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Ask our practitioner: Just Checking and the Mental Capacity Act

I am often asked about how activity monitoring system, Just Checking, works with the Mental Capacity Act (2005) to ensure a person is able to live their life in the most natural manner possible without conflicting with the Deprivation of Liberty (and freedom) Safeguards (DoLS).

The Mental Capacity Act (MCA) was introduced to provide the framework for making decisions on behalf of others. Specifically, the Act outlines what to do if we are involved in the care, treatment or support of people aged 16 and over who may lack capacity to make their own decisions.

I’ve found that questions surrounding the MCA are becoming more and more prevalent as the general population gets older. Advances in health and social care services are prolonging lives and as a result we have seen an increase in the number of people who have an impairment of the mind or brain.

The core principle of the MCA is that we should never presume a person lacks capacity, even if they have a particular condition. In fact, we have to prove that they do not have the capacity to consent. In these circumstances it is vital to get a full understanding of their needs as they are often (although not always) unable to accurately communicate what they can and cannot do.

In my experience, I have found that gathering information about a person’s needs using an objective tool such as Just Checking, we are able to assess even the most complex situations with the right amount of proportionality.

Just Checking is often used as an assessment tool to help summarise how a person naturally behaves in their home. It is usually placed in the person’s property to gather objective information about movement patterns, routines and habits. This information helps us to fully understand a person’s needs, identify any risks which might be posed to them and gives an indicator of how they are functioning in the most objective, unobtrusive way possible.

When we are completing an assessment of capacity we have to demonstrate that we have made every reasonable effort to maximise the person’s capacity to make the specific decision.

Over the years, when I’m completing a capacity assessment, I have found that taking a Just Checking system with me helps explain exactly what it is we are doing. When we’re able to demonstrate that we are not installing cameras and that we only see blue or orange lines on the charts, people are often put at ease and have a more informed involvement.

It is often the simple phrases that have the most positive effects when explaining why we wish to use the Just Checking system. These can include:

“This will help me to understand how you move throughout the rooms in your home so that I know how much care to ask for.”

“I would like to put it in your home for a few weeks and then I will come back and take it away again.”

In those circumstances where it has been established that a person lacks the capacity to consent, we have to demonstrate that the course of action we are taking is both in the person’s best interests and we are following the less restrictive course of action. To evidence we have considered these principles it is useful to bear in mind the following points:

  • Just Checking objectively and proportionally supports identification of a person’s needs and how much support they require.
  • The Just Checking system only detects where and when movement has taken place and does not impinge on the person’s freedom of movement.
  • Just Checking is a less restrictive method than regular checks by a carer.
  • It allows a person to live their life in the most natural manner possible.
  • Just Checking does not conflict with the Deprivation of Liberty (and freedom) Safeguards (DoLS) as it does not meet the required criteria (or “acid test”) of continuous supervision and control. At any point a person has the ability to leave their environment.

Blog by Rosie Goy, Occupational Therapist

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