fist commit ftc staff app clone
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assets/consent-capacity.html
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631
assets/consent-capacity.html
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<html>
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<body>
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<div className="row">
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<div className="col-md-12">
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<p>
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<strong>Is an MCA required to be completed?</strong>
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<span id="isMCARequiredData"></span>
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</p>
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</div>
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<div className="col-md-12">
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<p><strong>Comments</strong> <span id="commentsData"></span></p>
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</div>
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<div id="ifMcaRequiredContentDiv">
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<!-- {/* Section1 */}-->
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<div className="row">
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<div className="col-md-12">
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<p>
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<strong>This Mental Capacity Assessment must adhere to the Act’s 5
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principles:</strong>
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</p>
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<ul>
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<li>Every adult has the right to make his or her own decisions and must be
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assumed
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to
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have capacity to make them unless proved otherwise.
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</li>
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<li>A person must be given all practicable help before anyone treat them as not
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being
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able to make their own decisions.
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</li>
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<li>Just because an individual makes what may be seen as an unwise decision,
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they
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should
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not be treated as lacking capacity to make that decision
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</li>
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<li>Anything done or any decision made on behalf of a person who lacks capacity
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must
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be
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done in their best interests.
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</li>
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<li>Anything done or any decision made on behalf of a person who lacks capacity
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should
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be the least restrictive of their basic rights and freedoms.
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</li>
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</ul>
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</div>
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<div className="col-md-12">
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<p>This form has been developed to support compliance with the Mental Capacity Act
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2005.
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There is a statutory requirement for anyone undertaking an assessment to have
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regard
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to
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the Code of Practice for the Mental Capacity Act. References given below refer
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to
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the
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relevant paragraphs of the Mental Capacity Act Code of Practice. Please also
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refer
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to
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MCA and DoLS Policy and Guidance. (For day to day decisions, please print out/
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fill
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in
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relevant sections 1.1 - 1.10)
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</p>
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<p>
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<strong>Detail</strong>
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<span id="mentalCapacityAssessmentDetail">
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<!-- /*mentalCapacityAssessmentDetail*/-->
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</span>
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</p>
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</div>
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</div>
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<!-- {/* Section2 */}-->
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<div className="row">
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<div className="col-md-12">
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<p>
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<strong>1.2 What is the specific decision relevant to this mental capacity
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assessment?</strong> Please ensure that the decision is phrased in a way to
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enable
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all viable options to be discussed. The MCA Code paragraph 4.4 states 'An
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assessment
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of
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a person’s capacity must be based on their ability to make a specific decision
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at
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the
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time it needs to be made, and not their ability to make decisions in general.'
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</p>
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<p>
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<strong>Detail</strong>
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<span id="specificDecisionDetail">
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||||
<!-- /*specificDecisionDetail*/-->
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||||
</span>
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</p>
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</div>
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</div>
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<!-- {/* Section3 */}-->
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<div className="row">
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<div className="col-md-12">
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<p>
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<strong>1.3 Person undertaking/or who has undertaken this assessment of
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capacity?</strong> The person with greatest responsibility for the specific
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decision
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is known as the ‘decision-maker’ and should assess capacity. The decision maker
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is
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the
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person intending to make the decision or carry out the action. Complex decisions
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may
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require specialist assessment - seek guidance. See 4.38 to 4.43 of the Code.</p>
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</div>
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<div className="col-md-6">
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<p>
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<strong>Name</strong>
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<span id="personUndertakingName">
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||||
<!-- /*personUndertakingName*/-->
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</span>
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</p>
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</div>
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<div className="col-md-6">
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<p>
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<strong>Role</strong>
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||||
<span id="personUndertakingRole">
|
||||
<!-- /*personUndertakingRole*/-->
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</span>
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</p>
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</div>
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<div className="col-md-6">
|
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<p>
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<strong>Organisation</strong>
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<span id="organisation">
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||||
<!-- /*organisation*/-->
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||||
</span>
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</p>
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</div>
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<div className="col-md-6">
|
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<p>
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<strong>Address</strong>
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||||
<span id="address">
|
||||
<!-- /*Address*/-->
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</span>
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</p>
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</div>
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<div className="col-md-6">
|
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<p>
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<strong>Tel</strong>
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<span id="tel">
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||||
<!-- /*Tel*/-->
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</span>
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</p>
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</div>
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<div className="col-md-6">
|
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<p>
|
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<strong>Email</strong>
|
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<span id="email">
|
||||
<!-- /*Email*/-->
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</span>
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</p>
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</div>
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<div className="col-md-6">
|
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<p>
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<strong>Date and time of assessment</strong>
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<span id="dateAndTimeOfAssessment">
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<!-- /*Date and time of assessment ("DD/MM/YYYY / hh:mm A")*/-->
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</span>
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||||
</p>
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</div>
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</div>
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<!-- {/* Section4 */}-->
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<div className="row">
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<div className="col-md-12">
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<p>
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<strong>1.4 What concerns/triggers have given rise to this assessment of
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capacity?</strong> People have the right to make decisions that others might
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think
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are unwise. A person who makes a decision that others think is unwise should not
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automatically be labelled as lacking the capacity to make a decision. See MCA
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Code
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4.35.
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</p>
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</div>
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<div className="col-md-12">
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<p>
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<strong>What is the reason to believe this person may lack capacity to make this
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||||
particular decision? State your evidence:</strong></p>
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<p>
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<strong>Detail</strong>
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||||
<span id="lackCapacityToMakeParticularDecisionDetail">
|
||||
<!-- /*lackCapacityToMakeParticularDecisionDetail*/-->
|
||||
</span>
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||||
</p>
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||||
</div>
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||||
</div>
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||||
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||||
<!-- {/* Section5 */}-->
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||||
<div className="row">
|
||||
<div className="col-md-12">
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<p>
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<strong>1.5 Record your evidence here of the actions you have taken to support
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the
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person. </strong>
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Consider what kind of help and support you can give the person to help them
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understand,
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retain, weigh up information and communicate their decision. </p>
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||||
<p>
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<strong>Have you discussed with the person and/or appropriate others the most
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suitable
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venue for the assessment? </strong>
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For example: Does the person feel more comfortable in their own room? Does it
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||||
need
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||||
to be
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||||
quiet? See MCA Code 3.13.</p>
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||||
<p>
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||||
<strong>Have you discussed with the person and/or appropriate others to
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establish
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||||
timing
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of assessment</strong> For example: Is there a time of day that is better
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for
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the
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person? Would it help to have a particular person present? See MCA Code 3.14.
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</p>
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<p>
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<strong>Does the person have any language/communication issues? </strong> For
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example:
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Do they have hearing or speech difficulties? Do you need an interpreter? Do they
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communicate using special equipment e.g. a light talker communication device?
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||||
See
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||||
MCA
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Code 3.11.</p>
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<p>
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<strong>Have you provided all the information, regarding all viable and
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available
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options that the person needs to consider, to make an informed
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decision? </strong>See
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MCA Code 3.7. The assessor must ensure that the person has:</p>
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<ol>
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<li>Sufficiently detailed alternative plans explained to them to allow them to
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weigh
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up
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the alternatives and make an informed choice where possible.
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</li>
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<li>Been supported by the assessor to explore the reasonably foreseeable
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consequences of
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deciding one way or another, or failing to make the decision.
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</li>
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||||
</ol>
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</div>
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<p>
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<strong>Describe</strong>
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<span id="recordYourEvidenceDescribe">
|
||||
<!-- /*recordYourEvidenceDescribeController*/-->
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||||
</span>
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||||
</p>
|
||||
|
||||
<p>
|
||||
<strong>Viable options considered</strong>
|
||||
<span id="viableOptionsConsidered">
|
||||
<!-- /*viableOptionsConsidered*/-->
|
||||
</span>
|
||||
</p>
|
||||
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>If the decision is not urgent can it be delayed because the person is
|
||||
likely
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||||
to
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regain or develop the capacity to make it for themselves?</strong></p>
|
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<div id="keyPoints" className="keyChecksWrapper">
|
||||
<div className="keyPoints">
|
||||
<div className="table-responsive">
|
||||
<Table striped bordered hover className='canDecisionBeDelayedTable'>
|
||||
<tbody id="canDecisionBeDelayedTable"></tbody>
|
||||
</Table>
|
||||
</div>
|
||||
</div>
|
||||
</div>
|
||||
<p>
|
||||
<strong>Explain why you have ticked box(s)</strong>
|
||||
<span id="explainWhyTickedBox"></span>
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||||
</p>
|
||||
</div>
|
||||
</div>
|
||||
|
||||
<!-- {/* Section6 */}-->
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||||
<div className="row">
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||||
<div className="col-md-12">
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||||
<p>
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||||
<strong>1.6 Two Stage Capacity Assessment</strong> Answer the question with
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||||
facts.
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The
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questions cannot be answered with a simple “yes” or “no” and you are asked to
|
||||
describe
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||||
the assessment process. See MCA Code Ch. 4. </p>
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||||
<p><strong>Stage 1. Is there an impairment or disturbance in the functioning of the
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||||
person’s
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mind or brain</strong> The person may not have a diagnosis but the Code says
|
||||
that
|
||||
proof
|
||||
of an impairment or disturbance of the functioning of the mind or brain is
|
||||
required.
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||||
You
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should record here your reasons for believing this to be the case. See 4.11 -
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4.12
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||||
of
|
||||
the Code. This could be because of, for example, a head injury, a suspected
|
||||
infection or
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||||
stroke, a diagnosed dementia, mental illness, or learning disability.</p>
|
||||
<div className="checkboxList spaceInCheckList mb-3">
|
||||
<p><span id="selectedImpairmentOption">
|
||||
<!-- /*selectedImpairmentOption*/-->
|
||||
</span></p>
|
||||
</div>
|
||||
|
||||
<p>
|
||||
<strong>Describe</strong>
|
||||
<span id="impairmentDescribe">
|
||||
<!-- /*impairmentDescribe*/-->
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>If the person does not meet Stage 1, the assessment should immediately
|
||||
stop.
|
||||
Stage 2. Record here how the identified impairment or disturbance in Stage 1
|
||||
is
|
||||
affecting the person’s ability to make the decision.
|
||||
</strong>See 4.13 to 4.30 of the Code.</p>
|
||||
<p><strong>Can the person understand the information relevant to the
|
||||
decision? </strong>
|
||||
See
|
||||
4.16 to 4.19 of the Code.</p>
|
||||
<div className="checkboxList spaceInCheckList mb-3">
|
||||
<p><span id="selectedCanPersonDecisionInfoOption">
|
||||
<!-- /*selectedCanPersonDecisionInfoOption*/-->
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<p>
|
||||
<strong>Describe how you assessed this</strong>
|
||||
<span id="describeCanPersonDecisionInfo">
|
||||
<!-- /*describeCanPersonDecisionInfo*/-->
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>Can they retain that information long enough to make the
|
||||
decision? </strong>See
|
||||
4.20 to 4.22 of the Code.</p>
|
||||
<div className="checkboxList spaceInCheckList mb-3">
|
||||
<p><span id="selectedCanTheyRetainOption">
|
||||
<!-- /*selectedCanTheyRetainOption*/-->
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<p>
|
||||
<strong>Describe how you assessed this</strong>
|
||||
<span id="describeCanTheyRetain">
|
||||
<!-- /*describeCanTheyRetain*/-->
|
||||
</span>
|
||||
</p>
|
||||
|
||||
</div>
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>Can they use or weigh up that information as part of the process of
|
||||
making
|
||||
the
|
||||
decision? </strong>See 4.21 to 4.22 of the Code.</p>
|
||||
<div className="checkboxList spaceInCheckList mb-3">
|
||||
<p><span id="selectedCanTheyUseOption">
|
||||
<!-- /*selectedCanTheyUseOption*/-->
|
||||
</span></p>
|
||||
</div>
|
||||
<p>
|
||||
<strong>Describe how you assessed this</strong>
|
||||
<span id="describeCanTheyUse">
|
||||
<!-- /*describeCanTheyUse*/-->
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>Can they communicate their decision, by any means available to
|
||||
them? </strong>See
|
||||
4.23 to 4.25 of the Code.</p>
|
||||
<div className="checkboxList spaceInCheckList mb-3">
|
||||
<p><span id="selectedCanTheyCommunicateOption">
|
||||
<!-- /*selectedCanTheyCommunicateOption*/-->
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<p>
|
||||
<strong>Describe the reasons for your conclusion</strong>
|
||||
<span id="describeCanTheyCommunicate">
|
||||
<!-- /*describeCanTheyCommunicate*/-->
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>NB. If all of the answers to the four questions above are YES, then
|
||||
Stage 2
|
||||
is
|
||||
not met and the assessment must end. </strong></p>
|
||||
<p><strong>Stage 3: Causative Nexus</strong> There is a causative link between the
|
||||
impairment or disturbance in the functioning of mind and brain AND the inability
|
||||
to
|
||||
make
|
||||
the required decision. You must be able to evidence that the reason the person
|
||||
is
|
||||
unable
|
||||
to make the decision is because of the impairment or disturbance in the
|
||||
functioning
|
||||
of
|
||||
mind or brain and for no other reason. </p>
|
||||
|
||||
<div className="keyChecksWrapper">
|
||||
<div className="keyPoints">
|
||||
<div className="table-responsive">
|
||||
<Table striped bordered hover className='causativeNexusOptions'>
|
||||
<tbody id="causativeNexusOptions"></tbody>
|
||||
</Table>
|
||||
</div>
|
||||
</div>
|
||||
</div>
|
||||
<p>
|
||||
<strong>Evidence</strong>
|
||||
<span id="evidence"></span>
|
||||
</p>
|
||||
</div>
|
||||
</div>
|
||||
|
||||
<!-- {/* Section7 */}-->
|
||||
<div className="row">
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>1.7 Lack of mental capacity as a result of an impairment/disturbance in
|
||||
mind/brain must be distinguished from a situation where a person is unable
|
||||
to
|
||||
make
|
||||
their own decision as a result of duress or undue influence. A person who
|
||||
has
|
||||
the
|
||||
mental capacity to make decisions may have their ability to give free and
|
||||
true
|
||||
consent impaired if they are under constraint, coercion or undue influence.
|
||||
Duress
|
||||
and undue influence may be affected by eroded confidence due to fear of
|
||||
reprisal
|
||||
or
|
||||
abandonment, sense of obligation, cultural factors, power relationships or
|
||||
coercive
|
||||
control within domestic abuse. Do you have a concern that the person may be
|
||||
under
|
||||
duress/coercion or undue influence in relation to the making of this
|
||||
decision?
|
||||
If
|
||||
so, this will not satisfy the Stage 1 (Diagnostic) test. You have to have an
|
||||
impairment or disturbance of the mind or brain to satisfy that
|
||||
test. </strong>
|
||||
</p>
|
||||
<p><strong>Do you have a concern that the person may be under duress, coercion or
|
||||
undue
|
||||
influence?</strong></p>
|
||||
|
||||
<div className="checkboxList spaceInCheckList mb-3">
|
||||
<p><span
|
||||
id="selectedDoYouHaveConcernOption">
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<p>
|
||||
<strong>If yes, what is your evidence for saying this?</strong>
|
||||
<span id="whatIsYourEvidence">
|
||||
</span>
|
||||
</p>
|
||||
<p>If yes, what actions you intend to take (including consideration of seeking
|
||||
management/legal advice)</p>
|
||||
<p>
|
||||
<strong>Describe</strong>
|
||||
<span id="seekingManagementDescribe"></span>
|
||||
</p>
|
||||
</div>
|
||||
</div>
|
||||
|
||||
<!-- {/* Section8 */}-->
|
||||
<div className="row">
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>1.8 Please record here any further information or content of your
|
||||
interview
|
||||
with
|
||||
the person.</strong></p>
|
||||
<p>
|
||||
<strong>Describe</strong>
|
||||
<span id="recordInterviewDescribe"></span>
|
||||
</p>
|
||||
</div>
|
||||
</div>
|
||||
|
||||
<!-- {/* Section9 */}-->
|
||||
<div className="row">
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>1.9 Determination of Capacity</strong></p>
|
||||
<p>I have assessed this person’s capacity to make the specific decision and
|
||||
determined
|
||||
on
|
||||
the balance of probability that they do not have the capacity to make this
|
||||
decision
|
||||
at
|
||||
this time.</p>
|
||||
</div>
|
||||
<div className="col-md-6">
|
||||
<p>
|
||||
<strong>Name</strong>
|
||||
<span id="section9DontHaveDecisionNameData"></span>
|
||||
</p>
|
||||
|
||||
</div>
|
||||
<div className="col-md-6">
|
||||
<p>
|
||||
<strong>Date</strong>
|
||||
<span id="section9DontHaveDecisionDateData">
|
||||
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<div className="col-md-12">
|
||||
<p>I have assessed this person’s capacity to make the specific decision and
|
||||
determined
|
||||
that
|
||||
on the balance of probability that they have the capacity to make this decision
|
||||
at
|
||||
this
|
||||
time.</p>
|
||||
</div>
|
||||
<div className="col-md-6">
|
||||
<p>
|
||||
<strong>Name</strong>
|
||||
<span id="section9HaveDecisionNameData"></span>
|
||||
</p>
|
||||
</div>
|
||||
<div className="col-md-6">
|
||||
<p>
|
||||
<strong>Date</strong>
|
||||
<span id="section9HaveDecisionDateData">
|
||||
|
||||
</span>
|
||||
</p>
|
||||
</div>
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>Is an IMCA Required?</strong></p>
|
||||
<ul>
|
||||
<li>If the person (16+) is unbefriended and the decision is about a change of
|
||||
accommodation, or serious medical treatment, you MUST involve an IMCA.
|
||||
</li>
|
||||
<li>If a friend or family member exists, but they may not act in the person’s
|
||||
best
|
||||
interests (for example because they are the alleged victim or abuser in a
|
||||
Safeguarding Adults investigation) you MAY involve an IMCA.
|
||||
</li>
|
||||
<li>If the person is unbefriended and a health or social care review is being
|
||||
carried
|
||||
out, you MAY CONSIDER involving an IMCA as good practice.
|
||||
</li>
|
||||
<li>Although you may involve an IMCA under the Mental Capacity Act legislation,
|
||||
if
|
||||
there
|
||||
is no appropriate person, for people over age 18, you MUST instruct a Care
|
||||
Act
|
||||
Advocate if the person has substantial difficulty engaging with the relevant
|
||||
assessment & support planning/review/safeguarding process. Please use the
|
||||
most
|
||||
appropriate legislation to ensure entitlement to advocacy.
|
||||
</li>
|
||||
</ul>
|
||||
|
||||
<p>Does the individual require an IMCA? </p>
|
||||
<div className="checkboxList spaceInCheckList mb-3">
|
||||
<p><span id="isIMCARequired"></span></p>
|
||||
</div>
|
||||
<p>
|
||||
<strong>If not, please give reasons.</strong>
|
||||
<span id="giveWhyIMCARequiredReason"></span>
|
||||
</p>
|
||||
<p>
|
||||
<strong>Date</strong>
|
||||
<span id="whyIMCARequiredDateTime"></span>
|
||||
</p>
|
||||
</div>
|
||||
<div className="col-md-12">
|
||||
<p>
|
||||
<strong>Assessors Details.</strong></p></div>
|
||||
<div className="col-md-6">
|
||||
<p>
|
||||
<strong>Name</strong>
|
||||
<span id="section9AssessorsName"></span>
|
||||
</p>
|
||||
</div>
|
||||
<div className="col-md-6">
|
||||
<p>
|
||||
<strong>Designation</strong>
|
||||
<span id="assessorsDesignation"></span>
|
||||
</p>
|
||||
</div>
|
||||
|
||||
<div className="col-md-6">
|
||||
<p>
|
||||
<strong>Base / Address</strong>
|
||||
<span id="assessorsBaseAddress"></span>
|
||||
</p>
|
||||
|
||||
</div>
|
||||
<div className="col-md-6">
|
||||
<p>
|
||||
<strong>Contact Details</strong>
|
||||
<span id="assessorsContactDetailsData"></span>
|
||||
</p>
|
||||
</div>
|
||||
</div>
|
||||
</div>
|
||||
</div>
|
||||
</body>
|
||||
</html>
|
||||
|
||||
Reference in New Issue
Block a user