Decision Making in Relation to Mental Capacity

The Deprivation of Liberty Safeguards (DOLS) provide essential legal protection for those who are in hospitals and care homes for care/ treatment and lack the capacity to consent to this. Conducting the necessary assessments which are required by these regulations has become a very important and burdensome task for the health and social care system, currently costing over £1 billion per year (Law Commission Impact Assessment 2015). Given the significant burden on the care system in terms of both time and money and given the large numbers of citizens who are subject to these assessments it is important that the correct guidelines are followed in relation to the capacity assessment and that self –determination and supported decision making is encouraged wherever possible. Mental capacity assessments are central to the assessment process in both existing and new proposed legislation (Liberty Protection Safeguards).This paper will present initial findings from interviews with Best Interests Assessors, DOLS signatories in local authorities, and Mental Health Assessors, about the factors that influence their judgements about mental capacity, based on four brief vignettes presented to them shortly before interview. The findings will have relevance to all involved in the DOLS process, but also to other health and social care staff, who are routinely involved in mental capacity assessments