Social workers need more effective training and guidance in applying the Mental Capacity Act 2005 to take decisions on behalf of service users and support them to make decisions for themselves.
That was the message from a two-year study, published today, which called for the Mental Capacity Act code of practice to be revised to better support professionals in applying the legislation.
A “significant minority” of best interests decisions were being made by professionals on behalf of people who had been shown to possess capacity or had been wrongly assessed as lacking capacity, found the Mental Health Foundation and researchers at Bristol and Bradford universities.
Under the Act, people must be presumed to possess capacity to make particular decisions and supported to do so; where people are found to lack capacity, decisions taken on their behalf by professionals must be in their best interests.
Current training and guidance for social workers and other professionals did not fully reflect the complexities of the cases they dealt with nor take account of different ways of taking best interests decisions that had been identified elsewhere, found the study.
The study said the code of practice, which governs how professionals should interpret the Mental Capacity Act, should be revised to draw a clearer distinction between a lack of capacity and cases where service users may lack insight into their care needs, but may possess capacity.
Professionals also needed more case examples to be included in the code to reflect the complexities of the cases they encountered.
The study also said care homes needed to review capacity assessments and best interests decisions on behalf of residents on a weekly basis, and ensure all care staff were trained to carry out capacity assessments themselves, rather than have to rely on specialists.
It also recommended that the Care Quality Commission carry out regular audits of providers’ compliance with the MCA and the deprivation of liberty safeguards.
The research involved health and social care professionals supplying evidence of how well they had carried out best interests decisions through an online audit tool, the Best Interests Determination General Research and Evaluation Tool.
See Community Care’s interactive guide to carrying out a mental capacity assessment, based on the Mental Health Foundation’s Assessment of Mental Capacity Audit Tool.
For the latest good practice tips on dementia care, attend Community Care’s conference on the topic on 23 February.
Advice on the deprivation of liberty safeguards will be available at our conference on safeguarding adults at risk on 21 March.