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There is a new law that can help - The Mental Capacity Act 2005

Making decisions

A guide for family, friends and other

unpaid carers

Helping people who are unable to make some decisions for themselves

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A guide for family, friends and other unpaid carers

Making decisions

A guide for family, friends

and other unpaid carers

Helping people who are unable to make

some decisions for themselves

This booklet provides information on the Mental Capacity Act 2005 and how it will affect you.

It is not a statutory Code of Practice issued under the Mental Capacity Act 2005

and is not a guide to how the law will apply to speciﬁc situations.

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This document has been produced by:

In association with the Making Decisions Alliance, including:

A guide for family, friends and other unpaid carers

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Acknowledgements

The Mental Capacity Implementation Programme (MCIP) published

this booklet. MCIP is a joint government programme between the

Department for Constitutional Affairs, the Department of Health, the

Public Guardianship Ofﬁce and the Welsh Assembly Government

that has been established to implement the organisation, process

and procedures to launch the Mental Capacity Act in 2007.

We are very grateful to the team from the Making Decisions

Alliance who wrote this booklet. In particular, Sue Brown, Head of

Campaigns and Public Policy at Sense and Andrew Chidgey, Head

of Policy and Campaigns at the Alzheimer’s Society who wrote this

booklet with support from Pauline Thompson, Policy Adviser at Age

Concern and Richard Kramer, Director of Policy at Turning Point.

We are also very grateful to our Advisory Group which was made up

of organisations who work with or represent family and other unpaid

carers of people who lack the capacity to make some decisions for

themselves. They played an important role in sharing their views and

perspectives on the booklet and helped us to reﬂect on our work.

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Contents

1 Introduction 6

About this booklet 6

2 Why do I need to know about the Mental Capacity Act? 8

3 What is mental capacity? 10

4 What are the key principles of the new Act? 11

5 Who decides if someone has capacity? 13

How could I be involved in assessing capacity? 13

How might I help a person to make a decision for themselves? 14

When might a person’s capacity change? 14

What is a reasonable belief? 15

6 What happens if a person does lack capacity to make

the decision for themselves? 16

How do I decide on best interests? 17

Providing care for a person who lacks capacity 18

The use of restraint 19

7 When should I expect to be consulted? 20

8 What is a Lasting Power of Attorney (LPA)? 22

How will attorneys be appointed? 23

What are attorneys expected to do? 24

Personal welfare attorneys 24

Property and affairs attorneys 25

What happens if I am already the EPA attorney for the

person I care for? 26

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9 What is the role of a Deputy? 27

How do I become a deputy? 28

What do I have to do if I am already a receiver for someone? 28

10 What will the Court of Protection do? 29

11 What will the Ofﬁce of the Public Guardian do? 31

12 What are advance decisions to refuse treatment? 32

What are the rules about advance decisions to

refuse treatment? 32

What are the rules about advance decisions to refuse

life-sustaining treatment? 33

What if the person I care for already has an advance decision

(or ‘living will’)? 34

Where can I get more information on advance decisions? 34

13 Wishes and feelings and requests for treatment and care 35

14 Protecting people who lack capacity from ill-treatment

or neglect 36

15 Research 37

16 Complaints, disputes and challenging decisions 38

17 Further sources of information and guidance 39

18 Some useful contacts 40

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1. Introduction

About this booklet

The purpose of this booklet is to tell you about a new law called the

Mental Capacity Act which is expected to come into force on

1 April 2007. The booklet is for anyone who helps to care for

someone over 16 who is unable to make some or all decisions.

The inability to make a decision could be because of a brain injury

or stroke, dementia, learning disability, mental health problems,

alcohol or drug misuse, the side effects of medical treatment or any

other illness or disability.

The person you care for may lack capacity to make decisions about

money, health and other matters. You may need to help them to

make those decisions or you may have to take action or make

decisions on their behalf. The Mental Capacity Act sets out what

should happen when someone lacks capacity to make decisions.

This booklet explains:

• what the Act says about mental capacity

• how to decide if a person lacks capacity to make a decision

• how you can help a person plan in advance for what would

happen if they lack capacity to make decisions in the future

• what will happen if a person can’t make a particular decision

• how you can help a person make their own decisions

• on what basis you would take actions on behalf of a person

who lacks capacity

• the role of family and friends when professionals are involved

• what to do if you think the Act is not being followed

• how the Code of Practice for the Mental Capacity Act will help

you.

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This booklet is not about detention or compulsory treatment under

the Mental Health Act 1983. The 1983 Act is primarily about people

who are diagnosed as having a mental health problem which

requires that they be detained or treated in the interests of their own

health or safety or with a view to protecting other people.

The information in this booklet relates only to England and Wales

and unless speciﬁed, to people over the age of 16.

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2. Why do I need to know about the

Mental Capacity Act?

The Mental Capacity Act will be relevant to anyone who has a

relative or friend who may lack capacity.

• It will clarify the process for caring for people who may lack

capacity.

• It will clarify how decisions should be made for your relative or

friend if they are unable to make those decisions for themselves.

• It sets out when you should be consulted about decisions made

on behalf of your relative or friend.

• It sets out how your relative or friend is protected when others

are making decisions on their behalf.

The Act applies whenever decisions are being made on behalf

of a person who lacks capacity to make a particular decision

for themselves. This includes any assessment of their need for

treatment, services or support. The Act will provide a clearer legal

framework for dealing with mental capacity issues. It includes some

new measures and safeguards and incorporates existing best

practice.

However, there are certain decisions which the Mental Capacity Act

does not allow anyone to make on behalf of a person who lacks

capacity. This is because the decisions or actions are either so

personal to the individual concerned or because they are governed

by other legislation. This includes decisions in areas such as

marriage or civil partnership, divorce, sexual relationships, adoption

and voting.

The Act will be accompanied by a Code of Practice which provides

guidance as to how it should work on a day-to-day basis. The Code

explains in more detail what the key features of the legislation are

and some of the practical steps that people using and interpreting

the new law will need to take into consideration. Certain people

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have to have regard to the Code, including professionals, attorneys,

deputies, paid carers and researchers. You may also ﬁnd the Code

provides useful guidance in relation to the Act. If you are also an

attorney (see part 8 of this booklet) or a deputy (see part 9) for the

person you care for you will have to have regard to the Code.

If you want to know more detail about the Mental Capacity Act you

can get the Code of Practice for free by downloading it from the

DCA website at: www.dca.gov.uk/legal-policy/mental-capacity

There will also be details of how you can order a hard copy of the

Code of Practice on the website.

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3. What is Mental Capacity

If you have mental capacity, it means that you are able to make your

own decisions. The legal deﬁnition says that someone who lacks

capacity cannot do one or more of the following four things:

• Understand information given to them.

• Retain that information long enough to be able to make a decision.

• Weigh up the information available to make a decision.

• Communicate their decision.

We all have problems making decisions from time to time, but

the Mental Capacity Act is about more than that. It is speciﬁcally

designed to cover situations where someone is unable to make a

decision because their mind or brain is affected, for instance, by

illness or disability, or the effects of drugs or alcohol.

A lack of mental capacity could be due to:

• a stroke or brain injury

• a mental health problem

• dementia

• a learning disability

• confusion, drowsiness or unconsciousness because of an

illness or the treatment for it

• substance misuse.

In all of these instances the person may lack capacity to make

particular decisions at particular times. It does not necessarily mean

that they lack all capacity to make any decisions at all. A person

with a learning disability may lack the capacity to make major

decisions but this does not necessarily mean that they cannot

decide what to eat, wear and do each day. A person with mental

health problems may be unable to make decisions when they are

unwell, but able to make them when they are well.

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4. What are the key principles of the new Act?

There is a lot of detail in the new law but there are some key

principles that are important to understand.

1 All adults are legally able to make a decision for themselves

unless it can be shown that they are unable to make it. This

means that people must not assume that someone cannot

make decisions for themselves just because they have a

particular medical condition or disability, or because they are of

a particular age or appearance.

2 Everyone should be given all the help and support they need

to make a decision before anyone concludes that they cannot

make their own decisions. This means that everyone helping

to care for someone must make an effort to provide all the

necessary information in a way the person can understand

and then make it easy for them to try and explain what

their preferences are. This may be through different ways of

communicating; for example, it may be easier for a person with

learning disabilities to understand something presented with

pictures, photographs, videos or tapes. A deaf person may

need the information explained using sign language.

3 People are allowed to make what we might think is an unwise

or eccentric decision. We cannot say because we think the

decision is unwise that the person does not have the capacity

to make the decision. Many people make unwise decisions

but this alone does not mean that they lack capacity to make

decisions for themselves.

4 Any actions taken or decisions made on behalf of someone

who lacks capacity must be done in their best interests, after

considering what is known about their preferences (unless they

have made a relevant and valid advance decision to refuse

medical treatment - see part 12). It is still important to involve

the person wherever possible in making the decision.

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5 The ﬁnal principle of the Act is to make sure that people who

lack capacity are not restricted unnecessarily. So if there are

a range of options open to someone making the decision or

acting for someone who lacks capacity, anything done for or on

behalf of that person must be the option which least restricts

the person’s freedom and rights.

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5. Who decides if someone has capacity?

Anyone in a position where they might need to make a decision

for someone who may lack capacity must decide whether that

person is able to make the decision on their own. In many cases

that decision will be your responsibility. There will be times when

a professional will need to make a decision about the person’s

capacity. The Act says that before you, or anyone else, acts on

behalf of someone else they must have a ‘reasonable belief’ that the

person lacks capacity to make the decision for themselves.

Anyone - a health or care professional, other professional, relative

or carer – might need to decide if a person has the capacity to

make a particular decision.

How could I be involved in assessing capacity?

You may be involved in assessing capacity in two ways:

1 A professional may consult you about the person’s capacity.

For instance the person you are caring for might need to have

an operation. The doctor might be unsure if the person has the

capacity to consent to this. Often family members and those

close to a person can provide valuable information to help

assess a person’s capacity and help explain things in a way the

person can understand.

2 You may need to assess the capacity of the person because

you need to do something in order to care for them. You are not

expected to be an expert in assessing capacity, but you have to

have a ‘reasonable belief’ that they lack mental capacity.

You will need to think about:

• Do they have a general understanding of what decision

needs to be made?

• Do they have a general understanding of the consequences

of this decision?

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• Can they weigh up this information and use it to make a

decision?

• Is there any way you could help them to make the decision

for themselves?

• Is there any way you can help them communicate their

decision or their wishes and feelings?

You will need to think about this for ‘big’ decisions such as where to

live, and for everyday decisions about what to eat or what to wear.

Just because the person makes a different decision from the one

you would make or a decision you consider to be unwise does not

mean that they lack capacity to make that decision.

How might I help a person to make a decision for themselves?

Sometimes people ﬁnd it difﬁcult to make a decision, but they

do have capacity to make it with support. You may need to take

a bit more time to explain the information. The person may need

support with communication or information, such as an interpreter

or information in Braille or pictures. In some cases an independent

advocate, or other professional, may be able to help. For instance

if the person you care for has communication difﬁculties it may

be useful to consult a speech and language therapist; or if the

person has been diagnosed with a particular condition it may be a

good idea to get an opinion from a specialist like a psychologist or

psychiatrist, or community learning disability nurse who is familiar

with caring for people with that condition.

When might a person’s capacity change?

The Act recognises that someone’s mental condition and thus their

ability to make decisions can change. For instance, the capacity of

a person with dementia may deteriorate, so that they lack capacity

to make decisions they used to be able to make for themselves. A

person with a learning disability may learn new skills and gain new

understanding so that they are now able to make decisions they

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could not make before. A person with mental health problems may

have capacity on one day but not the next. So an assessment of

capacity will not be ﬁxed. You will need to be aware of this if you

provide care to someone over a period of time.

What is a reasonable belief?

The Act says that you must have a reasonable belief that a person

lacks capacity to make the decision before you can act on their

behalf. The word reasonable is important. Capacity can change,

and a person can have capacity to make one decision and not

another. You will need to decide what is a reasonable way to take

account of this. For instance, if the person you are caring for has a

condition that does not ﬂuctuate, you might need to regularly make

similar decisions on their behalf, such as what they should wear

each day. If someone has a constant or degenerative condition,

however, it might not be reasonable to expect you to make a new

assessment every morning before helping the person to dress.

However, over time you would need to remember that they may

learn new skills and gain the capacity to decide what they should

wear.

Example:

Mary cares for her son, Michael, who is 24, has a learning

disability and is deafblind. Michael ﬁnds it very difﬁcult to

understand that he can make choices. As far as Mary can tell,

he is not able to make decisions for himself. Michael attends

a specialist day service ﬁve days per week and staff there are

working to teach him about making choices. Mary knows that,

given time, Michael will learn that he can make choices and that

when he does, she will need to support him to make his own

decisions. She regularly talks to the day service staff about this.

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6. What happens if a person does lack capacity

to make the decision for themselves?

If a person does not have capacity to make the decision for

themselves, then others will have to act in their best interests. Some

people plan ahead and may have written an advance decision

where they speciﬁed what sort of treatment they would not want

to receive (see part 12). Or they may have stated what sort of care

of treatment they are willing to receive (see part 13). Or they may

have appointed an attorney (see part 8) to make certain decisions

on their behalf. Sometimes the Court of Protection will appoint a

person to make decisions on their behalf: a ‘receiver’ under the old

law or a ‘deputy’ under the new Act (see parts 9 and 10).

If there is no relevant attorney or deputy with the necessary

authority to make the decision in question someone else will have to

decide what should happen. Depending on the particular decision,

this could be you, or a professional. Whoever makes the decision

must make it in the person’s best interests and in accordance with

the principles of the Act (see part 4).

A decision might be needed on a wide range of caring actions

such as diagnostic tests and examinations, medical procedures

and nursing care and decisions about where someone lives or

what services they need. It also includes care such as assistance

with washing, dressing, eating or mobility carried out by you or by

professionals.

When providing care, the carer or professional must have:

• assessed that the person lacks capacity

• assessed that the action they take is in the person’s best

interests.

Professionals should normally record how they made this

assessment in the person’s health record.

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Example:

Hirut has a medical condition and her doctor feels that a blood

test is needed to establish the most appropriate course of

treatment. The doctor needs her consent to take a blood sample.

Without her consent, the action could be illegal. But Hirut has

a learning disability and after discussing it with her, the doctor

concludes that she lacks the capacity to consent, because she

does not understand what might happen if she does not have the

test. Her doctor knows that he can lawfully take blood without her

consent provided he reasonably believes that Hirut lacks capacity

and that taking the blood is in her best interests.

How do I decide on best interests?

Anything done to or on behalf of someone who lacks capacity to

make the decision for themselves must be in their best interests.

The Act gives a non-exhaustive list of what you need to think about

when working out what is in a person’s best interests. This includes:

• Will the person regain capacity and be able to make the

decision? If so, could the decision be delayed to allow this?

• As far as possible the person must be involved in any act or

decision.

• If the decision is about life-sustaining treatment, the decision

must not be motivated by a desire to bring about the person’s

death.

• The wishes and feelings of the person. This includes, any

views they have expressed in the past, which would help to

understand what their wishes, and feelings might be. This might

be things they have written down, said to other people, or how

they have behaved in similar circumstances in the past.

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• Any beliefs or values they have that might inﬂuence the

decision. This might include religious beliefs, cultural

background or moral views.

• Any other factors they would be likely to consider if they were

able to do so.

To do this, whoever is assessing what is in the person’s best

interests will have to consult with carers and anyone with an interest

in their welfare. They will also have to consult anyone who the

person concerned said should be consulted, and any attorney or

deputy that has been appointed. Whoever is making the decision

will then have to weigh up all the factors to decide what is in the

person’s best interests.

Providing care for a person who lacks capacity

You may need to assess what is in a person’s best interests when

you need to carry out care for them. The new Act offers reassurance

that you will not be liable for your action provided you have a

reasonable belief that the person lacks capacity and that the action

you are taking is in the best interests of the person who lacks

capacity. You should be clear about why you have made these

decisions or taken these actions. If there may be disagreement about

what is in the person’s best interests, for example if family members

disagree about what should happen, you might want to keep a note

of your decisions and why you made the decisions you did.

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Example:

Peter is a young man who was studying at college until he was

involved in a road accident and suffered a brain injury. He now

lacks capacity to make any signiﬁcant decisions about managing

his money. The Court of Protection has appointed his father as

his deputy so that he can invest the compensation that Peter has

received. Peter’s father knows that his son had very strong ethical

objections to the actions of certain multi-national companies.

He therefore picks an ethical investment fund. Even though he

disagrees with his son’s views, he takes account of them when

determining what is in Peter’s best interests.

The use of restraint

The Act allows you to legally carry out caring actions provided that

you have assessed they are in the best interests of the person who

lacks capacity. For example, going into someone’s home without

their permission to clean if for them or helping the person you care

for to bath or dress.

However, where there are several different effective options available

to you or a professional who is providing care or treatment, the Act

says that you must use the one which is least restrictive.

Sometimes it is necessary to physically restrain a person. The Act

allows this but only if it is necessary to prevent the person coming

to harm. For example, you may prevent the person you are caring

for from stepping out into the middle of a busy road, if that person

lacks capacity to understand the danger posed by trafﬁc.

However, any restraint has to be reasonable and in proportion to

the potential harm. You might prevent a person from going out

alone because they cannot cross roads safely, but it would be

unreasonable for you to completely stop them from going outdoors to

protect them from road trafﬁc as this could amount to a deprivation

of their liberty which is not permitted under the Mental Capacity Act.

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7. When should I expect to be consulted?

The Act introduces a new requirement to consult anyone caring for

the person or interested in their welfare (for example family, friends

and unpaid carers) when deciding on best interests. Any person

making a best interests assessment will have to consult anyone

caring for the person or interested in their welfare. This will include

family members even if they no longer provide much direct care but

are still clearly interested in the welfare of their relative. It might also

include close friends.

There may be times when it is not practical and appropriate for the

decision-maker to consult close family and friends, for example, in an

emergency situation it may not be possible to do so. So whether you

are consulted will depend on what sort of decision needs to be made

and the circumstances as the decision-maker assesses them. But

when it is practical and appropriate you will have to be consulted.

This will not mean that you are making the decision, and you should

not be asked to give consent on behalf of another person.

You should be asked what you think would be in the person’s

best interests and whether you can give any information about

the person’s wishes, feelings, values or beliefs. You should not be

asked what you would do in similar circumstances. The person

deciding on best interests must take account of what you say but

they will have to balance what you say with other information to

make their ﬁnal decision.

Example:

John has dementia. His doctor has suggested that he should

have an operation to remove a cataract. John is no longer able

to remember facts for more than a few seconds, often asking

the same questions over and over again. It is clear that he is not

able to make a decision about the operation. He therefore lacks

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capacity to consent or refuse the treatment offered, and so a

decision has to be made on the basis of his ‘best interests’.

John’s wife is on holiday and his son comes with him to the

appointment. Since the operation is not an emergency, the doctor

decides that it is appropriate to wait until he can consult John’s

wife and a carer from the respite care home as well as his son.

They are able to tell the doctor that in the past John has had

no hesitation about consenting to anaesthetic or sedation. He

also still enjoys watching sport on television, and his cataract is

signiﬁcantly affecting his ability to do this. However he does get

very distressed if he wakes up in an unfamiliar environment, and

John’s wife is concerned that he will ﬁnd the whole experience

deeply distressing, especially if it involves a hospital stay.

The family, doctor and care worker all agree that a cataract

operation will signiﬁcantly improve John’s quality of life and

is in his best interests. It is agreed that John should have the

operation as day surgery, with John’s wife able to be with him the

whole time to provide reassurance.

In most situations, people who lack capacity will have support from

family members or friends, or from a deputy or attorney. However,

the Act creates an Independent Mental Capacity Advocate (IMCA)

service for cases where there are no family or friends that can be

consulted for decisions about serious medical treatment or changes

in accommodation, for example moving to a hospital or care home.

In England Local Authorities and the NHS can also extend the IMCA

service to care reviews where they are satisﬁed that an IMCA would

provide particular beneﬁt. They can also extend the IMCA service

to adult protection procedures whether or not the person who lacks

capacity has family or friends. In Wales, Local Health Boards and

Local Authorities will be able to extend the IMCA service to care

reviews and adult protection procedures if the National Assembly

for Wales approves this.

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8. What is lasting power of Attorney (LPA)?

The new Act will allow people 18 and over to choose and appoint

someone to make their health, welfare and/or ﬁnancial decisions

if in the future they lack capacity to make these decisions for

themselves. This person is called an attorney and is appointed by a

formal document called a Lasting Power of Attorney (LPA).

There are two different types of LPA:

1 A personal welfare LPA is for decisions about both health

and personal welfare, such as were to live, day-to-day care or

having medical treatment.

2 A property and affairs LPA is for decisions about ﬁnances, such

as selling the donor’s house or managing their bank account.

The person making an LPA is called the donor.

The person/people who the donor chooses to act on their behalf is

called the attorney(s).

An attorney is appointed to make decisions as if they were the

donor themselves. It is very different from being consulted by

professionals, as in the end, where the LPA has given the power to

the attorney, those decisions will rest with the attorney. Attorneys

must act in the donor’s best interests (see part 6) and follow the

Code of Practice (see part 2).

The donor will be able to choose:

• the same person to be their personal welfare and property and

affairs attorney

• different people for making different decisions relating to their

personal welfare or ﬁnance

• only a personal welfare attorney

• only a property and affairs attorney.

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The donor will also be able to specify whether their attorney can

only make some decisions on their behalf. For instance a donor

might want an attorney to make welfare decisions such as where he

or she should live and about his care, but not medical decisions.

How will attorneys be appointed?

When the Mental Capacity Act comes into force, if the person you

are caring for has capacity to understand what it means to appoint

an attorney, they can choose one or more people to make decisions

on their behalf in the future, should they become unable to do this

for themselves. As a relative, friend or other unpaid carer, you may

be appointed as an attorney.

To appoint an attorney or attorneys the person will be able to get

a special form from the Ofﬁce of the Public Guardian (OPG) (see

part 11), or stationers that provide legal packs. The form will have

guidance on how to complete it and will also explain how the donor

can place limits on what the attorney can do.

The most important thing is that the donor must be able to

understand what it means to appoint an attorney and to be able

to choose for themselves who they want to make decisions for

them in the future. When completing the form they will also be

able to choose who they want to be notiﬁed when the LPA is being

registered. This does not have to be family members; it is up to the

donor to choose. A certiﬁcate will also have to be signed to say that

the donor understood what they were doing when signing the form

and that there was no fraud or undue pressure on them when the

LPA was being created.

If the person you care for no longer understands what it means to

appoint an attorney then you might need to consider applying to

the Court of Protection in order to be granted permission to make

decisions on their behalf as a deputy (see part 9).

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What are attorneys expected to do?

Before an LPA can be used, it must be registered with the Ofﬁce

of the Public Guardian. The donor could choose to register it as

soon as the forms have all been completed, or the donor can leave

the LPA unregistered until it is needed, at which point the attorney

must register it. At registration of the LPA, people chosen by the

donor and listed on the form must be notiﬁed. If the LPA is for

health and welfare decisions, the donor might wish to consider early

registration so it could be used in an emergency.

There will be a fee for registration.

Agreeing to become an attorney means you will take on an

important role as the attorney will be able to make decisions on

behalf of the donor. Every attorney will have a duty of care and

must follow the principles in the Act (explained in part 4). They will

also have a legal duty to follow what is in the Code of Practice (see

part 2) which has been written to help professionals, paid carers,

deputies and attorneys know how the Act will work in practice.

All decisions made by attorneys and any actions they take must

be in the donor’s best interests. If there is more than one attorney

appointed jointly they will need to consult with each other to work

out what is in the donor’s best interests.

Personal welfare attorneys

A personal welfare attorney can only use the LPA once it has been

registered and only when the donor is unable to make a particular

health or welfare decision themselves. The decisions an attorney

can make will depend on whether the donor has included any

restrictions on the LPA form. If the donor wants the attorney to be

able to make decisions about life-sustaining treatment they will

need to speciﬁcally provide for this in the LPA form. The attorney

cannot make ﬁnancial decisions unless they have also been

appointed as a ﬁnancial attorney.

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Example:

Jean is in the early stages of Alzheimer’s disease. She appoints

her daughter as welfare attorney to make any personal welfare

decisions that she loses capacity to make herself. She talks to

her daughter about things which are important to her such as

wanting to stay near her friends, or to be able to go into a care

home that allows pets. If her daughter has at some time to make

decisions using the registered LPA, about where her mother

should live, she is able to take account of the things her mother

has stated when looking at her best interests.

Property and affairs attorneys

A property and affairs LPA could be used at any time after it is

registered, unless the donor has said that it must not be used whilst

they have the capacity to manage their own ﬁnances. Some people

want their attorneys to take over the management of their ﬁnances

even though they can still manage themselves. For instance, they

may want their attorney to take on managing their bank accounts

and dealing with their bills because they do not like dealing with

money. Others may want their ﬁnance LPA used only when they

lack capacity make decisions for themselves.

Unless the donor has placed any restrictions on the form then the

attorney will be able to sign cheques, operate bank accounts, make

investments and buy and sell property in the person’s best interests.

The attorney will have to keep the person’s money separate from

their own, and be able to produce detailed accounts should he/she

be asked to do so by the Ofﬁce of the Public Guardian (see part

11). Attorneys cannot make any decisions about health and welfare

unless they are also a welfare attorney.

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What happens if I am already the EPA attorney for the person

I care for?

There is already a system for people to appoint attorneys for

ﬁnancial matters called an Enduring Power of Attorney (EPA).

Existing EPAs will still be valid and can be registered after the

Mental Capacity Act comes into force although new ones cannot be

drawn up after this time.

If you are already an attorney and the EPA has been registered

because the donor can no longer make their own ﬁnancial decisions

then you just carry on as before. You might ﬁnd the Code of

Practice (see part 2) and the principles of the Mental Capacity Act

(see part 4) helpful. You are already expected to act in the donor’s

best interests.

If the EPA has not been registered because the donor is still able

to make their own decisions, then after the Act comes into force a

donor can:

• destroy the EPA and make a ﬁnance and property LPA

• keep the EPA for ﬁnance decisions

• in either case make a separate LPA for welfare decisions if they

wish to.

If a donor decides to keep the EPA for their ﬁnance decisions the

attorney can continue to use it unregistered unless it has been

speciﬁed that it is only to be used if they no longer have capacity.

If at some future date they are no longer able to make ﬁnancial

decisions for themselves then the attorney will need to register

the EPA at that time. The same procedures that apply to EPAs will

continue as now.

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9. What is the role of a Deputy?

Deputies replace the current system of Court-appointed receivers

to deal with property and affairs of someone who lacks capacity,

but in future deputies could also be appointed to deal with personal

welfare decisions.

If it is necessary to give someone continuing authority to deal with

a series of on-going decisions, the Court of Protection (see part 10)

can appoint a deputy to act and make decisions about property and

affairs or to make personal welfare decisions on behalf of a person

who lacks capacity. The court order from the Court of Protection

will specify what powers a deputy should have. The court will make

these powers as limited in scope and duration as possible. It can

just make an order itself covering a one off decision that needs

making. In most cases deputies will be appointed when a series of

on-going decisions are necessary.

Being appointed a deputy means taking on an important role, as

the deputy stands in the shoes of the person who cannot make the

decision(s) him or herself. The deputy makes any decisions (about

matters speciﬁed in the court order) on behalf of the person who is

unable to make the decision themselves. Deputies will have a legal

duty to follow the principles of the Act and always act in the best

interest of the person. They also must follow the Code of Practice

(see part 2).

Finance deputies will be much like the current receivers who look

after the ﬁnances of the people who lack capacity and who need to

make a range of ﬁnancial decisions. Welfare deputies are new and

it is not likely they will be appointed by the court unless a series of

linked health or welfare decisions need to be made, so that a single

order is not appropriate or where there are serious disputes about

what is in the person’s best interests.

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How do I become a deputy?

If the person you care for has not appointed or is unable to appoint

an attorney, and they need certain decisions made on their behalf

which cannot be taken other than by bringing the matter to court,

then you will need to apply to the Court of Protection (see part 10).

An application form will be available from the Ofﬁce of the Public

Guardian. You have to be 18 or over to become a deputy. The Court

will decide whether it thinks you are suitable to be a deputy. The

Court will also decide if a deputy is needed, or whether it can just

make an order to cover the particular decision that needs making.

Although you apply to the Court of Protection to become a deputy,

in most cases the application can be decided on the information

given in the forms, without any formal hearing.

The Ofﬁce of the Public Guardian (see part 11) is responsible for

supervising and supporting deputies. There will be fees for the

costs of the application process and for ongoing supervision.

What do I need to do if I am already a receiver for someone?

If you are currently a receiver, when the new Act comes in, you

will continue to act as before but will be known as a deputy for

ﬁnancial affairs. The August 2006 edition of Reaching Out for

receivers explains the changes. See www.guardianship.gov.uk/

formsdocuments/publications.htm for this edition of Reaching Out.

More information will be sent to receivers nearer April 2007. If at any

later stage the person you care for needs to have a welfare deputy

appointed you will need to apply separately for that. For more

information please go to www.guardianship.gov.uk

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10. What will the new Court of Protection do?

The new Court of Protection will be able to make decisions about

both property and affairs and personal welfare matters. The Senior

Judge will be based in London and he will be assisted by specially

trained judges at key locations in England and Wales. This will mean

that any hearings can be nearer to the people concerned. The Court

will make ﬁnal decisions on capacity if there is uncertainty whether

a person is able to make the decision in question. It will deal with

decisions about the ﬁnances and property of a person who lacks

capacity and certain serious medical treatment decisions, most

commonly where there is a dispute about best interests. The Court

will normally only hear personal welfare cases where parties have

not been able to reach consensus about what is in the person’s

best interests by other means (see part 16).

In addition it will be able to:

• make one-off orders to deal with one off situations. For

instance, where there is a serious dispute about where the

person should live which has not been resolved by other means

• appoint deputies (see part 9)

• deal with applications to object to registrations of EPAs and

LPAs. If necessary it will give directions to the attorney or

deputy

• remove the powers of an attorney or deputy who has not

been acting in the person’s best interests and put alternative

arrangements in place.

Although the Act does not generally cover children the Court will

be able to make decisions about the property and affairs of a child

under 16 if it is likely they will continue to need to have decisions

made for them about ﬁnances after they are 18. In some situations,

the Court could therefore make an order or appoint a deputy for a

child.

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Although many Court hearings will take place in key regional

locations all applications should be made initially to the Court of

Protection’s Central Registry in Archway, North London. The Central

Registry will deal with any urgent interim directions required and will

then if necessary refer the matter to be heard at a regional court if

this is in the best interests of the individual concerned.

Some people will need to get the Court’s permission to make an

application. The rules about this will be set out in the application

forms and guidance.

There will be more information about how you can access the Court

of Protection and who needs to seek permission for court action

in 2007. It will be available in leaﬂet form and on the OPG website.

The OPG Customer Service will always be a ﬁrst point of contact

and able to give advice (see part 11).

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11. What will the Ofﬁce of the Public Guardian do?

The Act creates a new public ofﬁce - a Public Guardian. The

Public Guardian will be supported by a new Ofﬁce of the Public

Guardian (OPG). It will be responsible for the register of LPAs, EPAs

and deputies. It will supervise deputies and arrange for Court of

Protection visitors to visit you if you are a deputy and the person

you care for, from time to time. It will follow up cases where there

is any concern raised about the way attorneys and deputies are

acting.

The OPG will be monitored by the Public Guardian Board and will

be required to produce an annual report of its work throughout the

year.

When the Act comes in, the OPG will provide a Customer Contact

Unit which will be the ﬁrst point of contact for anyone who needs

advice or information about the Mental Capacity Act, becoming a

deputy, when a single order may be appropriate, or making an LPA

or registering either an LPA or an EPA.

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12. What are advance decisions to

refuse treatment?

An advance decision to refuse treatment allows people aged 18 or

over to set out what particular types of treatment they would not

want to have, should they lack capacity to decide this for themselves

in the future. An advance decision can be about any treatment that

a person does not want to receive at a time when they lack capacity,

even if the refusal may result in their death. An advance decision

does not need to be in writing, except for decisions relating to end of

life treatment (see below) but it is helpful if it is.

Some people have views about what types of treatment that they

don’t want to have and would not consent to and an advance

decision allows them to express these views clearly, before they

lose capacity. If a person has made an advance decision refusing

a particular medical treatment, and that advance decision is valid

and applicable, then the decision should be followed and treatment

should not be provided.

Advance decisions, currently also called advance directives or

‘living wills’, are possible under common law and the Mental

Capacity Act puts them on a statutory footing and also explains

what is required in law for an advance decision to be valid and

applicable. In addition, the Mental Capacity Act introduces new

safeguards to prevent the misuse of advance decisions.

This is a complex area and if you need more detail you should see

Chapter 9 of the Mental Capacity Act Code of Practice

What are the rules about advance decisions to

refuse treatment?

The Mental Capacity Act introduces a number of requirements for

making an advance decision. A doctor making a decision about

treatment must be satisﬁed that the advance decision exists, is

valid and applicable to the particular treatment in question.

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A valid and applicable advance decision must be followed and

takes precedence over any view that anyone else has about what is

in the bests interests of the person in question, even if the result is

that the decision ends the person’s life.

The following list gives a brief summary of some of the main

requirements for advance decisions (For more detail you should

consult the Code of Practice):

• It must be valid. The person must have had capacity to

make the advance decision and the person must not have

withdrawn it, or overridden it by making an LPA that relates to

the treatment in the advance decision, or acted in a way that is

clearly inconsistent with the advance decision.

• It must be applicable. It should make clear which treatment is

being refused (detailed medical terms do not have to be used)

and it should explain which circumstances the refusal refers to.

What are the rules about advance decisions to refuse

life-sustaining treatment?

There are special requirements for making advance decisions to

refuse life-sustaining treatment (any treatment that is needed to

keep you alive and without which you might die). Such advance

decisions must be in writing, signed and witnessed and the person

making the advance decision must have stated that the decision

is to apply even if life is at risk. If the statement is separate to the

advance decision this also needs to be signed and witnessed. If

someone makes an advance decision it should be reviewed from

time to time to ensure that it continues to reﬂect their views.

Advance decisions do not allow people to refuse to be detained

or treated without consent under the Mental Health Act. This is

because even people who have capacity to consent cannot refuse

such detention or treatment.

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An advance decision cannot be used to ask for medical treatment

- it can only say what types of treatment a person would refuse. Nor

can a person use it to ask for their life to be ended.

For more information on advance decisions it is advisable to refer to

the Code of Practice (see part 2).

What if the person I care for already has and advance decision

(or ‘living will’)?

If the person you care for already has an advance decision, then it

may still be valid when the Act comes into force. You should check

that it meets the new rules particularly if it deals with life-sustaining

treatment.

Where can I get more information about advance decisions?

A number of patient support groups and organisations provide

information about making an advance decision. You will ﬁnd details

of how to contact them at the end of this booklet.

Example:

Helen is a retired nurse and is concerned that if she develops

Alzheimer’s disease she might be given treatment in the later

stages of the disease which she would not consent to. For

example, if she reaches the later stages of Alzheimer’s she has

decided that she does not want to receive artiﬁcial nutrition

and hydration via tubes put into her stomach. She therefore

writes an advance decision stating that in the later stages of

Alzheimer’s disease she does not want to receive artiﬁcial

nutrition and hydration even if this puts her life at risk. Because

of the requirements of the Act she also writes that the decision

is to be applicable to life-sustaining treatment, signs next to the

statement and asks someone to witness her signature.

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13.Wishes and feelings and requests for

treatment and care

Under the Mental Capacity Act, families, carers and health and

social care professionals have a responsibility to give someone

who lacks capacity care or treatment that reﬂects their preferences

as far as possible. People can write down or tell others about their

wishes and feelings and preferences about their future treatment

or care. These statements must be taken into account when

determining what is in the person’s best interests, but they are

not legally binding in the same way as advance decisions. Such

statements can request certain types of treatment, which must be

carefully considered, in particular if they have been written down.

However, the request does not need to be followed if, overall it

would not be in the best interests of the person who lacks capacity

or if, in the doctor’s professional judgement, the request is clinically

unnecessary.

These statements can be about anything, including personal

preferences such as having a shower rather than a bath or wanting

to sleep with the light on. However, people cannot use such

statements about their preferences to ask for their life to be ended.

Example:

Shahid has a degenerative condition. He wants to make sure that

if he lacks mental capacity and needs people to help him with

daily tasks, they recognise his cultural traditions. He therefore

writes down a statement explaining his religious beliefs. Shahid

asks for the statement to be ﬁled with his medical notes so that

in the future, if he can no longer make or communicate his own

decisions, he receives the care that meets his needs. His family

know that this statement will help to ensure that Shahid receives

appropriate care.

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14.Protecting people who lack capacity from

ill-treatment or neglect

The Act introduces a new criminal offence of ill-treatment or neglect

of a person who lacks capacity. This is intended to deter people

from abusing, ill-treating or neglecting people who lack capacity.

If convicted, people can be imprisoned or ﬁned.

This could cover restraining someone unreasonably against their

will, failure to provide adequate care, and also the more commonly

understood types of abuse such as ﬁnancial, sexual, physical and

psychological abuse. Whilst the majority of people who are involved

in the care of vulnerable people are entirely trustworthy, everyone

should be alert to signs of abuse and take swift action to prevent

or stop it. If you think someone is abusing, ill-treating or neglecting

your friend or relative you can contact the police or social services.

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15.Research

Research is an important way for us to understand illness and

disability and to improve the care and support people receive.

This could include testing how effective a certain type of care or

treatment is in supporting those who may lack capacity, or ﬁnding

out what caused a condition, for example, dementia. Sometimes

this research will only be useful it involves people who lack the

mental capacity to agree to take part

The Act allows such research to take place but sets out strict

rules protect people who lack capacity to decide to take part in

the research and to make sure their current or previous wishes are

taken into account. These include:

• A recognised independent Research Ethics Committee must

agree that the research is necessary, safe and cannot be done

another way using people who are able to give their consent to

the research.

• Researchers must talk to family members, partners and other

carers or any other relevant person (such as an attorney or

deputy) about whether to involve the individual who lacks

capacity in the research. If they say that the person without

capacity would not want to be involved in the research, then it

cannot take place.

• The research must stop if the person without capacity shows

any sign that they are not happy to be involved.

• The possible beneﬁts of taking part in the research must be

greater than any potential risk or harm to the person or it must

help other people and must not hurt or upset the person.

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16.Complaints, disputes and challenging

decisions

There may be situations where you wish to challenge a decision or

need to ﬁnd a way to resolve a dispute. This might happen if you

think you have not been consulted where it would be appropriate,

or a decision is made which you do not think is in the best interests

of your friend or relative. You may be involved in situations where

there is disagreement, perhaps among family members or between

family and a professional, about a decision such as what is in a

person’s best interests. There are a number of steps you can take in

these situations.

• Involving an independent advocate (not an IMCA) who can

help make sure your friend or relative’s wishes and feelings are

properly understood may help to resolve disputes.

• Making a formal complaint. The NHS, local authorities,

voluntary and private care homes all have formal complaints

processes. If your complaint is about the NHS then the local

PALS (Patient Advice and Liaison Service) may be able to help.

The equivalent agency in Wales is the local Community Health

Council.

• The Ofﬁce of the Public Guardian will be able to give advice and

information about disputes under the Mental Capacity Act.

• The Court of Protection can make a ruling if other methods

are not suitable. You might want to get help from a lawyer or

Citizens Advice Bureau about this.

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17. Further sources of information and guidance

Title Available from

Free newsletter update

on the implementation of

the MCA. This will keep

you up to date on events,

communications products

and training materials on the

MCA

Email:

makingdecisions@dca.gsi.gov.uk to

Other information booklets

like this one

You can download these for free by going to:

www.dca.gov.uk/legal-policy/mental-

capacity/publications.htm

Or you can email to order hard copies:

makingdecisions@dca.gsi.gov.uk

The Mental Capacity Act

2005

You can download this for free by going to:

www.dca.gov.uk/legal-policy/mental-

capacity/index.htm

Or you can order a hard copy from TSO

by calling 0870 600 5522 or emailing

customerservices@tso.co.uk

The Code of Practice for the

Mental Capacity Act

You can download this for free by going to:

www.dca.gov.uk/legal-policy/mental-

capacity/index.htm

There will be details of how you can order

hard copies on the website.

Information on the IMCA

service, IMCA Pilots and

training materials for

IMCAs

www.dh.gov.uk/imca

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The following organisations were involved in writing and advising

on the information booklets on the Mental Capacity Act.

Organisation What it is/does Contact

Action for

Advocacy

A resource and

support agency for

the advocacy sector,

information, training

and advice

PO Box 31856, Lorrimore Square

London, SE17 3XR

www.actionforadvocacy.org

Age Concern

England

Age Concern is a

source of advice and

information for older

people

Astral House, 1268 London Road

London, SW16 4ER

www.ageconcern.org.uk

www.accymru.org.uk

T 020 8765 7200

Alzheimer’s

Society

Alzheimer’s Society

provides information

and support for

people with dementia

and their carers

Gordon House , 10 Greencoat Place

London, SW1P 1PH

www.alzheimers.org.uk

Helpline: 0845 300 0336

Association of

Black Social

Workers

and Allied

Professions

The Association aims

to improve the quality

of health and social

care for Black users

and staff

65 Woodrow, Woolwich , London,

SW18 5DH

T 020 8 854 7402

Association

of Directors of

Social Services

(ADSS)

ADSS represents

all the Directors

of Adults Social

Services (DASS) and

Directors of Children’s

Services (DCS) in

England, Wales and

Northern Ireland

ADDSS Administrator, ADDSS

Business Unit, Local Government

House, Smith Square, London,

SW1P 3HZ

www.adss.org.uk

T 020 7072 7433

British

Association of

Social Workers

(BASW)

BASW is the

largest association

representing social

work and social

workers in the UK.

16 Kent Street, Birmingham, B5 6RD

www.basw.co.uk

T (0121) 622 3911

18. Some useful contacts

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Organisation What it is/does Contact

British Medical

Association

(BMA)

BMA represents

doctors from all

branches of medicine

all over the UK

MA House, Tavistock Square,

London, WC1H 9JP

www.bma.org.uk

T 020 7387 4499

Carers UK

Looks after family,

partners or friends in

need of help because

they are ill, frail or

have a disability

20/25 Glasshouse Yard, London,

EC1A 4JT

www.carersuk.org

T 020 7566 7637

Down’s

Syndrome

Association

Offers help for

people with Down’s

Syndrome

Langdon Down Centre, 2a Langdon

Park

Teddington, Middlesex, TW11 9PS

www.downs-syndrome.org.uk

T 0845 230 0372

English

Community

Care

Association

The largest

representative body

for community care in

England

4th Floor, 145 Cannon Street,

London

www.ecca.org.uk

T 020 7220 9595

Foundation

for People

with Learning

Disabilities

Works with people

with learning

disabilities to improve

the quality of their

lives

Sea Containers House, 20 Upper

Ground

London, SE1 9QB

www.learningdisabilities.org.uk

T 020 7803 1100

General Medical

Council (GMC)

GMC registers

doctors to practise

medicine in the UK

Regents Place, 350 Euston Road

London, NW1 3JN

T 0845 357 3456

Headway

– the brain injury

association

To promote

understanding of

all aspects of brain

injury; and to provide

information, support

and services to

people with a brain

injury, their family and

carers

4 King Edward Court Service , King

Edward Street, Nottingham, NG1

1EW

www.headway.org.uk

T 0115 9240800

Helpline 0808 800 2244

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Organisation What it is/does Contact

Local

Government

Association

(LGA)

LGA promotes the

interests of English

and Welsh local

authorities – a total

of just under 500

authorities

Local Government House, Smith

Square

London, SW1P 3HZ

www.lga.gov.uk

T 020 7664 3131

MENCAP

Charity working with

people with learning

disabilities, their

families and carers

123 Golden Lane, London, EC1Y

ORT

www.mencap.org.uk

T 020 7454 0454

Mental Health

Foundation

A leading UK charity

that provides

information, carries

out research,

campaigns and works

to improve services

for anyone affected

by mental health

problems, whatever

their age and

wherever they live

Sea Containers House

(same address as Foundation for

People with Learning Disabilities)

www.mentalhealth.org.uk

T 020 7803 1100

MIND

A mental health

charity in England

and Wales

15-19 Broadway, Stratford, London

E15 4BQ

www.mind.org.uk

T 0208 519 2122

National Autistic

Society (NAS)

NAS exists to

champion the rights

and interests of all

people with autism

and to ensure that

they and their families

receive quality

services appropriate

to their needs

393 City Road, London, EC1V 1NG

www.autism.org.uk

Helpline 0845 070 4004

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A guide for family, friends and other unpaid carers

Organisation What it is/does Contact

National Care

Association

(NCA)

NCA represents the

interests and provides

services to support

small and medium

sized providers of

social care in England

and Wales

45-49 Leather Lane, London, EC1N

7JT

www.nca.gb.com

T 020 7831 7090

National Care

Forum

The National

Care Forum was

established to

represent the

interests of not-for-

proﬁt health and

social care providers

in the United

Kingdom

National Care Form, 3 The

Quadrant,

Coventry, CV1 2DY.

www.nationalcareforum.org.uk

T 024 7624 3619

The National

Family Carer

Network

A network that

provides a focal point

for issues affecting

families that include

an adult with a

learning disability

Merchants House, Wapping Road

Bristol, BS1 4RW

www.familycarers.org.uk

T 01376 345791

The National

Family Carer

Support Service

Provides support for

family carers

Merchants House, Wapping Road

Bristol, BS1 4RW

T 0117 930 2608

Patient Concern

is an organisation

committed to

promoting choice and

empowerment for all

health service users

PO Box 23732, London SW5 9FY

www.patientconcern.org.uk

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A guide for family, friends and other unpaid carers

Organisation What it is/does Contact

The Relatives

and Residents

Association

The Relatives &

Residents Association

exists for older

people needing, or

living in, residential

care and the families

and friends left

behind

24 The Ivories, 6-18 Northampton

Street

London, N1 2HY

www.relres.org

T 020 7359 8148

RESCARE

The national society

for children and

adults with learning

disabilities and their

families

Steven Jackson House, 31 Buxton

Road

Heaviley, Stockport SK2 6LS

www.rescare.org.uk

T 0161 474 7323

RESPOND

Challenging

vulnerability and

sexual abuse in the

lives of people with

learning disabilities

3rd Floor, 24-32 Stephenson Way

London, NW1 2HD

T 020 7383 0700

F 020 7387 1222

www.respond.org.uk

helpline: 0808 808 0700

Royal College of

Nursing (RCN)

The RCN represents

nurses and nursing

20 Cavendish Square, London, W1G

0RN

www.rcn.org.uk

T 020 7409 3333

Royal College of

Psychiatrists

The Royal College

of Psychiatrists is

the professional and

educational body

for psychiatrists in

the United Kingdom

and the Republic of

Ireland

17 Belgrave Square, London SW1X

8PG

www.rcpsych.ac.uk

T 020 7235 2351

Social Care

Association

A vibrant, inclusive and

informed Association

which visibly promotes

positive practice within

all social care services

throughout the UK

Thornton House, Hook Road,

Surbiton

Surrey KT6 5AN

www.socialcareassociation.co.uk

T 020 8 397 1411

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A guide for family, friends and other unpaid carers

Organisation What it is/does Contact

Scope

Disability organisation

in England and

Wales, whose focus is

people with cerebral

palsy

6 Market Road, London, N7 9PW

www.scope.org.uk

T 020 7619 7100

Sense

Charity providing

specialist information,

advice and services

to deaf blind people,

their families, carers

and the professionals

who work with them.

Funded to develop

training materials

which address the

advocacy issues for

deaf blind people

11-13 Clifton Terrace, Finsbury Park

London N4 3SR

www.sense.org.uk

T 0845 127 0060

F 0845 127 0061

Text 0845 127 0062

Turning Point

Turning Point is the

UK’s leading social

care organisation,

providing services for

people with complex

needs, including

those affected by

drug and alcohol

misuse, mental

health problems and

those with a learning

disability

New Loom House, 101 Backchurch

Lane

London E1 1LU

www.turning-point.co.uk

T 020 7702 2300

United

Response

A national

organisation creating

opportunities

and services with

people with learning

difﬁculties and people

with mental health

problems

113 – 123 Upper Richmond Road,

Putney

London SW15 2TL

www.unitedresponse.org.uk

T 020 8246 5200

F 020 8780 9538

Minicom: 020 8785 1706

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A guide for family, friends and other unpaid carers

When the Mental Capacity Act comes into force, the Ofﬁce of

the Public Guardian will provide a Customer Services Unit which

will be the ﬁrst point of contact for anyone who needs advice or

information about the Mental Capacity Act. Their contact details

are:

Phone 0845 330 2900 or go online: www.publicguardian.gov.uk

From April 2007 you should contact the OPG if you need

information on the Mental Capacity Act 2005.

This booklet will be updated once the Mental Capacity Act comes

into force in 2007.

If there is anything you really liked or didn’t like about the booklet

please let us know so that we can improve the next booklet.

Please write to us at:

Communications Team

Mental Capacity Implementation Programme

Department for Constitutional Affairs

5th Floor Steel House

11 Tothill Street

London

SW1H 9LH

Or email us:

makingdecisions@dca.gsi.gov.uk

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A guide for family, friends and other unpaid carers

Notes

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Notes

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Other booklets in this series include:

1 Making decisions about your health, welfare or ﬁnance.

Who decides when you can’t?

3 Making decisions. A guide for people who work in health

and social care

4 Making decisions. A guide for lawyers and advice workers

5 Making decisions about your health, welfare or ﬁnance.

Who decides when you can’t? An Easy Read guide

These booklets are available in other languages and alternative

formats. To order any of these booklets:

T 020 7210 0025

E makingdecisions@dca.gsi.gov.uk

The booklets are also available online at:

www.dca.gov.uk/legal-policy/mental-capacity

The Mental Capacity Implementation Programme published

this booklet. It was written by Turning Point, Sense, Alzheimers

Society and Age Concern who are members of the Making

Decisions Alliance.

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