Staff Perceptions and Capability in using the Mental Capacity Act to Assess Decision Making in those with Acquired Brain Injury and Executive Dysfunction

Abstract

AbstractThe purpose of this article is to establish the perceptions and capability of social care professionals (SCPs) in using the Mental Capacity Act (MCA) 2005 to assess decision-making capacity in those who have executive dysfunction and issues pertaining to the frontal lobe paradox, in comparison to health care professionals (HCPs). HCPs and SCPs from inpatient and community neurorehabilitation teams, social care teams and a best interest assessor team were contacted via convenience sampling and participated in semi-structured interviews. Data from these consultations were analysed using a form of thematic analysis known as template analysis. Four over-arching template themes were identified: ‘assessment structure’, ‘implications of brain injury’, ‘professionals’ capability/expertise’ and ‘consent, self-report and mental capacity’. The findings suggest that SCPs would benefit from bespoke practice guidance designed to help with the application of the MCA with the acquired brain injury/long-term neurological conditions population—particularly where there is a concern about a person’s ability to understand, apply or use information outside of an assessment or supportive conversation.