Distinctions between capacity and competence in people with learning disabilities in the Mental Capacity Act


We have posted elsewhere on the blog about some of the issues faced by people responding to the requirements of the Mental Capacity Act. The author of this paper set out to clarify the differences between the terms’ capacity’ and ‘competence’ as used in the Act, in order to help practitioners, people with disabilities and their families to understand the distinctions.

Whilst not reporting any data from original research, we decided to feature this post as the clarification set out by the author is clear and likely to be extremely useful. He points out that capacity and competence are often discussed in relation to their absence and the resulting restrictions placed on choice and action for individuals. He set out to discuss the concepts in relation to legal status, the process of assessment, and the scope of the terms.

The key distinction set out by Willner is that mental capacity refers to the ability to make decisions. Competence on the other hand refers to the ability to perform actions needed to put decisions into effect. Questions of capacity are governed by legislation and will only apply to those who have a “mental disorder”. If capacity is questioned, best-interests decision making processes can be set in motion along with other legal provisions.

Questions of competence however will involve assessment procedures and can apply to anyone, where others have the legal powers to control the person’s actions.
Willner concludes by considering some areas of practice where the Mental Capacity Act can be used to promote competence, in addition to capacity.

Capacity and competence: limitations on choice and action, Willner P., in Advances in Mental Health and Intellectual Disabilities, 5, 6, 49-56


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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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