Mental Capacity Act

The Mental Capacity Act applies in England and Wales to everyone who works in health and social care and is involved in the care of a person who is over 16 years of age who may lack capacity to make a specific decision at a specific time.
Core principles
Core principles:
• A person is assumed to have capacity. A lack of capacity has to be clearly demonstrated.
• No one should be treated as unable to make a decision unless all practicable and reasonable steps to help him or her have been exhausted and shown not to work.
• A person is entitled to make an unwise decision. This does not necessarily mean they lack capacity.
• If it is decided a person lacks capacity then any decisions taken on their behalf must be in their best interests.
• Any

In order to be valid, a Lasting Power of Attorney must be registered with the Public Guardian on the prescribed form. This role replaces the Enduring Power of Attorney role.
Lasting Power of Attorney can be granted for two different domains of responsibility:
• Financial
• Health and welfare
These domains of responsibility can be split between two people, or a single individual may be given Lasting Power of Attorney for both domains.
Deputy appointed by Court of Protection
From October 2007, a deputy appointed by the Court of Protection can make ongoing decisions about a person who lacks capacity. The Court of Protection will have defined the remit of their powers.
The Public Guardian
The Public Guardian has a number of roles. These include: keeping a register of people with Lasting Power of Attorney, keeping a register of orders appointing deputies, supervising deputies appointed by a court, directing Court of Protection visitors, receiving reports from attorneys, providing reports to courts and dealing with enquiries and complaints about the way deputies or attorneys use their

• The holder of a valid Lasting Power of Attorney or a deputy will be the decision-maker for decisions within the scope of their authority.
Using the FACE Mental Capacity Assessment
The remainder of this document provides guidance on key terms occurring in the FACE Mental Capacity Assessment and on what should be recorded in relation to its various sections. The notes follow the order of the assessment.
What prompted this assessment?
Any lack of capacity must be clearly demonstrated as a person is assumed to have capacity. No one should be treated as unable to make a decision unless all practicable and reasonable steps to help them have been exhausted and shown not to work.
Doubts about a person’s capacity can occur because of:
• The person’s behaviour.
• Their circumstances.
• Concerns raised by someone else.
However, age, appearance and condition do not by themselves establish lack of capacity. It is also important to acknowledge the difference between unwise decisions (which a person has the right to make) and decisions based on a lack of understanding of risks, or an inability to weigh up information relevant to a