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Audit of fidelity of clinicians to the Mental Capacity Act in the process of capacity assessment and arriving at best interests decisions

Oluwatoyin Sorinmade (Consultant Older Adult Psychiatrist, based at Oxleas NHS Foundation Trust, UK)
Geraldine Strathdee (Consultant Psychiatrist, based at Oxleas NHS Foundation Trust, UK)
Catherine Wilson (Core Trainee in Psychiatry, based at Oxleas NHS Foundation Trust, UK)
Belinda Kessel (Consultant Geriatrician at Princess Royal University Hospital, South London Health Care NHS Trust, London, UK)
Obafemi Odesanya (Core Trainee in Psychiatry at Oxleas NHS Foundation Trust, UK)

Quality in Ageing and Older Adults

ISSN: 1471-7794

Article publication date: 16 September 2011

Abstract

Purpose

The purpose of this paper is to evaluate health professionals' fidelity to the Mental Capacity Act (MCA) principles on determining mental capacity and arriving at best interests decisions in the care of individuals found to lack the relevant decision‐making capacity.

Design/methodology/approach

A retrospective review of the case records of 68 patients previously determined by clinicians as lacking mental capacity in at least one of three identified areas: treatment consenting capacity, capacity to decide on place of abode and capacity to manage financial affairs, was conducted. Notes were examined to determine how mental capacity was assessed and the process of arriving at best interests decisions in the care of the non‐capacitous individuals.

Findings

It was difficult to locate relevant entries as there were no designated folders for MCA related issues. There were (mostly) minimal entries made about the assessment process, only patchy documentation of the legal criteria used in capacity assessment, and which of the criteria the patient did not fulfil. Clinicians only partially followed the procedure prescribed by the MCA in determining best interests of non‐capacitous patients.

Originality/value

This paper highlights the need for health care professionals to better adhere to the principles of the MCA in assessing mental capacity and in determining the best interests of non‐capacitous individuals. Health care professionals and the public need to be better informed of the provisions of the MCA.

Keywords

Citation

Sorinmade, O., Strathdee, G., Wilson, C., Kessel, B. and Odesanya, O. (2011), "Audit of fidelity of clinicians to the Mental Capacity Act in the process of capacity assessment and arriving at best interests decisions", Quality in Ageing and Older Adults, Vol. 12 No. 3, pp. 174-179. https://doi.org/10.1108/14717791111163604

Publisher

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Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited