Health and social care practitioners’ experiences of assessing mental capacity in a community learning disability team

Ratcliff, Daniel and Chapman, Melanie (2016) Health and social care practitioners’ experiences of assessing mental capacity in a community learning disability team. British Journal of Learning Disabilities, 44 (4). pp. 329-336. ISSN 1354-4187

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Abstract

Accessible summary The Mental Capacity Act says when and how to assess someone's ability to make a decision and how best to support them to do this. Eight workers in community learning disability teams were interviewed about their experiences of assessing people's ability to make decisions. The workers said that there were a number of areas that they felt were important and which helped them to do good assessments. They also said there were some things that they found difficult. We suggest some changes that could be made to help workers when assessing people's ability to make decisions. It is important to help people make decisions for themselves where they can and to help them when they cannot. Abstract Background: The study explored experiences of health and social care practitioners within a community learning disability team in undertaking mental capacity assessments with people with learning disabilities. Materials and Methods: Eight practitioners were interviewed using a semi‐structured interview schedule. Results: The information gained was analysed using thematic network analysis. Twelve basic themes emerged which fit into five organising themes labelled: ‘systemic barriers to assessment’; ‘capacity assessing as a process’; ‘person‐specific challenges’; ‘protective practices’; and ‘protection of a fundamental human right’. A global theme, ‘freedom of action versus restrictions on action’, was identified. Conclusions: The themes highlighted that there were a range of organisational, systemic and person‐specific factors that impacted on the perceived quality of and assessors’ confidence in their assessments of mental capacity. Furthermore, these factors appeared to create a range of tensions for assessors increasing the likelihood of cognitive dissonance. Practice implications surround maintaining knowledge, ensuring adequate skills in the practical application of knowledge and reducing organisational barriers.