Assessing Capacity

1. Assessing Capacity What is your responsibility ? How do you do it ? Carly Houghton Team Leader Deprivation of Liberty Team LCC Helen Pearson Board Officer Safeguarding Boards (LSCB/SAB)

2. Capacity to do what?! • Understand risk to a child • Understand a Protection Plan • Sustain change • Be fit for interview • Be criminally responsible • Make decisions about where you live • Understand that what is happening to them is harmful • Refuse services

3. What affects decision making? • Alcohol • Drugs • Learning Disability • Alzheimer's/Dementia • Mental Health diagnosis • Domestic Abuse (coercion) • Lack of empathy/egotism • Personality disorders • Cycles of abuse /Learnt behaviour

4. What ever the reason ! What is the impact ? • On a person’s ability to understand, retain and act on information • On a person’s ability to protect themselves and others • Look beyond a diagnosis and consider how thinking and behaviour impacts

5. What do these statements mean? • They lack capacity ! • They have a Learning Disability so don’t understand • They do not have a mental health diagnosis so there is nothing we can do • I can’t assess capacity because I know nothing about mental health.

6. Who assesses capacity YOU

7. We can all contribute • Expertise in a particular area of work- Mental Health, Learning Disability, Child Development, Drugs and Alcohol • Knowledge of the child or adult and their day to day experience – ‘What they wake up to’; Walking with them through the day • Creative communication techniques • Joint working

8. Not going into detail of Mental Capacity Act but use the principles as a guide to best practice how we might consider a persons capacity

9. Mental Capacity Act 2005 The key principles of the Mental Capacity Act are: • Every adult assumed to have capacity unless demonstrated otherwise • Person not to be treated as unable to make a decision simply because his or her decision is an unwise one • Person must be empowered as far as possible to help them reach capacity • Any act done for a person who lacks capacity must be done in that person’s “best interests” • Must consider if there is a less restrictive option

10. Adults can make decisions( they may be unwise)

13. The test for capacity MCA s2 • A person lacks capacity if he is unable to make a decision because of an impairment of or a disturbance in function of the mind or brain • Impairment can be temporary • Lack of capacity cannot be determined either by a person’s age or appearance

14. Inability to make decisions MCA s3 • A person is “unable to make a decision for himself” if he is unable:- • To understand the information relevant to the decision • To retain that information • To use or weigh that information in the decision making process • Communicate his decision

15. Where we are now Is it understood ? How to stay there Capacity to Maintain Change To retain that information Accessible Information Testing out Understand information relevant to the decision Where we want to be Is it understood ? How to get there Is it understood ?

16. Asking the right questions • Break it down • Isolate decision • Is it understood • Test it out – • Evidence through observations actions

17. Building confidence in Capacity assessments • Use professional judgement • Ask for assistance/expertise • Think Whole Family • Adult workers think child • Children’s workers think adult • Multi Agency decision making