Understand the principles of mental capacity in adult care
1.1 Summarise the main purpose and principles of relevant legislation and codes of practice relating to mental capacity and how these principles interact
Understanding mental health and care for adults is very important for the well-being of the elderly population of the United Kingdom. For this purpose, there are many legislation codes of practices for the safeguarding of elderly people who need supervision and are not able to care for themselves. According to the “Mental Capacity Act 2005”, there are five principles to determine whether the individual lacks capacity to make decisions (Legislation.gov.uk, 2023). The principles are presumption of capacity, an individual’s right to be supported while making decisions, there should only be the best interests at the heart of decision making, an unwise decision should not be considered wrong, and there should be the least restriction involved during intervention.
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1.2 Explain how these principles underpin practice in adult care
During the care for the elderly people, the five principles of the Act should be kept in mind. It should be presumed that they are capable of making decisions even when they have suffered an impairment, and their decisions are difficult to communicate, unless proven otherwise, it should be presumed they are capable. The individual should be provided with the best support to make their own decisions before it is presumed that they are incapable (Fusar?Poli et al. 2021). Additionally, an unwise decision should not be deemed as an excuse to declare incapacity of the individual. Any decision, however odd, should be respected. If the individual is deemed to be incapable of making decisions for their own well-being, any decision made on their behalf should be in their best interests and their health conditions should be kept in mind. The last principle should be applied when it has been decided the individual is incapable. Any intervention required for the individual should be done with the least restriction possible (Malla et al. 2019).
1.3 Explain what is meant by ‘valid consent’
Consent is either a verbal or written confirmation of an individual agreeing to the terms and conditions of treatment or any kind of restriction required due to the treatment (Martin, 2023). Valid consent is the written confirmation to a treatment or restriction by an individual who has agreed to it after knowing the provisions of the treatment and is deemed to be capable of consenting to it. Valid consent typically should not involve any coercion from the family or the health provider’s side (Ico.org.uk, 2023). In context of the mental capacity of the elderly, valid consent refers to the individual giving consent to the treatment of their own accord.
1.4 Describe a range of factors that influence an individual’s mental capacity and ability to express consent
Consent is the first step to any medical procedure or treatment that might include restriction. For an individual to have informed consent of the procedures, there are certain factors that need to be kept in mind (Ghorbanhoseini et al. 2023). The main factor that needs to be considered is competency of the individual. It should be comprehended whether the individual providing consent is of a sound mind, is fully capable of caring for themselves, and is not prone to harming themselves or others as a result of mental capacities. In case of incapacity, there should be other authorities to consent for them. The other factor to be considered is the voluntariness of the individual to be treated with the procedure. There should not be any coercion involved in the process (Ali, et al. 2019).
1.5 Explain the relationship between an individual’s mental capacity, consent, choice and safety
The relation between mental capacity and choice is a very complicated process. An individual is capable of providing consent only when they are mentally competent and have the capacity to take care of themselves. Providing consent is the choice of the individual who wishes to be cured and treated with the proper procedures. When the individual loses their capacity to consent, the choice becomes tricky. The caregivers are obligated to take a decision for the well-being of the individual which might not be well received by them, and therefore should be carried on with compassion and empathy (Moore et al. 2021).
Understand the application of the principles of mental capacity and consent
2.1 Describe own role and responsibilities in relation to relevant principles, legislation and codes of practice, and upholding individuals’ rights
According to the “Care Act 2014”, local authorities in the area and citizens living near elderly people should be aware if they are receiving services they need for their mental health and physical health so that their conditions do not worsen (Legislation.gov.uk, 2023). As responsible citizens of the United Kingdom, we should be assisting any elderly person or family member who needs physical and medical assistance. If we come across any individuals whose liberties are being denied wrongfully, we should step up and report to the concerned authorities about any malpractices.
2.2 Explain the importance of establishing an individual’s consent when providing care and support
A medical procedure or long-term care for mental and physical disorders requires consent from the patient first. The patient or the individual receiving care should be first informed of the various aspects of the procedure and exactly how long it will take to finish the procedure. Then the individual should discuss with the concerned people involved and then make a decision. This process of informed consent is a crucial process so that the medical providers will not be involved in Human rights violations.
2.3 Give examples of how personal values and attitudes can influence perceptions of:
different situations
individuals’ capacity
Every individual has their own set of personal values like dependability, patience, respect, loyalty, honesty and many others. While providing consent to be taken care of or some other medical procedure, the individual’s personal values can influence their perception. For example, if a person who is very dependable might not react very well when having to depend on another person for their mobility and well-being (Arieli et al. 2021). They might see it as their personal failure and that might cause them distress. In other situations, the individual may not be capable of deciding the best for themselves, and some other authority is provided control. The individual who always liked to be in control might feel they are losing control of their circumstance,s and that can be distressing.
2.4 Describe a range of strategies and skills that could be used to maximise individuals’ capacity to make their own decisions
An individual who is at risk of incapacity should be provided with all the resources for them to be able to make their own decisions. The first step of the process would be to encourage the individual to participate more in activities regarding their well-being, such as encouraging them to take their own medicines, eating their own food, and so on. This will give the individual more confidence in making their own decisions. The second method could be to change their environment in which they reside in a more positive way and encourage them to do activities that engage their brain (NHS.uk, 2023).
2.5 State own role in identifying when an assessment of capacity may be required
As a citizen, whenever we come across a person who is under external care, we should be able to identify if the person is at the risk of incapacity. If any individual is denying treatment that is required for their well-being, it is a cause for concern. Additionally, if the individual is forgetting their medicines or losing the ability to comprehend their surroundings, we should be asking for an assessment from the authorities.
2.6 Explain the steps to take if consent cannot be readily established, and your own role in this
There are certain steps to be followed when the consent is not readily available, either due to the incapability of the person to consent in the immediate present, or they lack capacity to consent. The decision making would pass to the “Appropriate Person” who is either a family member or a guardian who can speak for the person lacking capacity. In the absence of that, the decision passes on to the authorities or in some cases, the Independent Mental Capacity Advocate (IMCA) for short (Elleman and Oslund, 2019). As a citizen of the UK, our role is to report any person requiring assistance and is unable to provide ready consent.
Understand restrictive practices
3.1 Explain what is meant by ‘restrictive practice’
Restrictive practices are practices which restrict the movement and actions of individuals who are in need of special care or treatment procedures. Restrictive practices are required when the individual is deemed incapable of caring for themselves or proves to be a threat to their own safety. There are many methods of restriction that might include physical, chemical, mechanical, or environmental depending on the needs of the patient.
3.2 Explain the importance and impact of seeking the least restrictive option for individuals
Restrictive practices are often the last resort applied to a patient when all the other options have failed. Implementation of these practices can be uncomfortable and confusing for everyone involved, including the family members. Therefore, it is important to seek out the least restrictive option available. The Government of England provides a framework to reduce restrictive practices through focusing on reducing the behaviors that need restricting (Gov.wales, 2023). Choosing the least restrictive method can improve the wellbeing of the individual and improve their condition
3.3 Identify how to raise concerns when restrictions appear out of proportion with evident risk
The “Mental Capacity (Amendment) Act 2019” provides Liberty protection safeguards (LPS), which is a code of practice, which ensures that the individuals who are being deprived of their liberty are well protected under the law. If any individual’s restrictions are out of proportion to the evident risk, they can reach out to the Care Quality Commission or the responsible body appointed to start the LPS process to look into the matter (Assets.publishing.service.gov.uk, 2023). The body in question will then inspect the issue and take action
3.4 Summarise the organisational policies and procedures in relation to restrictive practices and own role in implementing these
There are many policies and regulations regarding the use of restrictive practices. There are specific guidelines by the government in the reduction of restrictive practices. Individuals who are under restrictive practices are protected under the “Mental Capacity (Amendment) Act 2019” if there are many kinds of malpractices in action (Gov.uk, 2023).
As a citizen, our role is to provide as much assistance to the individuals in need as possible. It is also our responsibility to contact the concerned authorities if we notice any misconduct in restrictive practices.
Assets.publishing.service.gov.uk. Liberty Protection Safeguards, About us, Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1061434/LPS-easy-read-summary-booklet.pdf [Accessed on 25.05.2023]
Gov.uk, Mental Capacity (Amendment) Act 2019: Liberty Protection Safeguards (LPS), About us, Available at: https://www.gov.uk/government/collections/mental-capacity-amendment-act-2019-liberty-protection-safeguards-lps [Accessed on 25.05.2023]
Gov. wales. Reducing restrictive practices framework, About us, Available at: https://www.gov.wales/reducing-restrictive-practices-framework-html [Accessed on 25.05.2023]
Ico.org.uk. What is valid consent? , About us, Available at: https://ico.org.uk/for-organisations/uk-gdpr-guidance-and-resources/lawful-basis/consent/what-is-valid-consent/ [Accessed on 25.05.2023]
Legislation.gov.uk. Care Act 2014, About us, Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents/enacted [Accessed on 25.05.2023]
Legislation.gov.uk. Mental Capacity Act 2005, About us, Available at: https://www.legislation.gov.uk/ukpga/2005/9/section/1 [Accessed on 25.05.2023]
Nhs.uk. Mental Capacity Act, about us, Available at: https://www.nhs.uk/conditions/social-care-and-support-guide/making-decisions-for-someone-else/mental-capacity-act/#:~:text=The%20MCA%20says%3A,they%20make%20an%20unwise%20decision [Accessed on 25.05.2023]
Journals
Ali, F., Gajera, G., Gowda, G.S., Srinivasa, P. and Gowda, M., 2019. Consent in current psychiatric practice and research: An Indian perspective. Indian Journal of Psychiatry, 61(Suppl 4), p.S667.
Arieli, S., Sagiv, L. and Roccas, S., 2020. Values at work: The impact of personal values in organisations. Applied Psychology, 69(2), pp.230-275.
Elleman, A.M. and Oslund, E.L., 2019. Reading comprehension research: Implications for practice and policy. Policy Insights from the Behavioral and Brain Sciences, 6(1), pp.3-11.
Fusar?Poli, P., Correll, C.U., Arango, C., Berk, M., Patel, V. and Ioannidis, J.P., 2021. Preventive psychiatry: a blueprint for improving the mental health of young people. World Psychiatry, 20(2), pp.200-221.
Ghorbanhoseini, M., Kang, K., Yang, A., Abbasian, M. and Vaynberg, E., 2023. Assessment of the Factors Influencing the Patient’s Comprehension of the Informed Consent to Interventional Pain Procedures. Pain Research and Management, 2023.
Malla, A., Iyer, S., Shah, J., Joober, R., Boksa, P., Lal, S., Fuhrer, R., Andersson, N., Abdel?Baki, A., Hutt?MacLeod, D. and Beaton, A., 2019. Canadian response to need for transformation of youth mental health services: ACCESS Open Minds (Esprits ouverts). Early intervention in psychiatry, 13(3), pp.697-706.
Martin, R.K., 2023. Trustworthiness as information: Satisfying the understanding condition of valid consent. Bioethics.
Moore, S.E., Wierenga, K.L., Prince, D.M., Gillani, B. and Mintz, L.J., 2021. Disproportionate impact of the COVID-19 pandemic on perceived social support, mental health and somatic symptoms in sexual and gender minority populations. Journal of homosexuality, 68(4), pp.577-591.
