Adults with Incapacity, Capacity and Consent Audit - Care Homes

Q1 | Unanswered

Is there a current policy and staff guidance for capacity, consent and Adults with Incapacity (Scotland) Act 2000 practice that reflects Scottish law, codes of practice and the needs of people living in the home?

Q2 | Unanswered

Do staff understand that adults are presumed capable of making their own decisions unless there is evidence of incapacity in relation to the specific decision at the time it is needed?

Q3 | Unanswered

Are people given every practical support to understand, communicate and make their own decisions, including accessible information, extra time, familiar staff, interpreters, hearing or visual aids and an appropriate setting?

Q4 | Unanswered

Are capacity assessments decision-specific, proportionate and recorded with the decision, relevant information, support offered, assessment findings, conclusion, assessor and review arrangements?

Q5 | Unanswered

Are fluctuations in a person's capacity recognised, with important decisions revisited at the best time and assumptions avoided because of diagnosis, age, communication difficulty or an unwise decision?

Q6 | Unanswered

Do staff seek consent before everyday care, personal care, medication support, photography, information sharing, activities, monitoring and other interventions, and respond respectfully to refusal or changed views?

Q7 | Unanswered

Are consent arrangements and any decision-specific capacity assessments reflected accurately in the personal plan and followed consistently in daily practice?

Q8 | Unanswered

Where a person lacks capacity for a decision, is there evidence that any action or intervention will benefit them and that the benefit cannot reasonably be achieved without it?

Q9 | Unanswered

Where intervention is necessary, is the option chosen demonstrably the least restrictive of the person's freedom while still achieving its purpose?

Q10 | Unanswered

Are the person's past and present wishes, feelings, values, beliefs and preferences sought and taken into account when decisions are made on their behalf?

Q11 | Unanswered

Are relevant people consulted before significant decisions, including the person, nearest relative where appropriate, primary carer, named person, welfare attorney, guardian, advocate and professionals with relevant knowledge?

Q12 | Unanswered

Are welfare powers of attorney, guardianship orders and intervention orders verified against the relevant documentation, recorded accurately and used only within the powers they grant?

Q13 | Unanswered

Are people supported to access independent advocacy when this would help them participate in decisions, express their views or challenge an intervention?

Q14 | Unanswered

Are decisions about residence, care arrangements, significant changes in support or restrictions escalated to the appropriate social work, legal or healthcare professionals when authority or consent is unclear?

Q15 | Unanswered

Where medical treatment is proposed for a person who may lack capacity, are decisions made by the appropriate healthcare practitioner under the correct legal authority, with relevant proxies involved as required?

Q16 | Unanswered

Are medication decisions, including covert medication and PRN medicines, supported by individual assessment, lawful authority, professional advice, clear recording and regular review?

Q17 | Unanswered

Are decisions about personal finances, property, spending, benefits and possessions made only by people with relevant authority, with transparent records and safeguards against financial harm?

Q18 | Unanswered

Are restrictions such as locked doors, bed rails, sensor equipment, surveillance, contact limitations or restraint individually assessed for capacity, consent, benefit, necessity, proportionality and least-restrictive practice?

Q19 | Unanswered

Are restrictive interventions and capacity-related decisions reviewed regularly and promptly after a change in circumstances, risk, health, wishes or legal authority?

Q20 | Unanswered

Where Adult Support and Protection, mental health, adult-with-incapacity or other legal frameworks may apply, do staff seek appropriate advice and avoid using one framework as a substitute for another?

Q21 | Unanswered

Do personal plans, risk assessments, daily notes and handovers give staff clear, respectful guidance on how to support each person's decision-making, consent and lawful safeguards?

Q22 | Unanswered

Are staff trained, supervised and assessed as competent in capacity and consent practice, including communication support, the principles of the 2000 Act, escalation and accurate recording?

Q23 | Unanswered

Do staff understand that a person's disagreement, refusal, risky choice, communication style or diagnosis does not by itself establish incapacity, and can they explain the correct response?

Q24 | Unanswered

Are disagreements about capacity, best interests, welfare powers, care arrangements or restrictions identified early, recorded clearly and escalated through appropriate professional or legal routes?

Q25 | Unanswered

Are people and their representatives given clear, accessible information about decision-making arrangements, their rights, available support and how to raise a concern or seek review?

Q26 | Unanswered

Are capacity, consent and legal-authority records secure, current, available to authorised staff when needed and audited for quality, accuracy and timely review?

Q27 | Unanswered

Do audits, incidents, complaints, safeguarding concerns and feedback identify capacity or consent issues, lead to improvement actions and check that changes have improved practice?

Q28 | Unanswered

Can the service demonstrate that its Adults with Incapacity, capacity and consent practice protects people while maximising their voice, autonomy, rights, dignity, wellbeing and control over their lives?