Mental Capacity Act – Helping Clients Make Decisions

Clients, their families and friends and independent advocates working together to make decisions

Clients should always be involved and participate in all aspects of service delivery and decisions that affect them.

Remember – ‘no decision about me, without me’

Clients decide how and to what degree they want family and friends involved in their lives and decisions that affect them.

Clients who do not have mental capacity have a legal right, under the Mental Capacity Act 2005 to an independent advocate or representative who can act in their best interest when significant decisions about their lives need to be made.

An independent advocate is someone who does not have any personal or professional connections/ interests with the provider Agency (e.g. is not paid by the organisation) who speaks up on behalf of the person expressing the persons needs, wishes and choices. They do not impose their own or other peoples views or decisions upon the person.

For less important decisions or those that don’t involve challenging the service, support workers may sometimes be required to advocate on a clients behalf.

Remember, all clients who have mental capacity have the right to express and give informed consent about whether information is shared with members of the clients family, carers or others.

Clients that lack capacity also have rights in relation to how significant decisions are made and who should represent them.

Under Self- Directed Support – Clients who have the mental capacity to make an informed decision about their assessment process have the right to decide which friends and family, if any, they wish to be involved in their assessments and support planning. They also have the right to exclude certain professionals from this process.

Peoples informal carers, such as members of their family, friends or neighbours who provide clients with care and support have a right to a separate assessment from the person they support and to be consulted in their own right about how services provided to them should be organised and their own needs are to be met.

They sometimes have a legal right to make certain decisions on behalf of the person who they support if that person lacks capacity and they have the status of deputy or lasting power of attorney.

It is essential and not optional to involve service users and/ or their representatives or advocates:

  • On an individual level – where decisions are being made about determining the persons needs and how, when and where these will be met.
  • On a general level – where decisions about Policy, practise changes to the service which might affect more than one client.

Working in partnership means more than just consulting people, it means involving them in decision – making and enabling them to participate. It means encouraging them to express their views, listening to these views and responding appropriately to them.

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