Two phase approach to assessing mental capacity improves confidence of all staff in process


Previous posts on this blog have pointed to the fact that there is a lack of knowledge in some areas around the mental capacity act. This paper sets out the learning from developing and implementing a two phase process to help professionals involved in conducting capacity assessments to overcome any hesitation or lack of confidence.

Phase one in the process is described as the determination of the extent to which the person being assessed can process and recall information, with phase two involving the understanding of more detailed information which related to the decision under scrutiny.

The authors describe the use of this two-phase process by using a series of case studies which they have recorded over a two year period. In this period, seventeen people were referred from the eye unit to the capacity team of whom two progressed past the first phase to the second. One of these people demonstrated capacity to make the decision.

The two phase process was fed back to staff in the eye unit to help them to better and more quickly assess capacity in relation to their field and in particular to the potential need for eye surgery.

The authors suggest that the description of this functional process should demonstrate that capacity assessment skills can be found in all staff working with people with a learning disability not just specific groups of professionals.

Demystifying the process? A multi disciplinary approach to assessing capacity for adults with a learning disability, Skinner R et al., in British Journal of Learning Disabilities, 39: 92–97.

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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