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What is the Mental Capacity Act 2005?



The Mental Capacity Act is a legal framework that helps protect vulnerable people who may not be able to make their own decisions. The Act states that every adult has the right to make their own decisions where possible and that people, including dental teams, should always support a person to make their own decisions when they can.

The Act also says that if a person cannot make a decision, then a decision must be made that is in their best interests. The Act helps to ensure that vulnerable people get the support they need to make decisions about their lives and aims to protect their rights and freedom to make choices and live the way they want.


Why do dental teams need to understand and apply the Mental Capacity Act?


Dental practices see many patients daily; some may be vulnerable patients needing extra help and support to make decisions about their dental care. To provide the best possible care for these patients, dental teams need to have a good understanding of the Mental Capacity Act. It is important to understand what capacity is and the factors that can affect it. Recognising patients who need support to make decisions is also crucial. Dental teams should have a good understanding of how to support patients in making decisions and the principles underlying best interest decision-making. They should also be aware of the role of the Independent Mental Capacity Advocate and when this may be appropriate. By having a good understanding of the Mental Capacity Act, dental teams can ensure that they provide the best possible care for vulnerable patients, using a person-centred approach.


Capacity and decision making


What does capacity mean?


‘Capacity’ means the ability to understand information and to make decisions based on this understanding.

The Mental Capacity Act protects people who may find themselves in a situation where they cannot make decisions due to a sudden event or an ongoing condition. Some conditions affecting decision-making ability include mental illness, dementia, brain injury, severe learning disabilities, concussion, delirium, and alcohol or drug abuse symptoms. In some cases, the inability to make decisions is temporary, but for others, it may be a permanent change. However, it is essential to remember that each person should be assessed individually, as these conditions do not always diminish capacity.

With the proper support, many people are still able to live fulfilling lives despite challenges with decision-making.

An individual’s capacity can be difficult to ascertain as it is ‘decision specific and time specific’. This means that a person’s capacity can fluctuate and that a person cannot be assumed to be unable to make a decision based on their diagnosed condition. For example, a person with Alzheimer’s disease may be able to make decisions about their daily routine but not about long-term financial planning. A person with severe learning disabilities may be able to make simple decisions but not complex ones. It is important to remember that capacity is not static and that individuals may be able to make some decisions but not others. As such, it is important to assess an individual’s capacity on a case-by-case basis.


What are the five key principles of the Mental Capacity Act?


The Mental Capacity Act 2005 sets out five key principles for anyone who works with or cares for adults who may lack the capacity to make decisions for themselves. These principles provide a framework for how dental care and treatment should be delivered to patients who may lack the mental capacity to make decisions about their care. For example, the principle of best interests means that any decision made on behalf of a patient must be in their best interests, taking into account their wishes and preferences. This is particularly important when considering dental treatments, such as extractions. Similarly, the principle of the least restrictive option means that any decision made on behalf of a patient must be the least restrictive option available in terms of their freedom and autonomy. This is important to consider when deciding whether or not to sedate a patient for treatment. By following the principles set out in the Mental Capacity Act, dental practitioners can ensure that they are providing the best possible care and treatment to patients who may lack the ability to make decisions for themselves.

The five key principles are:

  1. A person must be assumed to have capacity unless it is established that they lack capacity.

  2. A person is not to be treated as unable to make a decision unless all practicable steps to help him/her to do so have been taken without success.

  3. A person is not to be treated as unable to make a decision merely because they make an unwise decision.

  4. An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in their best interests.

  5. Before any action is taken, or a decision is made, regard must be had as to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action. This means that decisions must be the least restrictive of freedom as possible.

What should dental practices have in place to support the Mental Capacity Act?


Dental teams must be adequately trained in the Mental Capacity Act. Practices should have a copy of the Mental Capacity Act, and policies that cover the Mental Capacity Act, consent and restraint. The dental team should have regular team training. Induction training should also include the Mental Capacity Act, and team members should understand the five fundamental principles and two-stage test. Excellent record-keeping in clinical notes is essential. By ensuring that dental teams are properly trained in the Mental Capacity Act, we can safeguard the rights of patients who may not be able to make decisions for themselves.


Mental Capacity Act – An online course from Apolline Training


The aim of the Mental Capacity Act 2005 is to provide guidance to providers of health and social care, including providers of dental care and treatment, on how best to ensure that the best possible decisions are made about the care or treatment of patients who do not have the capacity to make some decisions for themselves.

This is one of our most popular courses. We’ve issued more than 7,000 certificates to dental professionals just like you for Mental Capacity Act online training.

More than 98% of dental professionals who completed this course would recommend this course to others.

See our Mental Capacity Act course


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