In previous blogs, we have explored some of the many different elements required to assess mental capacity for a specific decision. This brings us then to the two stage test, which is composed of the functional and diagnostic steps that are then bound together as part of the causative nexus (the justifiable link).
Mental Capacity Assessment
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.
- 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.
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.
There are many elements of daily life that we don’t learn about until we reach certain stages of our lives or have greater levels of independence in our everyday lives. For example, on first moving away from a parents or caregivers home, a whole new world of experiences and responsibilities will suddenly occur. This can be anything from how to change a lightbulb or put up a shelf, to how to organise a loan or buy a car.
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.
Mental Capacity case studies help us apply knowledge in action. They can help us visualise scenarios and understand processes, as well as challenges, before considering the who, what, when, where and how.
In today’s blog, we start a series of case studies that explore particular aspects of the Mental Capacity Act within everyday practice. To help us with this, we will draw on familiar characters from the worlds of TV, film and literature that give an array of contexts and presentations.
A key focus of the Mental Capacity Act (Northern Ireland) is the Deprivation of Liberty, also known as DoL. While there are some similarities with the MCA for England and Wales, there are some key differences in how the process works in Northern Ireland. In particular, there are two separate Codes of Practice that professionals must adhere to. The process for conducting an assessment is also slightly different.
There are a number of details that need to be established before a mental capacity assessment is carried out. Without this information, the test may not be valid, and the outcome may be challenged at a later date.
A Lasting Power of Attorney (LPA) is a trusted person (or persons) assigned to make decisions on behalf of someone who lacks capacity to make decisions for themselves. Crucially, LPAs are assigned by an individual while they still have capacity, as a means of preserving their wishes should they become unable to make decisions for themselves at some point in the future.