Evaluation of Mental Capacity Assessment in England and Wales

This study evaluated the Mental Capacity Act, which came into force in 2007 to support vulnerable people to make decisions for themselves whenever and as far as possible and to protect these individuals and those who care for them when decisions have to be made on their behalf.

The study asked:

  • What guidance is currently available and what materials/training are being developed to assist with the introduction of the Act?
  • How is mental capacity being assessed and how are decisions being made before the introduction of the new Act?
  • How will mental capacity be assessed and how will decisions be made following the introduction of the new Act?

The study visited 18 sites throughout England and Wales in both rural and urban settings. It  looked at statutory and non-statutory services for adults, people with learning disabilities and older people.

The study found that, in the months leading up to the implementation of the Mental Capacity Act, many health and social care staff felt confused about mental capacity issues. 98% of staff interviewed for the report said they felt they needed more training on mental capacity and making capacity assessments.

The report's recommendations for the health and social care sectors included:

  • ensuring coherent strategies are in place to communicate guidance and training about how to apply the Act to frontline staff
  • an audit of current knowledge and training to identify and plug gaps that need to be filled
  • more resources to be employed to support service users and their carers in playing as full a role as possible in decisions about their care.

Researchers spoke to professionals working with vulnerable adults throughout the social care and health sectors, as well as to service users themselves and their carers. While they found some good practice, the overall picture was one of confusion about what mental capacity means and the criteria needed for assessments of capacity to be made.