At first glance mental capacity assessments and the Mental Capacity Act can seem fairly daunting concepts to get to grips with. However, the subject really isn’t as complicated as it might seem on the surface and most of the content covers actions and activities you’d recognise from your own best practice as a care provider.
This article will help you to understand what mental capacity is, what the Mental Capacity Act is, work out when you should perform an assessment, why they need to be performed, how you do them and who in a care setting is best placed to get involved.
Mental capacity isn’t a state which is all-or-nothing. Commonly people feel that diagnoses such as Alzheimer’s, dementia or learning disabilities – even heightened levels of frailty, automatically mean someone lacks the capacity to make their own decisions. This is not always the case!
Mental capacity is defined as the “ability to make your own decisions” and can be broken down down into four main questions:
The Mental Capacity Act 2005 (also known as the MCA) is an act designed to help protect and empower people who might lack the mental capacity to make their own decisions about their care and treatment.
It’s not easy to ensure that someone isn’t wrongly stopped from making decisions that are rightfully theirs to make. Nevertheless, a person needs to be protected from making decisions when they don’t have the capacity.
Before you decide that an individual lacks capacity to make a decision for themselves, you need to ensure that you’ve:
Someone’s mental capacity needs to be assessed when they are:
The Mental Capacity Act puts forth a two-stage test you can perform in order to ascertain a person’s capacity. This is called the, “2 stage test” and consists of:
Remember someone’s mental capacity can fluctuate, therefore you need to make sure you allow the person time to make a decision themselves. The best way to do this practically is to start a conversation. Ask that person how they got to that particular decision. Remember that they might need more information and so you need to be ready to provide that if at all possible.
In a care setting this will typically be carers who are directly concerned with the person at the time. This means that multiple care team members and even teams can become involved in the assessment. However, this isn’t a negative factor, as this will allow a broader time spectrum to be taken into account and how a person’s capacity varies over time. If a care worker feels that they’re following the care plan and have a, “reasonable belief” that the person lacks capacity to make specific decisions they need to make the assessment – this could be anything from accepting food to personal care. This means that their care plans need to be created collaboratively with the person, who agrees to them or an assessment must be made of their capacity to decide if they refuse specific care interventions.
Nourish empowers care workers by providing them with an easy way to plan, record and manage care. This means that carers can easily work with people on their care plans and identify whether they have the capacity to make choices about their particular set of care interventions.
For more information on Nourish, then please get in touch – our team of experts are always happy to help.
At Nourish we don’t take the typical path when it comes to care plans. Rather than telling care providers how they ‘should’ go about their care planning, we prefer to learn how they like their own care plans built. We know that care plans are not a one-size-fits-all exercise. There are a whole host of good reasons for care providers to adopt different styles in the care plans they choose to use.
How is a robust care planning template created?
Much has been written about how care plans should be put together. But ultimately, the structure of the care plan template needs to be decided by the senior team of the care provider (including its owners) who will set how the service should be led and by the care managers who will conduct service delivery day to day.
Care planning isn’t just about documents, its about shared journeys with each person
Although it is tempting to shrink the care planning exercise to a structure of needs assessments, a list of support services and the risks involved; good care providers are increasingly recognising that a good care plan covers a representation of a person as a whole. This means they need to cover their wants as well as their needs, their abilities as well as their frailties.
Getting this information goes well beyond an admission interview, or a comprehensive assessment; getting to know a person takes time, and people change their preferences and habits. Care planning is part of all interactions with the person and their close circle of support, family and close friends, not just at discrete times.
Care providers are different and so is their care planning
Some care providers may prefer to tackle recovering mobility with garden activities, others will focus on dancing, this will allow different care providers to resonate with different clients. This is why care plans cannot be the same for all care providers. Because care providers decide, which services to provide and together with their team decide how they are provided, how they are adapted to each individual’s wants and needs, the care planning framework must support the team in this journey.
Fundamental building blocks to a robust care planning framework
The building blocks you need to consider when building each care plan include:
In a modern care planning framework, people receiving care have the ability to continuously give feedback about their care, as well as help to improve and adapt the care they receive. This includes the ability to manage consent, allow a next of kin and other informal carers to record relevant notes, raise warnings and alarms, as well as help to stay involved in the care of the person.
Interactions in someone’s day to day care are typically recorded by carers as daily notes. However increasingly, there is information from connected devices, Telehealth or Telecare equipment, wearables and internet of things (IoT), as well as notes from relatives and volunteers outside of the care provider’s organisation. All of this information, when managed digitally, can be used to automatically update care plans, trigger reviews and enable care managers to have the best possible representation of the context of the person and their care, and feel reassured by the clarity of transparency of the quality of the care being provided.
How can Nourish help with your care planning?
Nourish is designed to support organisations in transforming how care information is managed, with radical improvements to the operation of care services and continuous improvement to care delivery. To find out more please don’t hesitate to get in touch.
