Do you meet CQC’s requirements?
- Do all of your staff know how to apply the MCA in practice?
- Could all of your staff talk competently to a CQC inspector about the principles of the MCA and how they apply to particular service users in their care?
- Are all decisions made under the MCA correctly recorded in care plans?
- Do relatives of your service users understand their role in decision-making under the MCA?
- Do you know what CQC require in order to judge your organisation compliant with the MCA at an inspection?
Compliance with the MCA is a current hot topic for both CQC and local authority inspectors and one of the areas that is coming under regular scrutiny during inspections. In the past few months, we have seen a number of recent inspection reports highlight non-compliance with the MCA, and, in some cases, warning notices have been issued.
These are some of the criticisms we have seen in reports:
- Whilst the majority of providers have arranged the requisite MCA staff training, staff find it difficult to apply the principles they have learned to real situations.
- Staff are not able to talk knowledgeably to inspectors about how they apply the MCA in their day-to-day roles.
- Decisions are not always recorded and reviewed and care plans do not always document the service user’s past and present wishes, feelings, beliefs and values.
- Parents and relatives of service users, particularly those who have never had capacity, do not always understand the process of decision-making under the MCA and their role within it. This can cause conflict between relatives and staff, particularly where staff do not fully understand the MCA themselves.
- Mental Capacity/DOLS policies are not up-to-date.
In 2011, CQC issued Guidance on the MCA, which detailed what they expect to see during an inspection. All staff, whatever their seniority, must understand the five key principles of the MCA and be able to talk about them. CQC do not expect the same level of experience/knowledge from all staff but they will expect staff to be conversant with the principles. CQC Guidance indicates that it expects all staff to understand the “best interests checklist”, when assessments are needed, the role of IMCAs, the Court of Protection, the Office of the Public Guardian, LPAs and DOLS.