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Mental Health Nurse and Trainer, Jenni Pennington, writes about closing the current gaps in meeting the best interests of those lacking capacity to make decisions in the latest edition of Sanctuary Social Work News. Here’s what she has to say:




“It is estimated that as many as 6.5 million people provide either paid or unpaid care or support to people lacking capacity. This is expected to rise to 9 million by 2037, (Policy Briefing, Carers UK, 2015). It is vital, therefore, that these carers are aware of and work within the legal framework and spirit of the Mental Capacity Act (MCA). 

The MCA (2005) sets out a groundbreaking statutory framework to empower and protect vulnerable people who are incapable of making their own decisions. It also provides a legal framework for everyone working in health and social care who is involved in the care, treatment and support of people aged 16 and over who live in England and Wales and who are unable to make all or some decisions for themselves.

Section 1 of the Act sets out the core principles at the heart of the legislation; the right to make decisions for oneself protected by the assumption of capacity; a right to support so that decisions might be made (even if those decisions are thought to be unwise); the requirement to act only in an individual’s best interest where indicated and to ensure that a least restrictive approach is taken when acting in someone’s best interest (Cave, 2015). 

Whilst the principles are now firmly embedded into health and social care practice and organisations appear to be protecting autonomy by empowering individuals in their life choices, the House of Lords Select Committee Report (2014) concluded that there remains a poor understanding and implementation of the empowering ethos of the Act. Evidence shows that there are gaps resulting in differential treatment of people, particularly where there may be tensions between potential risk and resulting deprivations of liberty.

As a specialist trainer for Sanctuary Training’s MCA and DoLS course and Best Interest Assessor (BIA) Refresher course, I work with practitioners to refresh their knowledge of the MCA and impact of deprivation of liberty. Given the wide ranging implications of recent Supreme Court judgements in relation to deprivation of liberty, it’s particularly timely for practitioners to reflect on their practice. It’s important to consider how paternalistic decision-making might be limited so that a balance can be made between protecting the individual autonomy of people lacking capacity and protecting them from their own harmful decision-making.”

The next two BIA Refresher courses are being held on 10 June 2016 (Birmingham) and on 13 October 2016 (London). 

We also run a host of other social work training courses, including those tailored to specific local authority needs. Simply visit Sanctuary Training to find out more. 

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