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Table of Contents

Introduction

SECTION The Boring Yet Essential Stuff

A very brief overview of the Mental Capacity Act

The five principles of the Mental Capacity Act

A brief overview of the two-stage test for mental capacity

Applying the Mental Capacity Act

What is not covered by the Mental Capacity Act?

What age groups are covered by the Mental Capacity Act?

Who can assess mental capacity?

Setting the Threshold of Understanding

The CMSL Principle

Setting the bar

'Best interest' v 'unwise' decisions

Capacity is time and item specific

Fluctuating capacity

Delirium

SECTION Setting the assessment

The referral process: identifying the decision to be addressed

Gathering the information

Engaging with the patient

When and where to assess

Asking the right questions

Engaging with the patient/client

Live video-link assessments

SECTION The two-stage test: breaking it down step by step

What is the two-stage test?

The diagnostic test

The functional test

The Causative Nexus

Administering the functional test

Understanding information relevant to the decision being made

Retaining information relevant to the decision being made

Defining an unwise decision

Communicating the decision

Understanding v Communication

Recording your assessment

You've done your assessment: what now?

SECTION The most common mistakes when assessing mental capacity

Not being specific about the decision in question

Using the wrong tests

Assuming a lack of capacity or 'blanket capacity'

Asking the wrong questions

Making a moral judgement

Failure to validate information

SECTION Additional resources

Report template

Anonymised report

Referral Form

Appendix

The two-stage test

What Next? Acknowledgements

About the Author

Tim Farmer is an award-winning author and expert witness specialising in the assessment of mental capacity. He believes that the individual should be central to the assessment of capacity and that everyone has a right to be the best that they can be. Considered to be one of the leading experts in the field Tim regularly trains legal, health and financial professionals in the assessment of mental capacity and is recognised by both the Court of Protection and the Office of the Public Guardian. He has assessed thousands of individuals both in the UK and abroad, including members of governments and royal families.

Reviews

"I would highly recommend this excellent book. An engaging and easy to read practical guide to the assessment of capacity, it uses everyday case studies to help demystify the assessment process. A must read for everybody who assesses mental capacity or needs to understand the process of assessment further".Baroness Finlay, Chair of the National Mental Capacity Forum

"Relevant to all nurses, in particular those working in the field of mental health, learning disabilities and with older adults . . . an essential text for student nurses . . . It would be a dream for those studying the subject, but more importantly it will teach the practitioners of the future some key lessons that will improve the way we deliver services in a thoughtful and measured way".

The Nursing Times

"A very practical guide to the process of assessing mental capacity in individuals over 16 . . . Section 3 alone is worth the money for the whole book!"

LawSkills - reviewed by Laura Banks (Solicitor and visiting Lecturer for University of Law and also Birmingham City University)

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