Advocacy and the Mental Capacity Act (2005)

What is the Mental Capacity Act?

The Mental Capacity Act is a new law that will empower and protect people who may lack capacity to make some decisions for themselves.

It will make clear who can take decisions, in which situations and how they should go about doing this.

It also allows for people to plan ahead if they think they may lack capacity in the future.

People may have difficulty making some decisions because they have a learning disability, dementia, a mental health problem, a brain injury or a stroke.

A Code of Practice (PDF, 1.4Mb) that provides more in depth guidance accompanies the Act.

All professionals such as GPs, doctors, social workers and paid carers must have regard to the guidance in the Code of Practice when they are supporting anyone who lacks capacity.

This applies to all health and social care settings, including GP and hospital appointments, social care assessments and reviews.

Key principles of the Mental Capacity Act

There are five key rules or principles that have to be followed by anyone who is supporting or working with a person who may lack capacity:

  1. All adults have the right to make decisions for themselves unless it is shown that they are unable to make it.
  2. People should be supported as much as possible to make their own decisions before anyone concludes that they cannot make their own decisions.
  3. People are allowed to make a decision that may seem to other people to be an unwise or strange decision.
  4. If a person lacks capacity any decisions or actions taken on their behalf must be taken in their best interest
  5. Anything done for or on behalf of people lacking capacity should be the least restrictive of their basic rights and freedoms.

The Act introduces a number of important safeguards to protect people who lack capacity including a requirement to provide an Independent Mental Capacity Advocate (IMCA) service. This must be independent and is in place to help people who lack the capacity to make important decisions about serious medical treatment and/or changes in accommodation.

An advocate must be available to those people who have no family or friends whom it would be appropriate to consult about these decisions.

The type of advocacy that an IMCA would provide is commonly described as non-instructed advocacy. This type of advocacy is used when a person does not have the capacity to appoint an advocate and needs to make an important decision that may affect their future.

It has always been ‘good practice’ to act in a person's best interest but there is now a statutory requirement for all authorities with social care responsibility and health trusts to provide IMCA’s for people who have no family or friends and who need to make important decisions as laid down in the Act.

You can read a summary of Mental Capacity Act. Alternatively, you can read an easy read summary of the Mental Capacity Act.

The IMCA’s are required to provide a report to the person who referred for the service to help them reach a best interest decision about the customer.

Only people who are responsible for making a decision about a person can refer for an IMCA. These people are known as ‘decision makers’ and are likely to be Social Workers, General Practitioners, Consultants, Surgeons and other medical professionals who are responsible for assessing and meeting the needs of customers.

Find out more about the Independent Mental Capacity Advocate in Section 10 of the Code of Practice

More information and downloadable booklets can be found on the Adult Safeguarding web site.