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Other booklets in this series include:
OPG601 Making decisions...about your health, welfare or finances. Who decides when you can’t?
OPG602 Making decisions: A guide for family, friends and other unpaid carers
OPG603 Making decisions: A guide for people who work in health and social care
OPG604 Making decisions: A guide for advice workers
OPG606 Making decisions: The Independent Mental Capacity Advocate (IMCA) service
Making decisions booklets are available to download at:
www.publicguardian.gov.uk
Making decisions booklets are available in English, Welsh and Braille formats. There is also an Easyread booklet and Easyread Audio version. Contact the Office of the Public Guardian for more information.
The Mental Capacity Implementation Programme published this booklet. It was written by the National Care Association.
OPG605 Making decisions: An Easyread guide (10.07)
© Crown copyright 2007 (2nd edition)
The Mental Capacity Act
The Mental Capacity ActHelping and supporting people who are unableto make some decisions for themselves
Easyread
This booklet gives information on a law called theMental Capacity Act. This booklet is not a Code ofPractice under the Act and is not a guide to how the newlaw will apply to people in different situations.
Credits & thank yous
The Mental Capacity Implementation Programme (MCIP)published this booklet. MCIP is a Government project thatwas set up to get everything ready for when the MentalCapacity Act came in.
This booklet was written by Andrew Holman and StephMoore with help from the Making it Easier group andmaterial from Vanessa Rogers at the Mental CapacityImplementation Programme. We are very grateful to themand the rest of the team at Inspired Services.
Thank you very much to everyone else who helped us withthis booklet, including:
Newmarket Day CentreThe Tower Hamlets Video GroupAPASENTHThe Sharing Caring Project
and all the other people who gave us their time andcomments to make this booklet better. We would also like tothank all of the models in the photographs and the peoplewho helped make this happen.
The photographs used in this booklet cannot be usedanywhere else without the written permission of InspiredServices and the Mental Capacity ImplementationProgramme.
Having mental capacitymeans being able to makeyour own decision aboutsomething.
This booklet is about a newlaw on decision makingcalled the Mental CapacityAct.
It has stories in it aboutpeople and making somedecisions.
At the end of this bookletthere is a list of words andwhat they mean. The wordsare in red in this booklet.
There is also a CD you canlisten to whilst looking at thestories.
There is a lot of informationabout the new law in thisbooklet.
You might like to havesomeone support you whenyou look at the booklet.
You might like to look at justone bit at a time.
1
PageAbout the new law called theMental Capacity Act 3
Tony's Story 5 - Helping and supporting Tony to make his own decisions 6 - Deciding to go on a trip 8 - Deciding about a lot of money 10 - Supporting Tony to plan ahead for the future 17
Mrs. Smith's Story 21 - Planning for the future 23 - Deciding about money and property 25 - Deciding about care and treatment 26 - Setting up a Lasting Power of Attorney 27
Mrs. Anand 's Story 31 - Making a decision for the future 32 - Making a decision for Mrs. Anand 34 - Getting help and support from an Independent Mental Capacity Advocate (IMCA) 37
What the words mean 40
How to find out more about the new law 45
What is in this booklet?
2
3
Having mental capacitymeans being able to makeyour own decision aboutsomething.
The Mental Capacity Act isa new law about decision-making.
It will help you to make decisions for yourself.
About the new law called the MentalCapacity Act
4
It will help you to plan forthe future when you might
not be able to make your own decisions.
It will also help to protectyou if you can’t make
some decisions for yourself.
Most of the new law startedin October 2007.
5
Tony’s Story
6
Helping and supporting Tony to make hisown decisions
Tony is in his 30s and has alearning disability. He lives athome with his parents butplans to move out one day.
He has a girlfriend calledMary and he has been left alot of money by an uncle.
Sometimes Tony finds it hardto tell people what he wantsbut this does not mean thathe can’t make decisions forhimself.
At school he learnt how touse picture cards to help himtell people what he wants.
7
Tony can make somedecisions for himself aboutthings like what to eat andwear, but he might not beable to make some biggerdecisions (this is calledlacking capacity).
Under the new law, Tony'sparents know that they mustsupport Tony to try to makehis own decisions.
Depending on the type ofdecisions that Tony needs tomake, there are differentthings that can be done. Thestories below show us someof these different decisions.
8
Tony likes going to a socialgroup. He has made somegood friends there,especially Mary.
The group is planning to goon a day trip to the seaside.Tony likes the sea and islooking forward to this.
The night before the tripTony tells his parents that hedoes not want to goanymore.
Deciding to go on a trip
9
His parents are surprised.The sea is one of Tony’sfavourite places and he hasnever missed a trip to theseaside.
They talk to him about hisdecision and remind him ofall the things he likes doingat the seaside.
Using words and his picturecards Tony is able to tell hisparents that his friend Maryis ill and is not going on theday trip.
Tony does not want to gowithout Mary. He hasdecided not to go on the daytrip. His parents respect hisdecision.
10
Tony’s uncle left him a lot ofmoney.
His Dad knows that withsupport Tony can makemoney decisions about dayto day things like whatclothes to buy and what tobuy when he goes out forlunch.
But his Dad thinks Tonymight not be able to makebig decisions about hismoney like keeping it safeand making sure he hasenough for the rest of his life.
His Dad knows that he can’tjust decide that Tony isunable to make decisionsabout his own money.
Under the new law he knowsthat he must support Tony totry to make his owndecisions first.
Deciding about a lot of money
11
Tony's Dad talks to him a fewtimes about keeping hismoney safe and planningwhat to do with it.
He tries to help and supportTony to make a decisionabout his money.
He gives Tony all theinformation he needs usingwords that Tony understandsand his picture cards.
His Dad realises that Tonycan't remember how muchmoney he has and he can’tremember how much thingscost.
12
His Dad decides that at thistime:
Tony can make everyday decisions about his money like what clothes to buy and what to buy when he goes out for lunch.
But
Tony is unable to make some of the big decisions about his money, like keeping it safe and making sure he has enough for the rest of his life.
This does not mean thatTony can never make a bigdecision about his money.Tony's Dad knows that overtime Tony might learn newskills and be able to make abig decision about hismoney.
Tony’s Dad wants to makesure that Tony’s money iskept safe and that he hasenough money for the rest ofhis life.
13
Tony’s Dad thinks it would bebest for Tony, if he lookedafter Tony’s money.Under the new law he mustget permission from theCourt of Protection to dothis.
This is a new court thatmakes decisions about whatis best for people who can’tmake some decisions forthemselves. It also helps tomake sure that they areprotected.
The Court of Protectionthinks carefully about whatTony’s Dad is asking. Theylook at if Tony really needssomeone to look after hismoney for him and if his Dadis the best person to do this.
The court decides that itwould be in Tony’s bestinterests if his Dad looksafter his money for him. Bestinterests is about making adecision that is best for Tony,not about what anyone elsewants.
14
The Court gives Tony’s Dadthe power to make decisionsabout Tony's money. Theymake him a Deputy forTony's property and affairs(his money).
Under the new law, whenTony’s Dad makes bigdecisions about Tony’smoney, he has to think aboutwhat is in Tony’s bestinterests. This meansthinking about what is bestfor Tony and not about whathe or anyone else wants.
15
Under the new law, workingout best interests is veryimportant and there is a bookcalled the Code of Practiceor Code for short, whichgives information on howTony’s Dad should do this.Some people, includingDeputies must pay attentionto what the Code says.
Under the new law thePublic Guardian keeps aneye on Deputies like Tony'sDad making sure that theyare doing their job properly.This is an extra check to helpto make sure that people likeTony and their money areprotected.
The Court of Protectionhas only given Tony's Dadthe power to make bigdecisions about Tony’smoney.
16
This does not mean that hehas powers to make otherdecisions for Tony.
Also, the new law says thatno one, not even Tony's Dad,can make a decision for Tonyabout things like gettingmarried, voting or havingsex.
Only Tony can make thesekinds of decisions and thenew law does not changethis.
17
Tony is happy living at homewith his parents but he isthinking about moving intohis own house one day.
Tony wants to make surethat if he does move out thatthe people who support himknow about the things thatare important to him.
Under the new law Tony canwrite down these things orjust tell someone.
Tony thinks it is better towrite these down so thatthere is a clear record of hiswishes and feelings aboutwhat is important to him.
Supporting Tony to plan ahead for the future
18
Tony finds it hard to write, sohe tells his Mum to writedown:
I am vegetarian and I do not like meat.
I like having a shower not a bath.
SPECIMEN
SPECIMEN
Specimen
19
I like to sleep with the light on so that I can see easily if I have to get up in the night.
When I go to the doctor or dentist I want someone I know well to be with me.
He then signs the list.
20
His Mum puts the list withTony's papers.
She also gives a copy to hissocial worker who puts it onhis care record.
Under the new law anyonewho makes decisions ordoes things for Tony mustthink about his list of wishesand feelings about what isimportant to him.
They must use it to helpthem decide what is in Tony'sbest interests if they haveto make decisions for him.
21
Mrs. Smith’s Story
22
Mrs. Smith has just movedinto Garden Park CareHome.
She is very close to herdaughter Linda who helpedher to choose the home.Linda heard that GardenPark is a good care homeand that the staff will lookafter her mum.
She knows that under thenew law if any of the stafftreated her mum badly, theycould be doing somethingagainst the law.
They could go to court andmaybe even to jail. Thishelps to protect people likeMrs. Smith.
23
If Mrs. Smith cannot make adecision on one day, thisdoes not mean that shewon’t be able to make thiskind of decision tomorrow ornext week.
Mrs. Smith is still able tomake all decisions for herselfbut she is getting ready forthe future when she mightnot be able to makedecisions for herself.
Mrs. Smith is pleased thenew law says she canchoose someone else tomake these decisions for herin the future. This is calledmaking a Lasting Power ofAttorney and the person shechooses is called anAttorney.
Planning for the future
24
Under the new law a personcan only make a LastingPower of Attorney if theyunderstand what it meansand they are still able tomake decisions forthemselves.
Mrs. Smith wants herdaughter, Linda, to be herAttorney and to makedecisions about her propertyand money and also abouther health and welfare. Thismeans making 2 differenttypes of Lasting Power ofAttorney.
25
Mrs. Smith trusts Linda andknows she will makedecisions that are best forher.
She wants Linda to makedecisions for her aboutthings like selling her house,paying bills and looking afterher money (her property andaffairs).
With this type of LastingPower of Attorney, Lindacan start making thesedecisions for her Mum assoon as it is registered.
Linda will be able to makethese kinds of decisionseven though her mum is stillable to make the decisionsfor herself.
1. Deciding about money and property
26
Mrs Smith also wants Lindato be able to make decisionsabout things like her health,having an operation or thekind of place Mrs. Smithshould live in (her personalwelfare).
With this type of LastingPower of Attorney, Lindacan only make these kinds ofdecisions if her mum cannotmake them for herself.
2. Deciding about care and treatment
27
Mrs. Smith needs to fill in aspecial form to set up aLasting Power of Attorney.
She also needs to getsomeone to sign the form tosay that she understandswhat she is doing and thatno one has forced her intosetting it up. Her solicitorsigns this bit.
Mrs. Smith fills in the namesof up to 5 people that shewants to know about herLasting Power of Attorney.Mrs. Smith wants thesepeople to be told about herLasting Power of Attorney.
Next, Mrs. Smith sends theform to the Office of thePublic Guardian along witha cheque for the fee she hasto pay.
Setting up a Lasting Power of Attorney
28
When the Office of thePublic Guardian get Mrs.Smith's forms they tell thepeople that she wanted toknow about her LastingPower of Attorney.
If these people think there isa problem with the LastingPower of Attorney or theAttorney, they can tell theOffice of the PublicGuardian. This helps toprotect people like Mrs.Smith.
The Public Guardian keepsan eye on Attorneys likeLinda making sure that theyare doing their job properly.This is an extra check to helpmake sure that people likeMrs. Smith and their moneyare protected.
29
As an Attorney, Linda has topay attention to the Code ofPractice and she has tothink about what is best forher mum and not whatanyone else thinks or wants.
Mrs. Smith is pleased thatshe can choose Linda to beher Attorney. She thinksLinda knows her better thananyone else and will makedecisions that are best forher and that are not aboutwhat Linda or anyone elsewants.
30
31
Mrs. Anand’s Story
32
Mrs. Anand lives in GardenPark Care Home with Mrs.Smith. She has no familyand is alone.
Mrs. Anand had a stroke afew months ago. The strokehas affected her memoryand how well she makesdecisions.
Before Mrs. Anand had astroke she was once givenmedicine, which made hervery sleepy and confused.She wanted the doctor togive her a different medicineeven though it took herlonger to get better.
Mrs. Anand knew that shecould make a decision abouttreatment or medicine thatshe did not want to be givenin the future (this is called anadvance decision).
Making a decision for the future
33
Mrs. Anand thought carefullyabout making an advancedecision. She knew therewere some strict rules formaking an advancedecision so she spoke toher doctor about this.
Mrs. Anand could write downher advance decision orjust tell someone about it butshe thought it would bebetter to write it down.
Mrs. Anand told the carehome manager about herdecision and asked him toput a copy in her file.
That way she felt that if oneday she got ill and could notmake a decision abouttreatment for herself, shewould not be given themedicine that made her feelsleepy and confused.
Mrs. Anand knows that thedoctor has to respect herdecision but to protect herthere are strict rules thedoctor has to follow.
34
The staff know that they can'tmake decisions for Mrs.Anand just because she isold or ill. They can only makea decision for Mrs. Anand ifshe cannot make thedecision herself.
The staff also must payattention to the Code ofPractice which gives theminformation on how to dotheir job properly.
For the last week Mrs. Anandhas had a very bad cough.The cough is getting worsebut Mrs. Anand keeps onsaying she does not want tosee a doctor.
The care home staff talk toher about this but she doesnot understand why it isimportant for her to see adoctor.
Making a decision for Mrs. Anand
35
The staff decide that shelacks capacity to make herown decision about what todo so they need to make adecision for her.
They know that under thenew law anything they do forMrs. Anand must be in herbest interests.
The new law has a checklistof things that people mustthink about when deciding onbest interests.
The checklist includestalking to Mrs. Anand aboutwhat she wants andspeaking to people whoknow her well, like friendsand other members of staff.
The staff agree that it is inMrs Anand's best intereststo see a doctor.
36
The new law allows staff toask a doctor to see Mrs.Anand but they have to bevery careful when they dothis. They can only do so ifMrs. Anand is not able todecide this for herself andthey think it is in her bestinterests.
The staff also know thatunder the new law justbecause Mrs. Anand can’tmake this decision does notmean that she cannot makeother decisions for herself.
37
Mrs. Anand's care review iscoming up soon. She isgetting weaker. The carehome manager thinks itmight be better for Mrs.Anand if she moved to adifferent home which cangive her more support.
As Mrs. Anand has no closefamily or friends to help her,the care home managerknows Mrs. Anand shouldhave someone independentspeaking up for her. This iscalled an IndependentMental Capacity Advocate,or an IMCA for short.
Getting help and support from anIndependent Mental Capacity Advocate (IMCA)
38
An IMCA is a special type ofadvocate under the new law.People like Mrs. Anand whohave no family or friends tohelp and support them makedecisions can get an IMCA.
An IMCA will speak up forpeople when there aredecisions about seriousmedical treatment or aboutwhere they are going to live.
IMCAs must also payattention to the Code ofPractice.
The IMCA talks to Mrs.Anand and the doctor andalso looks at Mrs. Anand’shealthcare records.
Mrs. Anand tells the IMCAabout her time at GardenPark Care Home.
She talks about the peopleshe has met and talks aboutwhat she does everyday andhow happy she is.
39
The IMCA tells the carehome manager about Mrs.Anand’s feelings.
The care home manager didnot know that Mrs. Anandwas so happy at GardenPark.
The care home manager isstill worried that she mightfall and hurt herself if shestays.
But because of what theIMCA found out, the carehome manager looks intoother options for Mrs. Anandso that she can stay atGarden Park but still get thecare she needs.
40
What the words meanAdvance decision a decision about medical treatment that a person does not want to be given in the future if they cannot make their own decision about the treatment. There are rules for making an advance decision so it is a good idea to talk to someone like a doctor, nurse or support worker if you want to make one.
Attorney someone who has been chosen by a person to make choices and decisions for them. The person does this by making a Lasting Power of Attorney.
Best interests anything done for a person who cannot make decisions for themselves must be in their best interests. This means thinking about what is best for the person and not about what anyone else wants. The new law has a checklist of things that people must think about when deciding on someone's best interests.
41
Care review a meeting where all those involved in a person’s care meet with the person to talk about whether they are getting the help and support they need.
Code of Practice (Code) guidance and information that explains how the Mental Capacity Act works. It tells people how to make sure they are following the new law. Some people – like doctors, nurses, lawyers,
Attorneys and Deputies must pay attention to the
Code of Practice.
Court of Protection the new court which deals with everything to do with the
Mental Capacity Act. The court decides what is best for people who cannot decide for themselves.
42
Deputy a person chosen by theCourt of Protection to make
some decisions for a person who cannot make these decisions for themselves.
Independent Mental someone who speaks up forCapacity Advocate (IMCA) people who have no family or friends. They help when important decisions have to be made by the NHS or local authorities. Decisions can be about things like serious medical treatment or moving to a hospital or care home.
They may become involved in other types of decisions as well.
Lacking capacity is when a person cannot make their own decision about something at a particular time.
This could be because of a stroke or brain injury, a learning disability, mental health problems or things like Alzheimer's.
43
Lasting Power of Attorney is a power a person can give to another person (the
Attorney) to make decisions for them about certain things in the future. A person can only do this if they understand what it means. They can also put limits on the power they give to their
Attorney.
Mental capacity is when a person is able to make their own decision about something at a particular time.
Mental Capacity Act a law about how to support and protect people who cannot make their own decisions because of a problem with the way their mind or brain works. It lets people plan ahead for a time when they may be unable to make their own decisions about some things.
44
Office of the Public supports the PublicGuardian Guardian by:
- Doing the paperwork and keeping a register of Lasting Powers of Attorney and Deputies.
- Keeping an eye onDeputies andAttorneys to make sure
they are doing their job properly.
- Working with the police and social services when they think that someone may have been abused.
Public Guardian the head of the Office of the Public Guardian.
45
To find out more about the MentalCapacity Act and get more copies ofthis booklet:
Telephone:
0845 330 2900
Text phone:
020 7664 7755
Web address:
www.publicguardian.gov.uk
Write to:
Office of the Public GuardianArchway Tower2 Junction RoadLondonN19 5SZ
Email:
Other booklets in this series include:
OPG601 Making decisions...about your health, welfare or finances. Who decides when you can’t?
OPG602 Making decisions: A guide for family, friends and other unpaid carers
OPG603 Making decisions: A guide for people who work in health and social care
OPG604 Making decisions: A guide for advice workers
OPG606 Making decisions: The Independent Mental Capacity Advocate (IMCA) service
Making decisions booklets are available to download at:
www.publicguardian.gov.uk
Making decisions booklets are available in English, Welsh and Braille formats. There is also an Easyread booklet and Easyread Audio version. Contact the Office of the Public Guardian for more information.
The Mental Capacity Implementation Programme published this booklet. It was written by the National Care Association.
OPG605 Making decisions: An Easyread guide (10.07)
© Crown copyright 2007 (2nd edition)
The Mental Capacity Act
