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Mental health practitioners dealing with older adults living in the community are commonly required to form judgements about the decision‐making capacity of someone with dementia. Newer ways of understanding the dementia experience that recognise the importance of relationships and social connections on the functioning of the person with dementia, offer promise for helping to better conceptualise and carry out these assessments of capability. A relational lens recognises that performance and behaviour of persons with dementia are determined not only by neuropathology but also by their personal histories, their interactions with others, and by how they are perceived within their social contexts. This paper will examine how this more ‘relational’ model of understanding can impact the assessment of incapacity.

The purpose of this paper is to consider the impact of mental capacity legislation when applied to parents with learning difficulties who lack capacity within childcare and family law proceedings in England and Wales.

The paper relies on a range of material including reports published by independent mental health foundations, official inquiries and other public bodies. It also refers to academic and practitioner material in journals and government guidance.

The paper critically reviews the application of the guidance when assessing mental capacity legislation as applied in England and Wales and offers by way of illustration several case examples where psychological assessments, and the enhancement of capacity, have assisted parents who were involved in childcare and family law proceedings.

There has been little published research or governmental reports on the number of cases when parents involved in childcare and family law proceedings have been found to lack capacity. No published prevalence data are available on the times when enhancing capacity has resulted in a change of outcome in childcare and family law proceedings.

The duty is on the mental health practitioners assessing mental capacity that they do so in a structured and supportive role adhering to good practice guidance and follow the guiding principles of mental capacity legislation assuming that the individual has capacity unless it is established that they lack capacity. Guidance and training is needed to ensure that the interpretation of the Mental Capacity Act (MCA) and its application is applied consistently.

For those who are considered to lack mental capacity to make specific decisions, particularly within childcare and family law proceedings, safeguards are in place to better support such individuals and enhance their capacity in order that they can participate more fully in proceedings.

While the MCA legislation has now been enacted for over ten years, there is very little analysis of the implications of capacity assessments on parents involved in childcare and family law proceedings. This paper presents an overview and, in places, a critical analysis of the new safeguarding duties of mental health practitioners when assessing for, and enhancing capacity in parents.

This chapter focusses on food systems' vulnerability. In a rapidly and unpredictably changing world, vulnerability of farming and food systems becomes a key issue. The conceptual bases for food vulnerability analysis and food vulnerability assessment are discussed in a systemic perspective with an eye to the transition approach (Geels, 2004) as a perspective capable to analyze how novelties can develop and influence the system capability to fulfil societal functions, and food and nutrition security in particular. A framework for assessing people's food vulnerability is presented together with a simple vulnerability model based on the three dimensions of exposure (the degree to which a system is likely to experience environmental or sociopolitical stress), sensitivity (the degree to which a system is modified or affected by perturbations) and adaptive capacity (the ability to evolve in order to accommodate environmental hazards or change) (Adger, 2006). Then, other sections are dedicated to discuss the general questions that should be answered by a vulnerability assessment exercise, and the specific challenges emerging when the assessment concerns a food system. These elements are then used in the Annex to this chapter as a base for the development of a detailed method based on seven distinct steps for conducting participatory assessments of the vulnerability of food systems.

The purpose in writing this paper is to highlight the lack of knowledge of many who are involved in capacity assessments, especially non‐professionals such as carers of the learning disabled, and the view that current guidance for capacity assessments does not take into account issues of emotionality.

The approach is to discuss current guidance and practice, and to offer academic criticism and explanation.

The findings include the discovery that the Mental Capacity Act 2005 Code of Practice suggests that healthcare professionals and family/carers may undertake assessments of decision‐making capacity, yet the guidance it provides for their doing so overlooks salient issues. Many of those involved in the daily lives of those, who may lack decision‐making capacity (and thus be seen as legally incompetent) such as the learning disabled, demented, mentally ill and neurodiverse, must decide whether to respect their decisions as competent, or to disregard the decisions on the grounds of incompetence and to act in the person's best interests. As many will lack training in their clinical and legal responsibilities and liabilities, it is crucial that they, and those they care for, are protected by not only an increased knowledge of mental capacity legislation and practice, but also how it may apply to questions of emotionality and neurodiversity.

This paper expands and builds on the authors' previous research into including emotionality in assessments of capacity, and will be of use to practitioners in the field of learning disability, and other psychiatric specialities.

The purpose of this paper is to examine the dilemma at the heart of nursing care – the striving for empowerment of people in nurses’ care with the responsibility to protect vulnerable adults from harm. In doing so, it argues that in difficult and borderline cases, capacity assessment is complex and ultimately based on a judgment involving interpretation, and welcomes the views of clinicians who have challenged the procedural test of capacity in the Mental Capacity Act (MCA).

It presents an illustrative study of a person with acquired brain injury (ABI) resident in a nursing home, who had been assessed under the MCA and judged to have capacity regarding health and welfare decisions, who subsequently displayed a persistent and impulsive desire to leave the unit without thought of risk and vulnerability to herself, prompting safeguarding concerns, and a reassessment of her capacity.

The paper asserts that supporting people with ABI during capacity assessments, as the MCA decrees, in a very structured way can create a false sense of “capacity”. It maintains that executive impairments in ABI, being difficult to assess in formal settings, are best undertaken over time, in real-life settings, with evidence from third parties. It welcomes the MCA’s desire to protect individual autonomy and avoid undue paternalism, through ensuring people are not deemed to lack capacity simply because they make an unwise decision.

But it goes on to argue that in ABI it is often the fact of unwise decision making that is the prominent factor and main concern, particularly in regard to impulsive decision making. If nurses have to make a judgment as to how unwise decisions made with decision-making capacity are to be distinguished from unwise decisions made without it in people with ABI, then, the author concludes, a major area of difficulty for nurses is ascertaining when the presumption of capacity should be challenged, an area that an updated code of practice needs to clarify.

The purpose of this paper is to present findings from a research project which investigated the approaches of different groups of assessors to the mental capacity assessments which are required to be conducted as part of Deprivation of Liberty Safeguards (DOLS).

Four case study vignettes were given to participants. Three groups involved in the DOLS assessment process were interviewed by telephone about the factors that may influence their capacity assessments.

Most assessors did not refer to the required two-stage test of capacity or the “causative nexus” which requires that assessors must make clear that it is the identified “diagnostic” element which is leading to the inability to meet the “functional” requirements of the capacity test. The normative element of capacity assessments is acknowledged by a number of assessors who suggest that judging a person’s ability to “weigh” information, in particular, is a subjective and value-based exercise, which is given pseudo objectivity by the language of the Mental Capacity Act (MCA). A number of elements of good practice were also identified.

In this exploratory study, participant numbers were small (n=21), and the authors relied on self-report rather than actual observations of practice or audit of completed assessments.

The findings are of relevance to all of those working in health and social care who undertake assessments of mental capacity, and will be helpful to all of those tasked with designing and delivering training in relation to the MCA 2005. They also have relevance to policy makers in the UK who are involved with reforms to DOLS regulations, and to those in other countries which have legislation similar to the MCA.

Much existing literature exhorts further training around the MCA. The authors suggest that an equally important task is for practitioners to understand and be explicit about the normative elements of the process, and the place of ethics and values alongside the more cognitive and procedural aspects of capacity assessments.

Assessment of mental capacity in people with learning disabilities involved in criminal proceedings has been debated, and the introduction of mental capacity legislation in the United Kingdom makes provisions for people who lack the capacity to make decisions about their welfare. However, while the new legislation is designed to protect people who lack the mental capacity to make decisions, it is not clear how this legislation applies in criminal cases where the capacity to consent to sexual relations has been questioned. Until recently there was no clear definition of capacity to consent to sexual relations, and the aim of this paper is to consider the key aspects of this legislation and apply it to a case example. The definitions and assessment procedures involved in assessing ‘mental capacity’ are considered, and practice guidance for mental health professionals working in this field is offered.

The purpose of this paper was to develop an integrated framework for assessing the flood risk and climate adaptation capacity of an urban area and its critical infrastructures to help address flood risk management issues and identify climate adaptation strategies.

Using the January 2011 flood in the core suburbs of Brisbane City, Queensland, Australia, various spatial analytical tools (i.e. digital elevation modeling and urban morphological characterization with 3D analysis, spatial analysis with fuzzy logic, proximity analysis, line statistics, quadrat analysis, collect events analysis, spatial autocorrelation techniques with global Moran’s I and local Moran’s I, inverse distance weight method, and hot spot analysis) were implemented to transform and standardize hazard, vulnerability, and exposure indicating variables. The issue on the sufficiency of indicating variables was addressed using the topological cluster analysis of a two-dimension self-organizing neural network (SONN) structured with 100 neurons and trained by 200 epochs. Furthermore, the suitability of flood risk modeling was addressed by aggregating the indicating variables with weighted overlay and modified fuzzy gamma overlay operations using the Bayesian joint conditional probability weights. Variable weights were assigned to address the limitations of normative (equal weights) and deductive (expert judgment) approaches. Applying geographic information system (GIS) and appropriate equations, the flood risk and climate adaptation capacity indices of the study area were calculated and corresponding maps were generated.

The analyses showed that on the average, 36 (approximately 813 ha) and 14 per cent (approximately 316 ha) of the study area were exposed to very high flood risk and low adaptation capacity, respectively. In total, 93 per cent of the study area revealed negative adaptation capacity metrics (i.e. minimum of −23 to <0), which implies that the socio-economic resources in the area are not enough to increase climate resilience of the urban community (i.e. Brisbane City) and its critical infrastructures.

While the framework in this study was obtained through a robust approach, the following are the research limitations and recommended for further examination: analyzing and incorporating the impacts of economic growth; population growth; technological advancement; climate and environmental disturbances; and climate change; and applying the framework in assessing the risks to natural environments such as in agricultural areas, forest protection and production areas, biodiversity conservation areas, natural heritage sites, watersheds or river basins, parks and recreation areas, coastal regions, etc.

This study provides a tool for high level analyses and identifies adaptation strategies to enable urban communities and critical infrastructure industries to better prepare and mitigate future flood events. The disaster risk reduction measures and climate adaptation strategies to increase urban community and critical infrastructure resilience were identified in this study. These include mitigation on areas of low flood risk or very high climate adaptation capacity; mitigation to preparedness on areas of moderate flood risk and high climate adaptation capacity; mitigation to response on areas of high flood risk and moderate climate adaptation capacity; and mitigation to recovery on areas of very high flood risk and low climate adaptation capacity. The implications of integrating disaster risk reduction and climate adaptation strategies were further examined.

The newly developed spatially explicit analytical technique, identified in this study as the Flood Risk-Adaptation Capacity Index-Adaptation Strategies (FRACIAS) Linkage/Integrated Model, allows the integration of flood risk and climate adaptation assessments which had been treated separately in the past. By applying the FRACIAS linkage/integrated model in the context of flood risk and climate adaptation capacity assessments, the authors established a framework for enhancing measures and adaptation strategies to increase urban community and critical infrastructure resilience to flood risk and climate-related events.

Brain Injury Case Managers (BICMs) work closely with individuals with Acquired Brain Injury (ABI), assessing needs, structuring rehabilitation interventions and providing support, and have significant experience of clients with impairments to decision making. The purpose of this paper is to explore the application of the Mental Capacity Act (MCA) and its guidance when applied to ABI survivors. This research aimed to: first, highlight potential conflicts or tensions that application of the MCA might pose, and second, identify approaches to mitigate the problems of the MCA and capacity assessments with ABI survivors. It is hoped that this will support improvements in the services offered.

Using a mixed method approach, 93 BICMs responded to an online questionnaire about decision making following ABI. Of these, 12 BICMs agreed to take part in a follow-up semi-structured telephone interview.

The data revealed four main themes: disagreements with other professionals, hidden disabilities, vulnerability in the community and implementation of the MCA and capacity assessments.

The findings highlight the need for changes to the way mental capacity assessments are conducted and the need for training for professionals in the hidden effects of ABI.

Limited research exists on potential limitations of the application of the MCA for individuals with an ABI. This paper provides much needed research on the difficulties surrounding mental capacity and ABI.

This research explores perceptions of knowledge management processes held by managers and employees in a service industry. To date, empirical research on knowledge management in the service industry is sparse. This research seeks to examine absorptive capacity and its four capabilities of acquisition, assimilation, transformation and exploitation and their impact on effective knowledge management. All of these capabilities are strategies that enable external knowledge to be recognized, imported and integrated into, and further developed within the organization effectively. The research tests the relationships between absorptive capacity and effective knowledge management through analysis of quantitative data (n = 549) drawn from managers and employees in 35 residential aged care organizations in Western Australia. Responses were analysed using Partial Least Square-based Structural Equation Modelling. Additional analysis was conducted to assess if the job role (of manager or employee) and three industry context variables of profit motive, size of business and length of time the organization has been in business, impacted on the hypothesized relationships.

Structural model analysis examines the relationships between variables as hypothesized in the research framework. Analysis found that absorptive capacity and the four capabilities correlated significantly with effective knowledge management, with absorptive capacity explaining 56% of the total variability for effective knowledge management. Findings from this research also show that absorptive capacity and the four capabilities provide a useful framework for examining knowledge management in the service industry. Additionally, there were no significant differences in the perceptions held between managers and employees, nor between respondents in for-profit and not-for-profit organizations. Furthermore, the size of the organization and length of time the organization has been in business did not impact on absorptive capacity, the four capabilities and effective knowledge management.

The research considers implications for business in light of these findings. The role of managers in providing leadership across the knowledge management process was confirmed, as well as the importance of guiding routines and knowledge sharing throughout the organization. Further, the results indicate that within the participating organizations there are discernible differences in the way that some organizations manage their knowledge, compared to others. To achieve effective knowledge management, managers need to provide a supportive workplace culture, facilitate strong employee relationships, encourage employees to seek out new knowledge, continually engage in two-way communication with employees and provide up-to-date policies and procedures that guide employees in doing their work. The implementation of knowledge management strategies has also been shown in this research to enhance the delivery and quality of residential aged care.