Structured assessment framework improves adherence to requirements of mental capacity act


The Mental Capacity Act has created a legal framework for those supporting people with learning disabilities making decisions about the way they live their lives. The Act provides safeguards for those people who may be unable to make decisions for themselves and sets out guidance for supporters.

The authors of this paper carried out an audit to assess the quality, thoroughness and completeness of making decisions for people with learning disabilities who lacked capacity in making specific decisions for themselves. The results of this first audit suggested that the requirements of the Mental Capacity Act were not always being followed appropriately.

The audit was then carried out a second time to using a checklist developed to reflect the requirements of the Mental Capacity Act.

The results showed that using the checklist enabled those involved to hold a clearly structured discussion regarding the decision-making process and also ensured that the documentation recording this process was complete. The authors suggest that the use of the checklist facilitated adherence to the Act and helped to establish better standards of clinical practice.

Evaluation of a structured assessment framework to enable adherence to the requirements of Mental Capacity Act 2005, Ramasubramanian, L.,  et al., in, British Journal of Learning Disabilities, 39: 314–320.

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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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