeguarding protection that is used if an individual is unable to make, or continue to agree to, their care arrangements and associated deprivations. The criteria for assessment is known as the Acid Test: is the individual subject to continuous supervision and control? Is the individual free to leave, whether or not they are attempting to?
A standard or urgent DoLS authorization is issued with specific time frames, conditions and an RPR (Responsible Person’s Representative) is assigned to monitor and support.
DoLS will be replaced by the new Liberty Protection Safeguards
Enduring Power of Attorney (EPA) – Allows individuals to appoint people to help them make decisions about property and money. Replaced by Lasting Power of Attorney from 1st October 2007.
Independent Mental Capacity Advocate (IMCA) – Works under the Mental Capacity Act to support people who can’t make or understand decisions by representing their views and Best Interests if they do not have a suitable friend of family member to represent them. This is a statutory role and should be actively referred to when significant decisions arise.
Lasting Power of Attorney (LPA) – Allows individuals aged 18 and over to appoint people to act in their Best Interest for questions relating to financial decisions and/or health and welfare. Health and welfare comes into force when the individual is assessed to lack capacity to make decisions within this domain, whereas financial LPA can commence on authorisation, working under the direction of the individual while they are assessed to have financial capacity or in the Best Interest of the person if they lack capacity for finances.
Mental Capacity Act (2005) – Applies to all people in England and Wales aged 16 and over who can’t make some or all decisions for themselves. The ultimate aim is to uphold an individual’s rights, empower their voice and protect them from harm. For a more detailed overview, see our guide to the Mental Capacity Act.
Mental Capacity Assessment – If an individual’s capacity to make a specific decision is in reasonable doubt, then it is a care professional’s responsibility to complete a Mental Capacity Assessment. This usually takes the form of a supported interview to assess whether an individual can understand, retain, weigh up and communicate a specific decision.
While any member of the public can carry out a Mental Capacity Assessment, for complex cases, it is advised to consult a healthcare professional and/or an independent assessor as appropriate. For more information, see our guide to the Mental Capacity Act, and notes on How Mental Capacity is Assessed.
Office of the Public Guardian – Works alongside the Court of Protection and hold a register of Lasting Power of Attorneys, Enduring Power of Attorneys and deputies, being responsible for the supervision of those within these roles. The Office of the Public Guardian is responsible for protecting individuals under the Mental Capacity Act from abuse.
Relevant Person’s Representative (RPR) – An RPR’s role is to be in regular contact with any individual who has been detained under Deprivation of Liberty Safeguards (DOLS), working alongside them to ensure the least restrictive practice is maintained and determine any level of objection is present, then to uphold their voice in the appropriate format.
An RPR can often be a friend of family member. However, where there is no friend of family member who is willing or suitable, a paid representative will be appointed.