1.1 The Mental Capacity Act 2005

The Mental Capacity Act 2005 details certain principles or guidance by which capacity should be assessed. It states how managing a cared-for person’s capacity must be carried out.

These principles are summarised below.

  • Capacity must be assumed, unless a lack of capacity is established (i.e. the starting point is to assume someone is able to make decisions).
  • A person is not to be treated as unable to make a decision unless all practicable steps to help them to do so have been taken without success.
  • A person is not to be treated as unable to make a decision merely because they make an unwise decision.
  • Any decisions or actions made related to capacity must be in the cared-for person’s best interests.
  • Any decisions or actions taken related to capacity must be achieved in a way that is least restrictive of the person’s rights and freedom of action. (You learn more about least restrictive practice later in this section.)

Activity 2

Timing: Allow about 10 minutes

To help you understand how the principles are applied, read the brief case study below. Would you conclude that the person at the centre of the case study, Desmond, has capacity or lacks capacity?

Case study: Desmond

While out shopping Desmond collected his pension and gave half to a Big Issue seller. He then found and wore a colourful hat, which he wore to the supermarket where he bought some processed food and enjoyed a strong coffee with four sugars.

Later that day a neighbour told Desmond’s daughter that he should not be allowed out by himself as he had made a fool of himself and clearly was unable to look after himself properly.

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Comment

It seems that the neighbour who witnessed Desmond’s behaviour earlier that day assumed he was not able to look after himself as he should. You might argue about how wise Desmond’s decisions were, but they do not necessarily demonstrate lack of capacity to make decisions. At this stage, no attempt had been made to ascertain if Desmond was able to understand any concerns about his behaviour, retain information about any concerns, think through why his neighbour was concerned or communicate his own views on what he was doing.

Placing restrictions on Desmond’s trips to town would not necessarily be acting in his best interests as it would deprive him of the opportunity to act independently and stop him doing what he wanted. If his daughter and others continued to have concerns about Desmond’s behaviour they could ask for an assessment of his capacity.

You learn more about assessing capacity in the next activity.

Activity 3

Timing: Allow about 20 minutes
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1.2 Assessing mental capacity