Understanding mental capacity
Understanding mental capacity

Start this free course now. Just create an account and sign in. Enrol and complete the course for a free statement of participation or digital badge if available.

Free course

Understanding mental capacity

2.1 Children under 16

In England and Wales, the Mental Capacity Act 2005 does not apply to children under 16. In Scotland there are provisions in the Age of Legal Capacity (Scotland) Act 1991, with a similar change at age 16. A child under 16 is therefore generally presumed not to have capacity, although they may be assessed as ‘Gillick competent’.

Activity 3 Decisions made on behalf of children under 16

Timing: Allow about 30 minutes

Making decisions on behalf of other people is not easy, especially if they are angry or distressed and therefore less able to understand what is being proposed, or if they are inclined not to tell the truth. But what kinds of decisions, other than about medical treatment, do professionals make about children, and how often do these involve an assessment of mental capacity? 

Watch the video below about a social worker, Liz Curry, in a local authority children and families team. Look for examples of Liz’s decision making.

Download this video clip.Video player: What is social work? Children and families
Skip transcript: What is social work? Children and families

Transcript: What is social work? Children and families

NARRATOR
In Tameside, near Manchester, senior practitioner Liz Currie is arriving for another day in Denton's Children's Social Work team. After starting her career in the voluntary sector, Liz has been with the Tameside team since 2008.
LIZ CURRIE
Coming to Tameside, because of the way that we work here, we don't have a separate duty team. We don't have a separate looked-after team. The area team does everything. And I wanted that very steep learning curve, and I wanted to get experience of all the different areas. I like that style or working, where you take something right from the beginning and follow it all the way through and build up those relationships with each your children and your families.
NARRATOR
Liz can have around 20 or 30 children on her caseload at any one time. Today's shift starts with a voicemail from a 12-year-old boy living in a children's home. He's unhappy and wants to leave.
It's Liz's role to try to listen and to manage the problem. It may mean reinforcing the boundaries the young person needs to follow.
LIZ CURRIE
He's struggling there at the moment, because a new young person moved into that children's home, and he's really struggling to adjust to that. Generally, when he rings me up, it's because he's not getting his own way. And he's kind of hoping that I will change whatever decision has been made.
What's up? What's been happening? Now, if you need some time out of that situation, you can go off down the park or whatever and then come back at an agreed time.
He wasn't entirely happy with me. He did put the phone down on me, I think, a couple of (LAUGHING) times. Which he tends to do, when he doesn't hear something that he wants.
I spoke to him, spoke to staff, to work out what was happening and what rules they were putting in place for him. Because, equally, we need to kind of support what they're doing but made sure he understands what they're doing, but also find a way out of that situation so that he and staff aren't, you know-- he isn't winding them up and getting annoyed and they're having to manage that all morning.
NARRATOR
With the situation stabilised, Liz will keep in close contact with the staff and the young person, to try to ensure the placement can continue. But her next case can't be dealt with over the phone. She's received a referral from another professional whilst on duty, around suspicions that a 12-year-old boy with learning difficulties may be involved in sexual activity and substance abuse.
LIZ CURRIE
We need to know whether parents know about that and what the supervision level is for the child. And also, having spoken to the child, he was very clear that there's a lot of people living in the house at the moment. There's a lot of arguing going on at the moment. And he's not actually very happy living there.
NARRATOR
Liz and family support worker Paul Wayne need to do a home visit, to investigate their concerns.
LIZ CURRIE
I think what we'd like to happen is to be able to sit down and have a discussion with Mum and Dad about where they feel things are up to with the child at the moment and how they think they're getting on in terms of supervising him, whether he's sticking to boundaries-- because that's been a problem in the past. We need to establish whether or not they can supervise him adequately and whether they would understand what the risks would be of not supervising him.
NARRATOR
Visiting children and families in the community is a crucial part of their child-protection work.
LIZ CURRIE
Ideally, we don't want to do unannounced visits, because obviously it's quite disruptive and rude to the people that you're visiting, to just have social workers banging on the door. But equally, if there's a concern that's been raised by another agency about the child, then we will do unannounced visits.
Hiya!
MAN
About 10 o'clock last night.
LIZ CURRIE
I'm Liz, from Children's Social Work Team. You all right? This is Paul.
I think home visits are one of the most useful parts of the job, in terms of engaging families, and in terms of assessing and understanding what's happening. I think the situation, when you get some people to come into the office and talk to you, it's a totally false situation. And you're not getting a true picture. You're just getting what they want you to know.
Whereas if you see them at home, you're seeing them dealing with things that they can't particularly control all the time. The understanding of what it feels like to be that child, what experiences of being parented is this child having? You know, what's their life like, day to day?
NARRATOR
As with many unannounced visits, it can provoke a strong reaction towards the social workers. Went in and spoke to Mum. And she was-- I think she was a bit upset. She called Dad in, and he was-- he was--
PAUL WAYNE
Really upset.
LIZ CURRY
Yeah, he was really upset. He was quite angry. He struggled to stay in the room, because he was feeling quite angry. So he went out.
But Mum stayed and talked to us. She's agreed for a worker to spend a bit of time with him and work out what was his wishes and feelings are, what his view is of what, if anything, has happened.
NARRATOR
With at least one parent open to support, Liz will ensure the family receive the correct help to put effective supervision in place. Back in the office, Liz rushes into a multiagency meeting about a separate case. A teenage boy is causing concern.
LIZ CURRY
The difficulty, I think, is that everyone has a lot of concerns, but no one has a lot of evidence about the concerns. So you get quite a lot of people being worried about the child and saying things like, well, I think this is happening, but nobody knows. The Youth Offending team have expressed some concerns about what's going on for this child at the moment. And we're going to look at what information they have, whether it's information we've had before or not, what the basis of that information is.
NARRATOR
It's a case Liz knows well. And, despite the lack of evidence, her experience and intuition always told her that something was not quite right. Effective social workers need to apply professional scepticism to cases like this.
LIZ CURRY
Mum says exactly the right things, and I have no reason to disbelieve her, other than I have a feeling that she's not telling me the truth or that she's telling me the party line. But, you know, if you've got [INAUDIBLE] some parents who've got years and years of experience of working with the system and getting rid of professionals, they're very good. And she is very good.
Yeah, I'm not disputing for a second her skills of getting rid of me. She's excellent at that. I think my intuition has held this case open, actually. I think we could quite easily have said, several years ago, they're not engaging. Let's shut it.
NARRATOR
New police information supporting her intuition is revealed in the meeting. And Liz believes she may need to escalate the case into a formal child-protection conference. First, she must discuss the evidence with team manager Tracy Rowe.
LIZ CURRY
We've got a lot of new information from police that I wasn't aware of. Police say that Mum spends a lot of time in the evening in the pub. They're saying they have been round, and she's been intoxicated.
I think we are supported really well. I think one of the things I really like about this authority is the high level of support and the opportunities for discussing things. I read something saying that all intuition is biassed. To some extent, it is. So, if you're having intuition, as a worker and as a professional you have a responsibility to examine and think about, you know, what am I reacting to, here? And working with managers can help you explore some of that.
There's very few facts. You know, you're on the hypothesis. You're on the, well, I've got this information that leads me to think this. And that doesn't mean that I believe that thing 100%. That means, at the moment my information leads up this way, and there's a possibility that I might be wrong. There's always a possibility that I might be wrong.
NARRATOR
Team manager Tracy agrees that Liz should consult the conference team, to take the case forward, as the new evidence clearly supports her initial concerns.
TRACY ROWE
You don't just pull it from thin air. It's your years of experience, it's your training, it's your knowledge. You may not be able to put your finger on what it is that's not quite right, but you sort of know.
It's something that you do, sort of, I guess, you get more confident to rely on, and you get more confident in looking for what is it that's not feeling right. The majority of the time, when people say, it's not quite right, usually it isn't right. And when they explore with other professionals, they talk to other agencies on health, education, it sort of backs up that sort of feeling, really.
NARRATOR
After lunch at her desk, typing up the morning's notes, Liz is back on the phone in the afternoon, dealing with various children, professionals, and foster carers. A teenage girl on Liz's caseload is struggling in a new placement. The foster carer is concerned about how to deal with contact with an older sibling. It's Liz's role to provide ongoing advice and support for the foster carer, to ensure the safe care of the child.
LIZ CURRY
She's not supposed to see her sister unsupervised, at the moment, because of the concerns about who her sister was associating with. She could have put her in contact with people that are inappropriate and people that could sexually harm her and sexually exploit her.
We're not convinced that she'd be safe. And our responsibility is to keep her safe. Now, if she goes against that and runs off to see her sister, then you need to report her missing.
I think she's a really good foster carer with younger children. But I think she does struggle with teenagers. And, you know, the young person's a quite difficult, challenging teenager.
We can't have a young person that's in our care, you know, put at risk like that. So we need to keep her safe-- which we have explained to this young person. But equally, you know, she's not that fond of boundaries. And she tends to kind of challenge. So, she may well challenge that.
NARRATOR
It's now midafternoon, and Liz is back on the road-- on her monthly home visit to 14-year-old looked-after child Paige. A month ago, Paige briefly ran away from her foster carers. Liz has been working with Paige for two and a half years and wants to make sure these current issues have been resolved.
LIZ CURRY
She wasn't very happy, last time I saw her. She was fine by the time that it ended, but she was quite-- things were disrupted a bit, at the time. So I needed to go and see her and see how she's been since then, see how everything's been going for her.
Hello.
WOMAN
Come in.
LIZ CURRY
Thank you! Last time I saw her, she had just had the blip. It was the day, the day when she'd come back from doing a runner. I need to see how it's been since she got back.
You know, how is she feeling? Is she still happy in the placement? You know, is she still having feelings about wanting to leave? Because sometimes she does, and I think that's natural. I also think particularly teenager is quite difficult. And quite a lot of teenagers-- I don't want to be here anymore. But when you've got the option of not having to be there anymore, that kind of magnifies it, makes it worse.
I saw your mum the other day.
PAIGE
Did you.
LIZ CURRY
Yes. Have you spoken to her recently?
PAIGE
Um, I phoned her. When I stayed at her house, that night, she only had, like, Coke and cream soda on the side. She's won't drink it. Which is pretty good.
LIZ CURRY
But overall you've been getting alright with Kevin.
PAIGE
Yeah. made friends with her.
LIZ CURRY
Good.
PAIGE
Yeah, fine.
LIZ CURRY
Good.
She was 11, the first time I met her. She's gone from being a quite sulky, quite difficult young lady into, she's absolutely brilliant now. You know, she's lovely. Does brilliantly at school. Does really, really well.
You know, she's working above average. Teachers love teaching her 100% attendance, participates in lots of activities. You know, wants to go to college.
She's great. She's doing so well. The change in her is amazing.
PAIGE
I've known her for about two and a half years, I think. And, at first, when I first got put in care, I didn't like her at all. Because I thought it was her fault, and she was saying that my mum was a bad mum and all that.
But I think, now I've actually grown up, I can understand where she's coming from when she says that my mum-- like, she's not a bad mum, but she couldn't look after us. I understand, now.
LIZ CURRY
Part of my assessment, when I go, isn't just what she's telling verbally, it's what she's telling me with her behaviour and, you know, how she appears. It's nice when she's in a good mood and she seems really settled. And she was clear that, you know, she's getting on really well with the carers at the moment, that the blip we were having last time was just a blip, and that's fine now, and she's moved on from that.
NARRATOR
Having ended the visit on a positive note, Liz returns to the office, to write up her case notes. Her job can be filled with emotional highs and lows. And she's constantly aware of her responsibilities to the children and families that she serves.
LIZ CURRY
Taking children into care is an extremely difficult thing to do. And I think that's right. I think it should be. I think it should have an emotional impact on you, and you should question it.
It's never a decision that I would make. It's a decision that we make in consultation with managers and senior managers and the legal department. It's very final. And, you know, the courts describe it as a draconian measure, and it is. And seeing how distressed the parents are, it is upsetting. It really is upsetting.
I like it when children start to trust you. And I also like it when you can see good outcomes for children, you know, when you can see them perhaps-- you know, things change within their family, and they're a lot happier at home, or they're settled in foster placement and they're a lot happier there.
And when you see a child that's gone from, say, having kicking off at school all the time, terrible school attendance, and then you see them perhaps living in a foster placement and wanting to go to school every day and thinking about career and thinking about future, and you think, well, actually if that child had stayed at home, that wouldn't have happened. And the fact that now they've got more choices is because of something that we've done.
The other thing that I really like is how well everyone gets on as a team. I think our team is really close and supportive. We get on really well with people from other agencies. And it's actually a really nice atmosphere to work in. And I really like that.
End transcript: What is social work? Children and families
What is social work? Children and families
Interactive feature not available in single page view (see it in standard view).

How often were the decisions related to assumptions about mental capacity, even though this term is not used? Make notes in the box below.

To use this interactive functionality a free OU account is required. Sign in or register.
Interactive feature not available in single page view (see it in standard view).

Comment

The video begins with Liz speaking by phone to a 12-year-old boy in a children’s home who was not happy and wanted to leave. Liz listened to his concerns, discussed the issue with staff and managed to stabilise the situation.

Next there was a home visit to a 12-year-old boy with learning disabilities, where there were concerns about inappropriate sexual activity and substance abuse. Liz managed to establish a working relationship with the mother, in order to more accurately hear and understand the views of the boy and assess the support required.

Following a discussion with her manager about another case involving a teenage boy, in which they decided to convene a formal meeting, Liz spoke by phone to a foster carer dealing with a dilemma about whether to allow a teenage girl to see an elder sibling. Finally, Liz visited 14-year-old Paige, a looked-after child. Paige reflected on decisions Liz had taken on her behalf in the past and acknowledged that they had proved to be in her long-term interests.

Liz tried to work with the children and young people where appropriate and intervened with those who had parental responsibility.  

Skip Your course resources
MHC_1

Take your learning further

Making the decision to study can be a big step, which is why you'll want a trusted University. The Open University has 50 years’ experience delivering flexible learning and 170,000 students are studying with us right now. Take a look at all Open University courses.

If you are new to University-level study, we offer two introductory routes to our qualifications. You could either choose to start with an Access module, or a module which allows you to count your previous learning towards an Open University qualification. Read our guide on Where to take your learning next for more information.

Not ready for formal University study? Then browse over 1000 free courses on OpenLearn and sign up to our newsletter to hear about new free courses as they are released.

Every year, thousands of students decide to study with The Open University. With over 120 qualifications, we’ve got the right course for you.

Request an Open University prospectus371