Mental Capacity and Consent Audit - Care Homes
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- Q1: Is there a clear policy on consent and mental capacity in line with the Mental Capacity Act 2005?
- Q2: Are staff trained in the five core principles of the Mental Capacity Act and how to apply them in care settings?
- Q3: Are capacity assessments completed for specific decisions, not assumed or applied globally?
- Q4: Is each capacity assessment clearly documented with the decision, time, person assessing, and rationale?
- Q5: Are best interest decisions recorded when capacity is lacking, with clear evidence of who was involved?
- Q6: Is the least restrictive option considered in all best interest decisions and documented accordingly?
- Q7: Are residents supported to make their own decisions wherever possible, using communication aids or extra time if needed?
- Q8: Are mental capacity assessments reviewed periodically and updated when circumstances change?
- Q9: Are Deprivation of Liberty Safeguards (DoLS) applications submitted when appropriate and kept up to date?
- Q10: Are residents with DoLS authorisations reviewed regularly to ensure they still meet criteria?
- Q11: Are staff aware of the difference between lawful care restrictions and unauthorised deprivation of liberty?
- Q12: Do care plans include details of residents' capacity and consent status for various care decisions?
- Q13: Are consent forms signed and stored for care, medication, photographs, digital records, and outings?
- Q14: Is consent revisited periodically, especially after changes in condition or medication?
- Q15: Do staff routinely ask for verbal or implied consent before delivering care tasks?
- Q16: Are decisions about the use of CCTV, bedrails, or tracking devices based on assessed need and consent or best interest?
- Q17: Are LPAs (Lasting Powers of Attorney) for health and welfare clearly documented and verified?
- Q18: Is there a record of any court-appointed deputies involved in the resident’s decision-making?
- Q19: Are staff aware of when to escalate concerns about undue influence, coercion, or potential safeguarding related to decision-making?
- Q20: Are advanced care plans and DNACPR decisions supported by appropriate mental capacity documentation?
- Q21: Do residents receive information in accessible formats to support informed decision-making?
- Q22: Are residents involved in decision-making as much as possible, even when capacity is limited?
- Q23: Are families and advocates involved appropriately, with the resident’s wishes remaining central to the process?
- Q24: Are consent and capacity discussed in team meetings, supervisions, or handovers where necessary?
- Q25: Are MCA principles evident in daily care practices, especially for residents with dementia or cognitive impairment?
- Q26: Is there a monitoring system to ensure that all staff follow capacity and consent procedures correctly?
- Q27: Are external professionals (e.g., social workers, GPs) consulted where required for complex decisions?
- Q28: Is there a process for escalating or reviewing disputes about best interest decisions?
- Q29: Are records of mental capacity and consent stored securely and accessible to authorised staff?
- Q30: Are capacity and consent included in the service’s routine audit and governance processes?