Skip to content
Home » News

News

Mental Capacity Ltd - Mental Capacity Assessment

Retrospective Mental Capacity Assessments

A standard mental capacity assessment (also known as the two-stage test) is usually carried out for a specific decision at a specific time. It is completed prior to the decision being made if there is either a ‘reasonable belief’ that an individual may lack capacity, or to reduce the risk of someone challenging the person’s capacity to make the decision at some point in the future.

Meanwhile, a retrospective mental capacity assessment refers to a traditional assessment of capacity for a specific decision, but for a decision made historically. Examples might include a Lasting Power of Attorney submission signed and submitted the previous month, or a financial gift made to a family member or friend several years in the past.

Read More »Retrospective Mental Capacity Assessments
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?

Read More »Case study: What do we mean by ‘decision specific’?
Man with learning disability getting married

DoLS in focus: The role of the Best Interest Assessor (BIA)

The primary role of a Best Interest Assessor (BIA) is to complete the Mental Capacity Assessment and Best Interest Assessment steps within the DoLS process. These are recorded as part of Form 3.

They can also be commissioned by the Supervisory Body to complete ‘Age’ and ‘No Refusals’ steps if required.

Read More »DoLS in focus: The role of the Best Interest Assessor (BIA)
Two women interviewing / assessing a person wearing a checked yellow shirt.

The six key assessments for DoLS

The Code of Practice for DoLS (2008) directs that wherever possible, DoLS authorisations should be applied for in advance of a hospital or care home admission, in order to ensure that appropriate safeguards are in place from day one. As such, a DoLS application should really be made at the point where the individual is assessed prior to admittance, in order that the application be processed in time.

Read More »The six key assessments for DoLS
Care in the home: carer helping elderly lady down the stairs

DoLS in focus: The role of the Managing Authority (MA)

Under DoLS, the Managing Authority (MA) is the nursing/care home or hospital providing (or going to provide) care and treatment for the relevant person. The responsibilities of the MA are outlined within the Code of Practice for DoLS (2008) and expanded on through Court of Protection (CoP) case law.

These documents require that the Managing Authority carry out its responsibilities with due care and diligence, with appropriate consultation. All decisions and actions taken should be fully documented as part of professional best practice.

Read More »DoLS in focus: The role of the Managing Authority (MA)
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
Read More »New official statistics for DoLS cases, 2022-23
Care in the home: young lady helping older woman with walking sticks

Occupational Therapy and Mental Capacity

In Terry Pratchett’s Going Postal, we meet the main character Moist von Lipwig as he tries to dig his way out of prison using a broken spoon. Just when he thinks he’s about to reach freedom, von Lipwig discovers that it isn’t the end at all, and that someone has hidden a brand-new spoon for him inside the wall in order that he carry on digging. This is because Lord Vetinari likes to provide ‘Occupational Therapy’ to all his inmates!

While Terry Pratchett’s wonderful satire doesn’t paint Occupational Therapy (OT) in a wholly positive light, though very entertaining, it does give some small insight into the sort of ‘purposeful activity’ that can be used to aid recovery, support identity and help people maintain cognitive and physical function.

Read More »Occupational Therapy and Mental Capacity