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3. Maximise the capacity of those who lack or may lack capacity to make certain decisions for themselves • Protect vulnerable adults who may have mental incapacity from abuse and neglect • Provide clarity to families, informal carers and professionals as to when they may act or make decisions themselves Next

4. MCA applies to people 16 years old or older though in some circumstances the Court of Protection will intervene for under 16 year olds. It covers people with the following: • Dementia • Learning disability • Brain injury • Severe mental illness • Anyone planning for the future • Temporary loss of capacity, for example because someone is unconscious, because of an accident, anaesthesia, alcohol or drugs Next

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7. Mental capacity is the ability to make a decision • Capacity can vary over time • Capacity can vary depending on the decision to be made • Physical conditions, such as location, can affect a person’s capacity • Do not assume lack of capacity because of a person’s age, physical appearance, condition or an aspect of their behaviour Next

8. An individual lacks capacity if they are unable to make a particular decision • This inability must be caused by an impediment or disturbance of the mind or brain whether temporary or permanent • Capacity can vary over time and type of decision Next

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11. Every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise by a capacity assessment. • People must be supported as much as possible to make their own decisions before anyone concludes that they cannot make their own decisions. • People have the right to make what others might regard as unwise or eccentric decisions. Everyone has their own values, beliefs and preferences which may not be the same as those of other people. You cannot treat them as lacking capacity for that reason. • Anything done for or on behalf of a person who lacks mental capacity must be done in their best interests. • Anything done for, or on behalf of, people without capacity should be the least restrictive of their basic rights and freedoms. Next

12. Finished Quiz

13. Question 1 This is correct. The Mental Capacity Act 2005 affects people with a temporary loss of capacity, including people affected by a stroke. Return to Quiz

14. Question 1 This answer is incorrect. The Mental Capacity Act 2005 affects people with a temporary loss of capacity, including people affected by a stroke. Return to Quiz

15. Question 2 This is correct. A condition such as dementia does not automatically mean that a person is unable to make decision or have choices. Nor should assumption regarding lack of capacity be made because of a person’s age, physical appearance, or any aspect of their behaviour. Return to Quiz

16. Question 2 This answer is incorrect. A condition such as dementia does not automatically mean that a person is unable to make decision or have choices. Nor should assumption regarding lack of capacity be made because of a person’s age, physical appearance, or any aspect of their behaviour. Return to Quiz

17. Question 3 This is correct. A person’s capacity to make decisions can be affected by the environment. For example, a person who finds themselves in hospital after an accident may be confused by the surroundings and hence less able to make a decision. Return to Quiz

18. Question 3 This answer is incorrect. A person’s capacity to make decisions can be affected by the environment. For example, a person who finds themselves in hospital after an accident may be confused by the surroundings and hence less able to make a decision. Return to Quiz

19. Question 4 This is correct. Verbal communication is not essential in making a decision. There are a wide variety of communication techniques which could be used to support a person with non-verbal communication in making an informed decision. Return to Quiz

20. Question 4 This answer is incorrect. Verbal communication is not essential in making a decision. There are a wide variety of communication techniques which could be used to support a person with non-verbal communication in making an informed decision. Return to Quiz

21. Question 5 This is correct. Making a decision which many other individuals may feel unwise, does not mean a person is not able to make that decision. Everyone has the right to make unwise decisions as long as a person shows they have understood the possible consequences of their decision. Return to Quiz

22. Question 5 This answer is incorrect. Making a decision which many other individuals may feel unwise, does not mean a person is not able to make that decision. Everyone has the right to make unwise decisions as long as a person shows they have understood the possible consequences of their decision. Return to Quiz

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25. This person’s putting himself at risk sitting in the road.An assessment of capacity will identify if he is able to make that decision. Next

26. Start from a presumption of capacity • Doubts as to an individual’s capacity can occur because: • Of the person’s behaviour • Of their circumstances • Of concerns raised by someone else • Always assess in relation to the specific decision to be made • The question of whether a person has the capacity to make particular decisions should be regularly considered, including when care plans are being reviewed. • An unwise decision does not necessarily indicate lack of capacity Next

27. Any assessment of a person’s capacity must consider their ability: • to understand the information relevant to the decision • to retain information for long enough to make the decision • to use or weigh up the information relating to the decision • to communicate their decision – by any means! If a person being assessed is unable to do any of the above, they are unable to make a decision for themselves. However remember that these assessments need to be decision and time specific. Anyone must be assessed at his or her best level of functioning. Next

28. Anyone caring for or supporting a person who may lack capacity could be involved in the test to assess capacity • The more significant the decision, the greater the number of people likely to be involved • Expert testing by doctors or psychologists will be required in some cases, but even when used may not be the only form of capacity assessment, as capacity is time and decision specific • Who you involve depends upon individual circumstances Next

29. Provide all relevant information • Do not give more detail than required • Include information on the consequences of making, or not making, the decision • Summarise and present options • Consult with family and care staff on the best way to communicate Next

30. Be aware of any cultural, ethnic or religious factors which may have a bearing. Make the person feel at ease • Try and choose the best time of day for the person • Try and ensure that the effects of any medication or treatment are considered • Take it easy – one decision at a time • Don’t rush, and be prepared to try more than once Next

31. Always keep records of any assessment These include: • Day-to-day e.g.. Following the Care Plan, Mrs Begum was helped to decide her choice of meals for the day • Professional Records e.g.. 2-stage test, assessment activities & outcomes, relevant care plan information, etc. • Formal reports/certificates of capacity Next

32. The next slide introduces the 2 stage assessment test which MUST be used and your records must show it has been used, even for day-to-day assessments of capacity. Next

33. Presumption of Capacity Refer back to existing assessments 1 - Is there an impairment of, or disturbance in the functioning of the person’s mind or brain? Reasonable steps must be taken to ascertain whether the person concerned has capacity in relation to the matter in question. NO YES Person is able to give consent and make self-determining decisions. 2 - Is the impairment or disturbance sufficient to affect the person’s decision-making capacity? NO YES Person is able to give consent and make self-determining decisions. Is the person’s capacity: a) Permanent; b) Temporary; c) Fluctuating Next

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35. True or False Statement 1 This is the correct answer. When assessing a person’s capacity, you should always start from an assumption that the person has capacity to make their own decisions. Do not assume lack of capacity because of a person’s age, physical appearance, condition or an aspect of their behaviour. Return to Quiz

36. True or False Statement 1 The correct answer is ‘True’. When assessing a person’s capacity, you should always start from an assumption that the person has capacity to make their own decisions. Do not assume lack of capacity because of a person’s age, physical appearance, condition or an aspect of their behaviour. Return to Quiz

37. True or False Statement 2 The correct answer is ‘False’. Capacity can vary depending on the decision to be made. Some decision are easy as there is little information to weigh up, such as choosing what to wear. Other decisions are more complex as a lot more information needs to be considered, such as financial decisions. Return to Quiz

38. True or False Statement 2 This is the correct answer. Capacity can vary depending on the decision to be made. Some decision are easy as there is little information to weigh up, such as choosing what to wear. Other decisions are more complex as a lot more information needs to be considered, such as financial decisions. Return to Quiz

39. True or False Statement 3 This is the correct answer. Doubts as to an individual’s capacity can occur because: • Of the person’s behaviour • Of their circumstances • Of concerns raised by someone else Return to Quiz

40. True or False Statement 3 The correct answer is ‘True’. Doubts as to an individual’s capacity can occur because: • Of the person’s behaviour • Of their circumstances • Of concerns raised by someone else Return to Quiz

41. True or False Statement 4 The correct answer is ‘False’. When a person was found to have no impairment or disturbance in their brain or mind function, they are fully able to make their own decisions. Return to Quiz

42. True or False Statement 4 This is the correct answer. When a person was found to have no impairment or disturbance in their brain or mind function, they are fully able to make their own decisions. Return to Quiz

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46. It varies depending on the individual’s circumstances and the type of decision involved. • Family members, informal carers as well as Health and Social Care staff can be decision makers • Deputies appointed by the court and people who have been granted Lasting Power of Attorney can be decision makers • Doctors and Solicitors can be decision makers, however are unlikely to be decision makers for social activities and day-to-day care Next

47. In determining a person’s best interests, consideration must be given to what is best for that person in those particular circumstances. Whilst the views of other people will need to be taken into account, the focus must be placed firmly on the person lacking capacity. Priority should be given to what is objectively the best course of action for them in that particular situation. Next

48. Avoid making assumptions about someone’s best interest merely on the basis of the person’s age, appearance, condition or behaviour Consider a person’s own wishes, feelings, beliefs and values and any written statement made by the person when they had capacity Take account of the views of family and informal carers Can the decision be put off until the person regains capacity? Next

49. Involve the person in the decision making process • Demonstrate that you have carefully assessed any conflicting evidence or views • Provide clear, objective reasons as to why you are acting in the person’s best interests • Take the least restrictive alternative or intervention This is not an exhaustive list, however by using this checklist the decision maker will ensure that decisions are made in the person’s best interests. Next

50. Please click each for a detailed case study below to view explanations, then click the Next button to move on afterwards: • Simple Decisions • Moderately Complex Decisions • Complex Decisions Next