Knowledge of mental capacity issues in residential services for people with intellectual disabilities
| Date | 13 January 2012 |
| DOI | https://doi.org/10.1108/20441281211198844 |
| Pages | 33-40 |
| Published date | 13 January 2012 |
| Author | Paul Willner,Jennifer Bridle,Vaughn Price,Elinor John,Sarah Hunt |
| Subject Matter | Education,Health & social care |
Knowledge of mental capacity issues
in residential services for people with
intellectual disabilities
Paul Willner, Jennifer Bridle, Vaughn Price, Elinor John and Sarah Hunt
Abstract
Purpose – An earlier study of health and social services professionals in community teams for people
with intellectual disabilities (CTIDs) identified a number of significant gaps in their knowledge of mental
capacity issues. The present study aims to ascertain the knowledge of staff working in residential
services for people with intellectual disabilities.
Design/methodology/approach – Participants were staff working in three specialist residential
settings catering to people with intellectual disabilities: qualified nurses working in the UK National
Health Service (NHS) and in independent-sector continuing health care settings; and senior staff in
residential houses. They were administered the same structured interviewas in the earlier study, which
was constructed around three scenarios concerning a financial/legal issue, a health issue, and a
relationships issue, as well as a set of ten ‘‘true/false’’ statements. Their performance was compared with
that of two reference groups, the earlier CTID participants, and a group of staff working in generic (i.e.
other than specialist intellectual disability) NHS services.
Findings – No differences in interview performance were found between the three groupsof residential
carers, who performed better than generic NHS staff but worse than CTID professionals. However, the
three residential groups did differ in their self-ratings of how well-informed and confident they felt in
relation to mental capacity issues.
Originality/value – The study shows that staff working in residential services for people with intellectual
disabilities have only a limited understanding of mental capacity issues and their confidence in their own
knowledge may not be a good guide to their ability to deal with such issues when they arise in practice.
Keywords Mental capacity, Intellectual disabilities, Learning disabilities, Staff, Residential services,
Self-confidence, Mental health services
Paper type Research paper
Introduction
The Mental Capacity Act (MCA) (DCA, 2005) was implemented in England and Wales in 2007.
The Act introduced the new principle that people must be presumed to have the capacity to
make their own decisions unless or until they are assessed as lacking capacity, which can
happen only after all reasonable steps have been taken to support capacity.The MCA applies
to all decisions a person might need to make (with a few specified exceptions), provides a
definition of capacity (the ability to understand, retain and weigh up the relevant information
and communicate a decision) that determines how capacity should – and should not – be
assessed, and stipulates that proxy decisions made on behalf of people who lack capacity
must be made in their best interests, after consulting all those who have an interest in the
person’scare. The Act to some extent formalized existing good practice, but it also introduced
some new principles and legal institutions, and the procedures for implementing the Act,
described in the Code of Practice to the MCA (DCA, 2007), were placed on a new statutory
footing. Guidance on the implementation of these principles has been provided not only in the
MCA Code of Practice (2007), but also by professional bodies (British Medical Association,
2004; General Medical Council, 2006; British Psychological Society, 2006; Joyce, 2007).
DOI 10.1108/20441281211198844 VOL. 6 NO. 1 2012, pp. 33-40, QEmerald Group Publishing Limited, ISSN 2044-1282
j
ADVANCES IN MENTALHEALTH AND INTELLECTUAL DISABILITIES
j
PAGE 33
Paul Willner is based in the
Directorate of Learning
Disability Services,
Abertawe Bro Morgannwg
University Health Board,
Port Talbot, UK and in the
Department of Psychology,
Swansea University,
Swansea, UK.
Jennifer Bridle is based in
the Directorate of Learning
Disability Services,
Abertawe Bro Morgannwg
University Health Board,
Port Talbot, UK.
Vaughn Price is based in
the National Institute for
Social Care and Health
Research Clinical Research
Centre, Medical School,
Swansea University,
Swansea, UK.
Elinor John and Sarah Hunt
are based in the National
Institute for Social Care and
Health Research Clinical
Research Centre, Medical
School, Cardiff University,
Cardiff, UK.
This study was supported by a
small grant from the Welsh
Office for Research and
Development in Health and
Social Care (WORD). The
authors are grateful to David
Jones and Andrea O’Loughlin
for facilitating access to
participants, and to the
participants themselves for
giving up their time.
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