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Last updated: 29.10.24

Getting to Grips with The Principles of the Mental Capacity Act

 

Knowledge of the Mental Capacity Act principles is essential for anyone working in health and social care. When it comes to correctly supporting people whose capacity to make decisions may be in question, you need to have actionable and up-to-date information about this legislation at your fingertips. 

This guide should help give you a crucial introduction to the 5 principles of the Mental Capacity Act (MCA) so that you can support and empower people who may have reduced mental capacity.

For a comprehensive safeguarding course that delves deeper into this subject, browse our training today. 

What Is Mental Capacity?

Mental capacity refers to an individual's ability to make their own decisions. This can vary a lot depending on the decision at hand and may fluctuate over time.

When Was the Mental Capacity Act Introduced?

The Mental Capacity Act was introduced in 2005 and came into force in England and Wales in 2007.

What Is the Purpose of the Mental Capacity Act?

The Mental Capacity Act was created with the aim of protecting and empowering people who may lack the mental capacity to make their own decisions about their care and treatment. 

The Mental Capacity Act is a key piece of adult safeguarding legislation that applies specifically to individuals aged 16 and over in England and Wales.

What Decisions Does This Apply To?

The MCA covers a wide range of decisions, including personal welfare decisions (such as medical treatments or where someone lives) and financial decisions right down to everyday decisions like what to eat or wear. The core MCA principles should be applied using sensitivity and emotional intelligence.

Let’s get into exactly what the Mental Capacity Act principles entail. 

The 5 Principles of the Mental Capacity Act

The core tenets of the Mental Capacity Act are intended to be followed in order to give the best and most empowering outcomes possible for all individuals. 

1. Presumption of Capacity

Every adult has the right to make their own decisions and must be assumed to have capacity to do so unless it is proved otherwise. 

How Might Principle 1 Be Applied?

In practice, this means not assuming someone lacks capacity based on their age, appearance, condition or behaviour alone. Understanding the importance of communication in health and social care is crucial in applying this principle effectively.

2. Support to Make a Decision

Individuals should be given all practicable help to make their own decisions before anyone concludes they lack capacity.

How Might Principle 2 Be Applied?

This could involve using simple language, visual aids, or choosing the right time and place for important conversations.

3. Ability to Make an Unwise Decision

People have the right to make decisions that others might consider unwise or eccentric. This alone does not mean they lack capacity.

How Might Principle 3 Be Applied?

Respecting an individual's choice to spend their money in a way you might disagree with, as long as they understand the implications.

4. Best Interest

Any decision made on behalf of someone who lacks capacity must be in their best interests.

How Might Principle 4 Be Applied?

When deciding on medical treatment, consider the person's past wishes, current feelings, beliefs and values, and consult with family members or an independent advocate. 

This principle works alongside the aims of safeguarding to ensure that decisions respect the person's wishes while also meeting their care needs.

5. Least Restrictive Option

When making decisions for someone who lacks capacity, choose the option that least limits their basic rights and freedoms.

How Might Principle 5 Be Applied?

Considering home care support before suggesting a move to a care home, if it can meet the person's needs safely. It’s crucial to take this particular MCA principle seriously or you risk depriving someone of their personal liberty.

By following the 5 principles of the Mental Capacity Act you should be able to support individuals as much as possible to make their own decisions. 

Understanding Mental Capacity Assessments

Mental capacity assessments are the proper way to determine whether an individual can make specific decisions for themselves. As well as giving us the 5 principles of the Mental Capacity Act, it provides a two-stage test for assessing capacity:

  1. Is there an impairment of, or disturbance in the functioning of, the person's mind or brain?
  2. If so - does the impairment or disturbance mean that the person is unable to make the specific decision when they need to?

A person is considered unable to make a decision if they cannot:

  • Understand information relevant to the decision
  • Retain that information.
  • Use or weigh up that information as part of the process of making the decision.
  • Communicate their decision (whether through language or non-verbal means).

When Should Mental Capacity Be Assessed?

Capacity should be assessed when there's reason to believe an individual might struggle to make a particular decision. It's important to remember that:

  • Capacity is decision-specific and time-specific.
  • A person may have capacity for some decisions but not others.
  • Capacity can fluctuate, so regular reassessment may be necessary.

How Many People in the UK Are Thought to Lack Capacity for Sage Decision Making?

When someone is assessed as lacking capacity, decisions must be made in their best interests. The MCA provides a checklist of key factors that must be considered when determining someone's best interests.

The list of the factors for making best interests decisions is:

  • Don't make assumptions based on age, appearance, condition, or behaviour.
  • Consider all relevant circumstances.
  • Consider if the person might regain capacity in the future.
  • Involve the person as much as possible in the decision.
  • Consider the person's past and present wishes and feelings.
  • Take into account the person's beliefs and values.
  • Consult others involved in the person's care.
  • Consider less restrictive options.
  • Weigh up all these factors to reach a decision.

This checklist ensures decisions are thorough and person-centred.

Learn How to Sensitively Apply These Principles

When it comes to safeguarding adults who may be vulnerable, it’s crucial your skills are sharp. Browse our online safeguarding training catalogue to get engaging and memorable online training in this vital subject.