The Mental Capacity Act

The Mental Capacity Act (MCA) was introduced in 2007. This set out a legal framework for assessing whether a person had the capacity to make a particular decision for themselves and, if they didn’t, who is able to make this decision on their behalf. It also clarified ways for people to make provision in advance for a time when they may lose the capacity to make their own decisions and introduced a statutory right to advocacy in certain circumstances. The Deprivation of Liberty Safeguards (DoLS) were introduced in 2009 to ensure that Care Homes and Hospitals were not unlawfully detaining people who lacked the capacity to consent to being there.

Useful Forms

Dorset has developed a combined Deprivation of Liberty Form for Urgent and Standard Authorisations to use instead of the individual DOH form 1 and 4 (this reduces duplication and saves time).

Best Interests Balance Sheet – this is very helpful to weigh up the social, ethical, medical, emotional and welfare needs of the person in order to make a significant best interest decision when they lack capacity.
Form A – Capacity Assessment – this is a Dorset Form to help complete and document whether a person has the capacity to make a specific decision.
Form B – Best interests – another Dorset Form to help complete and document a best’s interests decision for someone lacking capacity.

These forms are available from the downloads section of this page.

Deprivation of Liberty Statistics for Dorset (not including Poole or Bournemouth):

Summary of DOLS received in...	2009	2010
Applications from Hospitals which were Granted	7	13
Applications from Hospitals which were Hospitals Not Granted	15	23
Applications from Care Homes which were Granted	16	34
Applications from Care Homes which were Not Granted	11	18
	49	88

1/4/2011 to 31/3/2012	Hospitals	Care Homes	Total
Number Received	58	85	143
Number Granted	22	57	79
Number Not Granted	36	28	64
1/4/2010 to 31/3/2011	Hospitals	Care Homes	Total
Number Received	37	31	68
Number Granted	14	20	34
Number Not Granted	23	11	34
1/4/2009 to 31/3/2010	Hospitals	Care Homes	Total
Number Received	22	27	49
Number Granted	7	16	23
Number Not Granted	15	11	26

Useful Links and information:

Useful newsletters:

Dorset MCA Team Newsletters are available from the downloads section of this page.
39 Essex Street Newsletters

Training

We recommend people working in social care undertake Mental Capacity Act Training refreshers at least annually. Dorset County Council arranges full and ½ day courses for people working within Dorset County Council and Independent, Voluntary and the Private sector in care homes. To apply for a place see www.dorsetforyou.com or call 01305 224361.

Your responsibilities:

Section 5 of the Mental Capacity Act allows carers, healthcare and social care staff to carry out certain tasks without fear of liability. These tasks involve the personal care, healthcare or treatment of people who lack capacity to consent to them. The aim is to give legal backing for acts that need to be carried out in the best interests of the person who lacks capacity to consent. See the Code of Practice, chapter 6, starting on page 92 for information on:

how the Act provides protection from liability
how that protection works in practice
where protection is restricted or limited, and
when a carer can use a person’s money to buy goods or services without formal permission.

Recent Court Cases:

If you need any assistance with the implementation of the MCA or feel you are depriving someone of their liberty, please get in touch on 01305 368913.

News

The recent MCA Conference held at Merley House on the 14^th March 2012 was very well attended. It reviewed where we are 5 years into the Act and challenged the culture in health and social care to see if we really are talking to patients and family, do we always presume capacity and do we always use the least restrictive intervention possible?

Dorset Mental Capacity Act Team:

The MCA Team for Dorset County Council and Dorset PCT provide advice, consultancy and training on all aspects of the Act including the Deprivation of Liberty Safeguards. We aim to advice and support and build people’s confidence in applying the MCA. We are:

Paul Greening

Mental Capacity Act Manager

E: paul.greening@dorset-pct.nhs.uk T: 01305 368920

Mark Crawford

Mental Capacity Act Advisor (leads on training)

E: mark.crawford@dorset-pct.nhs.uk T: 01305 368944

Anna Hawes Smith

Mental Capacity Act Team Administrator (M,W,F)

E: anna.smith@dorset-pct.nhs.uk T: 01305 368913

If you or your patient/client lives in Bournemouth and is in a care home or in Bournemouth or Poole and is in hospital, please contact:

Esther Donald

Mental Health Policy and Deprivation of Liberty Safeguards Manager