The Unit 3 Mental Capacity and Restrictive Practice in Care Settings outlines essential principles, legislation, and practices that ensure individuals' rights, safety, and autonomy in care environments. This unit emphasizes understanding mental capacity laws such as the Mental Capacity Act (2005) and its amendments, alongside the Care Act (2014) and Data Protection Act (2018). It also highlights factors influencing mental capacity, the significance of valid consent, and strategies for maximizing individual decision-making abilities. Additionally, the unit details restrictive practices, their impact, and the importance of implementing the least restrictive options to maintain a safe and respectful care environment.
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Activity 40 - Explain The Main Purpose And Principles Of Relevant Legislation And Codes Of Practice Relating To Mental Capacity, And How These Principles Interact
The legislation and code of practice related with mental capacity are:
a. Mental capacity Act, 2005 which followed five principles:
1. Support to make decision
2. Best interest
3. Ability to make an unwise decision
4. Least restrictive
5. Presumption of capacity
b. Mental Capacity Act, 2019 (amendment) came into force on April 2022. The purpose of this act is to provide security and freedom to the individual’s best interest. It protects individuals from deprivation of liberty.
c. Mental Health Act, 1983 and amended in 2007 empowers healthcare professionals to detain, assess and treat people with mental illness in certain circumstances and should provide necessary treatment (Lawrence et al., 2022).
d. The Care Act, 2014 is aiming to provide legal support to people who are unable to make decisions about care and support. This act covers the duties that local agencies are responsible for to assess the fluctuating needs
e. The Data Protection Act, 2018 is aiming to empower the individuals to take control on personal information and data and support the organisation for using lawful procession of the public’s information and data
Assessment Criteria 1.1
Activity 41 - Identify Factors That Influence An Individual’s Mental Capacity And Ability To Express Consent
1. Time
2. Decision specificity
3. Environment
4. Noise
5. Time of day
6. Coercive or controlling behaviour
Additionally, there are other factors that influence individual’s mental capacity and ability to express consent:
a. Emergency procedure during the operation
b. Severe illness or mental ill health
c. Where there is a risk for individual
d. Where there is the person is severely ill or living in unsanitary or unhygienic condition
Assessment Criteria 1.2
Activity 42 - Describe The Relationship Between An Individual’s Mental Capacity, Consent, Choice And Safety
The Mental Capacity Act (2019) modifications state that there may be circumstances in which it is necessary to take action that could rob a person of their liberty before a formal decision has been made by a responsible body or court. To make an individual capable of making an informed choice, he or she must get necessary information, but this information will also include visual materials, aids, communication, hearing aids, and other equipment that make an individual able to understand the information. Another importance of the relationship between individual, consent, choice, and safety is to empower an individual under the Mental Capacity Act, informed about independent advocacy, and responsibility for offering the local authorities (Power et al., 2020). This responsibility has been described in Care Act, of 2014.
Assessment Criteria 1.3
Activity 43 - Define the term ‘valid consent’
According to the Information Commissioners’ Office, at The General Data Protection Regulations- Article 4[11], valid consent is “ any specific, freely given, unambiguous and informed indication of data, by which an individual by a statement or by clear affirmation can signify the agreement of processing personal data that related with that specific individual (Muir?Cochrane et al., 2018).
The consent can give either verbally or in written format and can also be provided through testimonials like blood test reports, giving thumb impressions and so on.
Assessment Criteria 1.4
Activity 44 - Outline Own Role And Responsibilities In Relation To Relevant Principles, Legislation And Codes Of Practice, And Upholding Individuals’ Rights
As social care worker, it should be important to adhere to the principles of the Mental Capacity Act, of 2005. We should work under the law and organisational policies and processes to uphold the rights for individuals as per the Human Rights Act, 1998.
For the children, own roles and responsibilities will be to follow the policy set up by the UN Convention on the Rights of the Child, 1992-Article 12. As per this principle, we must ensure that children can get equal rights to express their views freely in those matters that affect them (Hext et al., 2018).
We must encourage wise decision-making and control both prospective and actual dangers as well as risk-taking. We must work to settle any conflicts between our rights and our obligations. If we have trouble defending rights, we need to get help so that we can.
In general, we should strive to foster respect, dignity, privacy, choice, and independence.
We must keep confidential records that are clear, accurate, and readable, and we must support a person's right to access their own information if they request it.
Since that this is a fundamental right, we should assist anyone who want to express their worries and grievances.
Assessment Criteria 2.1
Activity 45 - Explain The Importance Of Establishing An Individual’s Consent When Providing Care And Support
The importance of establishing the individuals contest while offering care and support is:
a. It demonstrates the respect by the social care workers to the individuals and their dignity
b. It is a legal requirement as legislated by the Mental Capacity Act, 2005
c. It helps the service users to make informed choice about what they want to receive care and support
Assessment Criteria 2.2
Activity 46 - Describe How Personal Values And Attitudes Can Influence Perceptions Of Situations And Of Individuals’ Capacity
Different situations
In a different situation, we, as health care and social care workers should adhere to the principles of confidentiality set by the Mental Capacity Act, and Code of Practice.
Individuals’ capacity (Griffith et al., 2021).
A person could become forgetful with the age. In this situation, we should remember that dementia is not a normal part of aging, although it includes loss of cognitive functioning, and problems with thinking, learning, reasoning, and remembering.
Once experience, attitude, and beliefs are part of what makes an individual who he or she is. When it comes to offering service and care support to individuals personal values and attitude can change the perspective of delivering support- sometimes, attitude and beliefs can lead one to assume things about people in terms of which is right and which is wrong.
Assessment Criteria 2.3
Activity 47 - Outline Strategies And Skills That Could Be Used To Maximise Individuals&Rsquo; Capacity To Make Their Own Decisions
The strategies and skills to maximize the capacity of individuals will include:
a. Provide communication and engagement skills effectively to enable practical support
b. Provide information in a different format, like:
1. Use of communication tools
2. Address the environmental factors
3. Develop listening habits
4. Recognise and respond to the coercive behaviour by others or by individuals
During the assessment, the following will be considered:
a. Individuals’ habits and interests
b. Needs
c. Support networks
d. Wishes, aspirations, and goals
Assessment Criteria 2.4
Activity 48 - Outline Own Role In Identifying When An Assessment Of Capacity May Be Required
When providing support to someone, you might detect indications that the person may not be able to make judgments. Instead of assuming that a person lacks capacity, we should monitor them because it may be that they are unable to make decisions at that particular time.
So own roles will be:
1. Determine the presence of impairment of, and disturbance within the functioning process
2. Develop the general understandings of the person to whom service will be offered
3. Maintain the rules and regulations, and standards while offering care and support to the service users
Assessment Criteria 2.5
Activity 49 - Describe The Steps To Take If Consent Cannot Be Readily Established And Own Role In This
1. Reiterate the information that one gave to the individual to make them able of making an informed choice
2. Seek advice from the line manager
3. Take reference from organizational policies and procedures
4. If necessary, use legal guidance, and follow legal procedures which are previously outlined
5. Refer to the individual’s care plan to provide relevant information and make your own self aware
6. Follow the basic principles of the person-centric care approach, to show dignity, and respect, and offer choices to the service users
7. Listen to every individual and observe them for a response which can be by nodding of the head or holding hand to provide medication
Restrictive practices can include situations where people are restrained and restricted, either knowingly or unknowingly. One's rights may be curtailed through restrictive practices. Those who are subjected to restrictions may not be able to move around freely. The Human Rights Act of 1998 may be broken if we use restrictive tactics (Hext et al., 2018).
When necessary, a constraint may be used to safeguard others or prevent someone from endangering himself, others, or property.
So restraint can be the following format, which can also be termed as restrictive practice:
a. Physical intervention
b. Mechanical restraints
c. Chemical restraint
d. Seclusion
e. Forced care
f. The threat of restraint
g. Electronic surveillance
h. Psychological restraint
Assessment Criteria 3.1
Activity 51 - Explain The Importance And Impact Of Seeking The Least Restrictive Option For Individuals
When a person makes any wrong decision, then the importance of restrictive options can be realized. The care staff should worry that following or practicing any restrictive practice or option can increase workplace risk to a considerable extent. Additionally, when one will aware of the restrictive practice, a person will know his limit. Healthcare workers should always work in the least restrictive manner, for ensuring that both service seekers and service users are in the safe scenario (Butterworth et al., 2022). Another importance of seeking the restrictive option is to maintain balance in safety and dilemma in work or responsibility at workplace setup. If an individual is subjected to restrictive practice due to the behavior, it can increase risks or challenges for himself and for others, which in turn can increase the risk at workplace safety.
Assessment Criteria 3.2
Activity 52 - Describe How To Raise Concerns When Restrictions Appear Out Of Proportion With Evident Risk
1. Adhere to the principles mentioned in the Mental Capacity Act
2. Adhere to the organizational policies and procedures
3. Take the best -interest and decision into account – these are the concerns that have to be raised when restriction appear
Assessment Criteria 3.3
Activity 53 - Outline Organisational Policies And Procedures In Relation To Restrictive Practices
1. A defined layout of the responsible behavior for the workers
4. Action plan to offer legitimate support and services to the people who are in need
5. Set up organizational ethos and policies to reduce the restrictive practices
6. Implement Equality Diversity and Rights
7. Set up duty of care
8. Organise capacity assessment
9. Ensure reporting and recording requirements on time
10. Set up planned intervention
Assessment Criteria 3.4
Activity 54 - Outline Own Role In Implementing Organisational Policies And Procedures In Relation To Restrictive Practices
Ideal role to implement organisational policies and procedures in relation to restrictive practices will be:
a. Developing a caring and supportive attitude’
b. Able to show empathy to others
c. Committed to dignified care and choice
d. Involved in teamwork
e. Able to show compassion
f. Able to demonstrate courage to learn and adopt new things and deal with challenges
g. Able to show understandings towards importance of good communication
h. Should be able to show commitment towards diversity and equality
Assessment Criteria 3.5
Reference list / bibliography
Please list your sources of information in the box below. This includes anywhere you have accessed to gain the information required to answer the questions. At level 3 and above, it is expected that you read widely, and we would recommend that you include at least 3 References. These can be any books you have read, websites you have accessed or the NCC materials. Please try to reference it according to Harvard. For help with this, please visit the following website: https://www.ncchomelearning.co.uk/referencing
If you have gained information from other sources, please ensure that this has been referenced and written in your own words. Plagiarised work will not be accepted, and your work could be checked at any point throughout the course. If in doubt, please check your work using a plagiarism checker.
Butterworth, H., Wood, L. and Rowe, S., 2022. Patients’ and staff members’ experiences of restrictive practices in acute mental health in-patient settings: systematic review and thematic synthesis. BJPsych Open, 8(6), p.e178.
Griffith, J.J., Meyer, D., Maguire, T., Ogloff, J.R. and Daffern, M., 2021. A clinical decision support system to prevent aggression and reduce restrictive practices in a forensic mental health service. Psychiatric services, 72(8), pp.885-890.
Hext, G., Clark, L.L. and Xyrichis, A., 2018. Reducing restrictive practice in adult services: not only an issue for mental health professionals. British Journal of Nursing, 27(9), pp.479-485.
Lawrence, D., Bagshaw, R., Stubbings, D. and Watt, A., 2022. Restrictive practices in adult secure mental health services: A scoping review. International Journal of Forensic Mental Health, 21(1), pp.68-88.
Muir?Cochrane, E., O'Kane, D. and Oster, C., 2018. Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint. International journal of mental health nursing, 27(5), pp.1511-1521.
Power, T., Baker, A. and Jackson, D., 2020. ‘Only ever as a last resort’: Mental health nurses' experiences of restrictive practices. International Journal of Mental Health Nursing, 29(4), pp.674-684.
