We’ve recently added the Mental Capacity Act forms (MCA1 and MCA2) to the Curato system. In doing so, it’s been a great insight into why this piece of legislation came about and why it’s vital.

The whole point is geared around assessing an individual’s mental capacity for a specific decision. There are four main points to assess:

• Do they understand the question?
• Are they able remember the information for enough time to make a decision?
• Can they actually weigh up what the information means?
• Can they communicate their decision by any means?

If any of these are no, then it’s deemed that the individual doesn’t have the capacity to make this decision.

However, it then moves on – will they regain capacity? Can the decision be postponed until such time that they have capacity again? For example, if someone has been knocked out, it’s reasonable that they do not have the capacity to make a decision – if that decision is to simply move them to somewhere they can better cared for, or where they’re more comfortable then it makes sense. However, if you were to try to rewrite their will, sell their house, obviously these decisions should be left until they regain capacity. These examples are extreme. With the many decisions  in day to day life, when do they have capacity and when is it in their best interests starts to get more blurred. This is where professional judgement, guidance and training plays it part.

The MCA1 form is for simple day to day decisions; what to have for dinner, what clothes to wear, what book to read or TV to watch. It can be completed by any carer, and is a great reminder that you really need to consider and include the individual in any and every decision that affects them.

The MCA2 form is for significant decisions; change of estate, change of residence, surgery, or anything that has a significant impact on their life. This requires at least two assessors. Should they lack the capacity to make a decision, the assessors should consult family, friends, anyone appointed with a lasting power of attorney and anyone else close with the individuals best interests at heart.

The five key principles of the Mental Capacity Act are:

• Every adult has the right to make his or her own decisions and must be assumed to have capacity to make them unless it is proved otherwise.
• A person must be given all practicable help before anyone treats them as not being able to make their own decisions.
• Just because an individual makes what might be seen as an unwise decision, they should not be treated as lacking capacity to make that decision.
• Anything done or any decision made on behalf of a person who lacks capacity must be done in their best interests.
• Anything done for or on behalf of a person who lacks capacity should be the least restrictive of their basic rights and freedoms.

So, even if you do not agree with an individuals decision, or feel it is unwise, you still need to respect their decision. This is why it can be a prudent choice to ask for the advice of a Best Interests Assessor, who can remain independent and help decide if the course of action is in the individual’s best interests.

Deprivation of Liberty

Should the individual be deemed to lack capacity, and part of the decision is to restrict or restrain them in any way, you will then need to complete a Deprivation of Liberty form and submit it to social services. There are Government forms as a first point of reference. These are being added to the system soon.

The deprivation of liberty can be as subtle as putting bed rails on the side of a bed, or putting a lock on a door – either on their room or the whole building if they are not free to leave at any time. Any kind of sedation or medication can also be considered a deprivation of liberty.

Obviously this treads a fine line between trying to keep an individual safe from harm, and maintaining the freedoms that are our right and that we all enjoy.

More paperwork?

Here at Curato we’re trying to help with the paperwork! The MCA1 and MCA2 forms need to reviewed on a regular basis, in case the individual has regained capacity and can make a different decision. Curato tracks these dates, helps with the reviews – along with all the other forms, review tracking, signatures and acknowledgement, and other features it can be huge time saver. The forms we create on the system are researched, consulted with experts and endeavour to follow best practise – meaning you can spend less time developing the right paperwork, researching what forms you need and when and get on with the job at hand – providing care for those that need it!