Mental Capacity and Consent Audit - Domiciliary Care

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  • Is there a written policy on mental capacity, consent, and decision-making in line with the Mental Capacity Act (MCA)?
  • Are staff trained in the principles of the MCA and confident in applying them in practice?
  • Do care plans include a record of the individual’s capacity to make specific decisions?
  • Are capacity assessments completed for specific decisions rather than globally?
  • Are mental capacity assessments clearly documented with the decision, time, and assessor identified?
  • Is the least restrictive option considered and recorded when supporting decision-making?
  • Are staff trained to recognise when a person may lack capacity and know how to respond appropriately?
  • Are best interest decisions made in line with MCA principles when a person lacks capacity?
  • Are relevant others (family, advocates, attorneys) involved in best interest decisions as required?
  • Are records of best interest decisions clear, reasoned, and proportionate?
  • Are consent forms completed and signed where appropriate before care or treatment begins?
  • Is consent to care, medication, and sharing information clearly documented and revisited as needed?
  • Are staff aware of who holds Lasting Power of Attorney (LPA) for health and welfare or property and affairs?
  • Are copies of LPA documents held on file and verified as registered with the Office of the Public Guardian?
  • Are staff aware of the difference between LPA and deputyship, and when each applies?
  • Are any restrictions on liberty clearly documented and assessed for compliance with legal frameworks?
  • Are Deprivation of Liberty Safeguards (DoLS) or Liberty Protection Safeguards (LPS) relevant in the home setting identified and flagged?
  • Are staff aware of how to challenge or question decisions that may breach human rights or autonomy?
  • Are service users supported to express their views and wishes, even when capacity fluctuates?
  • Is accessible information (e.g., easy read) used to support understanding and informed consent?
  • Are consent and capacity routinely discussed during care reviews and service changes?
  • Are advance decisions and advance care plans recorded and respected?
  • Is there evidence that service users are supported to take risks when they have capacity to choose?
  • Are concerns about undue influence or coercion explored and recorded appropriately?
  • Is MCA compliance regularly audited and used to inform staff training or policy reviews?
  • Are lessons from incidents involving capacity or consent used to improve future practice?
  • Are managers aware of their responsibilities under the MCA and act as role models for staff?
  • Is documentation of capacity and consent easily accessible and consistently maintained?
  • Do staff seek verbal or written consent before each care task and record it when appropriate?
  • Are care decisions reviewed promptly when there are changes in capacity or circumstances?