Mental Capacity Act Training
The Mental Capacity Act (MCA) 2005 sets out the legal requirements for professionals working with people who may lack the mental capacity to make certain decisions. The Mental Capacity Act is relevant to anyone who might make decisions on behalf of others aged over 16, it is not just the responsibility of Social Workers and Health Professionals. Ensuring the Mental Capacity Act is followed is essential to human rights: people being able to exercise choice and make decisions.
The Newcastle Safeguarding Adults Board have been looking at how Mental Capacity Act practice can be improved due to growing body of national, regional, and local evidence that knowledge and confidence in all staff, involved in making decisions on behalf of others, needs to be improved in this critical area. It is identified that there are fundamental flaws in how the Mental Capacity Act is understood and applied in practice.
Learning from practice
A number of national and local analyses of Safeguarding Adult Reviews have highlighted common learning themes in relation the embedding of the Mental Capacity Act in practice.
Key Findings
- A National Review of Safeguarding Adult Reviews over a two-year period found that in 60% cases, mental capacity was not addressed, and risk assessment/risk management were not always to expected standards.
- Within records, capacity assessments were often missing or poorly performed, there was a lack of evidence as to the rationale underpinning best interest decision making and a lack of scepticism and respectful challenge of decisions.
- Professionals noted to lack confidence in assessing capacity.
- A considerable number of professionals believed that assessment of capacity was not their responsibility.
- Assessment not completed even where professionals observed concerning events, such as service users disengaging with service provision, making significant unwise decisions and / or having diagnoses which may have impacted their decision making.
- Mental Capacity Assessments not recorded in writing and assessments lacking detail and clarity about who conducted the assessment and its outcome This lack of transparency and accountability could expose workers and their employers, as well as adults in their care to unnecessary risk.
- Professionals sometimes using an individual’s capacity assessment to justify not intervening in cases of probable self-neglect, therefore leaving people at considerable risk.
- A prevailing issue of staff feeling unqualified or fearful of conducting assessments of capacity in case of getting it wrong.
- An overall need to communicate the importance and relevance of the Mental Capacity Act to the front-line workforce and “demystify” MCA for them through raising awareness and delivery of effective training.
Mental Capacity Act Training
The NSAB has an MCA Task and Finish Group which has explored the learning and development opportunities available to the workforce. As a result of this work, Vida Morris, Chair of the NSAB has written out to partners to ask them to consider making improvements to the training that is offered. Partners are encouraged to:
- Consider Mental Capacity Act training as being a mandatory requirement for relevant staff in line with the levels outlined in the National Mental Capacity Act Competency Framework (2017)
- Consider bespoke, accredited, Mental Capacity Act training at a more advanced level to reflect the needs of different workforce roles. Practitioners have fed back that they find case focussed examples relevant to their own area of work particularly helpful in aiding their understanding and application in practice.
- Separate Mental Capacity Act training from safeguarding training. The Mental Capacity Act is much broader than safeguarding and relevant to all who may make decisions for others, not just in relation to safeguarding matters. It can be helpful for the Mental Capacity Act to be referred to on safeguarding training, but this should not be solely relied upon as the mechanism for delivering Mental Capacity Act competencies.
In collectively addressing these actions it is hoped that people can be better enabled to exercise choice and make decisions – their fundamental human right and most importantly to reduce risk to the people we work with, our staff and our organisations.
The NSAB offer some multi-agency training around the MCA (and Deprivation of Liberty Safeguards):
This offer is focussed at a basic awareness level with a small number of more advanced courses being offered. As per the points above, it is recommended that advanced training is tailored to reflect the needs of specific roles. However, the NSAB acknowledge that for some organisations it might not be possible to access this, hence this offer.