Knowledge of mental capacity assessment in staff working with people with learning disabilities
DOI | https://doi.org/10.1108/AMHID-05-2019-0014 |
Pages | 14-24 |
Published date | 02 December 2019 |
Date | 02 December 2019 |
Author | Ashley Chapman,Karen Dodd,Laurence Rogers |
Subject Matter | Health & social care,Learning & intellectual disabilities |
Knowledge of mental capacity
assessment in staff working with
people with learning disabilities
Ashley Chapman, Karen Dodd and Laurence Rogers
Abstract
Purpose –The purpose of this paper is to evaluate staff knowledge of Mental Capacity Act (MCA) capacity
assessments within the Learning Disabilities division of a Mental Health and Learning Disabilities Trust. The
limited research available suggests staff knowledge tends to be poor, particularly concerning who is the
decision maker.
Design/methodology/approach –A 12-item multiple choice questionnaire, which reflects the five core
principles of MCA (2005), was developed. Questionnaires were completed by 262 health and social staff
members who support people with LD.
Findings –Results show high variability of MCA capacity assessment knowledge within the LD division.
However, qualified staff and those from health services scored significantly higher across all categories on the
questionnaire compared to non-qualified and social care staff, respectively. On average, all staff scored
poorly when asked to identify “who is the decision maker?”in a case scenario question.
Research limitations/implications –The main limitation is that we did not collect data on how many
previous capacity assessments and discussions each person had been involved with. The findings clearly
suggest current methods of training lack efficacy in helping staff apply MCA knowledge to their clinical work.
Originality/value –Compared to past literature, this study utilised a novel and more comprehensive
questionnaire. This focused on case scenario questions to assess staff situational judgement. In addition, the
findings add to a sparse evidence base that provides a foundation for future research.
Keywords Social care services, Mental Capacity Act, Health services, Learning disabilities,
Decision maker, Staff knowledge
Paper type Research paper
Introduction
The Mental Capacity Act (MCA) (Department of Health, 2005) received royal assent in April 2005
and has been fully implemented since 1 October 2007. The MCA (2005) applies to everyone who
is involved in the care, treatment and support of people aged 16 and over, in England and Wales,
who are unable to make some or all decisions for themselves. It supplies a framework which
empowers vulnerable individuals to be able to make decisions independently. If they are found to
lack capacity, the Act provides a structure which ensures that decisions made on their behalf are
done in their best interests. Within the MCA (2005) the central concept is that capacity is time and
decision specific.
The MCA (2005) is underpinned by five key principles (SCIE, 2016) which are outlined in Table I.
Principles 1–3 underpin the process before or at the point in time when it is being determined
whether the person lacks capacity. If a decision is made that the person does lack capacity, then
Principles 4 and 5 help to support the next stage of the decision-making process.
Under the MCA (2005) the starting point should always be a presumption that the person has
capacity, and can therefore make the specific decision for himself/herself. The MCA (2005)
Received 7 May 2019
Revised 23 September 2019
Accepted 1 November 2019
Ashley Chapman, Karen Dodd
and Laurence Rogers are all
based at the Department of
Psychology, Surrey and
Borders Partnership NHS
Foundation Trust,
Leatherhead, UK.
PAGE14
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ADVANCESIN MENTAL HEALTH AND INTELLECTUALDISABILITIES
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VOL. 14 NO. 1 2020, pp.14-24, © Emerald Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-05-2019-0014
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