Department of Health warns councils against narrow approach to mental capacity issues

Local authorities need to develop policies not simply “on the Mental Capacity Act” but on all aspects of their activities as they relate to people who lack capacity, the Department of Health has insisted.

In a circular issued this week, the Department said this work was needed in relation to “housing, transport, complaints, consultations, partnership working, personalisation, carer breaks and so on”.

“It is now time to look at capacity issues more widely in relation to local authority activity,” the circular said.

The Department also stressed the importance in the present economic climate that any reduction or re-organisation of local authority services is fair and proportionate in relation to the needs of people who lack capacity.

It warned: “People who lack capacity are least able to complain and challenge; local authorities must therefore remain vigilant that the interests of this group of people are represented in changes and re-organisations. Local authorities should make their own arrangements for these interests to be clearly represented.”

The Department acknowledged that much progress has been made in implementing the MCA since it came into force in 2007, with local authorities achieving “a great deal” in terms of training staff, raising awareness, introducing best interests decisions, commissioning an Independent Mental Capacity Advocacy Service and launching new Deprivation of Liberty Safeguards.

However, it added that this major culture change needed to continue.

The circular, which confirmed the funding available for 2010/11, said best practice “suggested that:

• The focus of future work should be on the inclusion of people who lack capacity
• How decisions are made is often as important as the decision itself, and serious attempts should be made to involve people in all decisions being made about them
• DH guidance on eligibility for services advises that people who lack capacity need more frequent reviews than others, and
• ADASS-SCIE guidance confirms that IMCAs are a specialist resource that may be commissioned outside of the MCA for advocacy or other work in relation to this client group (such as home closures, direct payments).”