Mental Capacity and Consent Audit - Care Homes

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