Mental capacity KSS 5

Last updated: 15 February 2021

Capacity jigsaw piece

Photo: tashatuvango/Fotolia

This page sets out the knowledge and skills listed under point 5 (mental capacity) in the Department for Health and Social Care’s knowledge and skills statement. Against this, we have mapped Community Care Inform Adults’ guides, research, learning tools and other resources to help social workers meet and evidence this part of the statement. The links to the resources are in blue; click to follow them to the page you’re interested in.

What the statement says Resources to help you
• Social workers must have a thorough knowledge and understanding of the Mental Capacity Act (MCA) and Code of Practice and be able to apply these in practice. They should always begin from the presumption that individuals have capacity to make the decision in question.

• Social workers should understand how to make a capacity assessment, the decision and time specific nature of capacity and hence the need to reassess capacity appropriately. They should know when and how to refer to a best interests assessor.

• Social workers must understand their responsibilities for people who are assessed as lacking capacity at a particular time and must ensure that they are supported to be involved in decisions about themselves and their care as far as is possible. Where they are unable to be involved in the decision-making process decisions should be taken in their best interests following consultation with all appropriate parties, including families and carers.

• Social workers must seek to ensure that an individual’s care plan is the least restrictive possible to achieve the intended outcomes.

• Social workers have a key leadership role in modelling to other professionals the proper application of the MCA. Key to this is the understanding that the MCA exists to empower those who lack capacity as much as it exists to protect them. Social workers must model and lead a change of approach, away from that where the default setting is “safety first”, towards a person-centred culture where individual choice is encouraged and where the right of all individuals to express their own lifestyle choices is recognised and valued. In working with those where there is no concern over capacity, social workers should take all practicable steps to empower people to make their own decisions, recognising that people are experts in their own lives and working alongside them to identify person-centred solutions to risk and harm, recognising the individual’s right to make “unwise” decisions.

The mental capacity, deprivation of liberty and best interests knowledge and practice hub covers assessing capacity and making best interests decisions, and guidance on how to do so in relation to cases involving sexual relations, marriage and contraception, birth and terminations, safeguarding, contact, residence and serious medical treatment.

Section-by-section guide to the Mental Capacity Act 2005 covers what each section of the act means for your role, referencing relevant regulations and the code of practice.

Case law and the process of assessing capacity includes advice on how to start from the presumption of capacity, tips on preparing for an assessment, and advice on distinguishing the fine line between unwise and incapacitous decisions.

Case study: a practical analysis of a mental capacity assessment contains an example of a good mental capacity assessment and how to reflect on your practice.

Assessing mental capacity and making best interests decisions provides an understanding of the presumption of capacity, practicable steps you can take to support someone to make a decision, and how to make use of the best interests checklist.

Case law in relation to making best interests decisions covers the importance of including the individual’s wishes and feelings when making a best interests decision, and how to use the best interests checklist and the balance-sheet approach to help you arrive at the right decision.

Fluctuating capacity and the law: quick guide highlights the difficulties associated with fluctuating capacity, and the related codes of practice and case law.

Assessing capacity to make residence decisions sets out the relevant and irrelevant information when it comes to capacity to make residence decisions, and how to ensure that someone’s capacity to make residence decisions and capacity to make care and treatment decisions aren’t assessed in “silos”.

The interface between the Mental Health Act 1983 and the Mental Capacity Act 2005 outlines the key differences between the two pieces of legislation, and how to decide which regime to follow in a hospital or community setting when admission and care or treatment might lead to a deprivation of liberty.

Section-by-section guide to the Mental Health Act 1983 covers what each section of the act means for your role, referencing relevant regulations and the code of practice.

Adults with learning disabilities and intimate relationships summarises the relationship characteristics that are specific to adults with learning disabilities and what the law says about sex and relationships for this client group.

The case law knowledge and practice hub contains expert-written case law digests that set out the implications for your practice to ensure your legal literacy and knowledge is comprehensive and up to date.

Links to resource maps for other parts of the KSS: