Action learning mca 2005 version 2

• 1. Action Learning
  

2. What are we doing? Aims
Learning to apply the Mental Capacity Act 2005 in practice.
Through Care Planning discussions
By Applying the Act to real life experiences
Discussion to promote learning.
Key words and prompts
Small group work
Videos
Critical Analysis
3. Models of learning
Experience
Reflective observation
Abstract conceptualisation
Active experimentation
4. Critical Practice
5. Critical practice
6. Welcome to Arnham Home for the Emotionally Troubled.
Set in a hospital setting ( although this could be a nursing home)
You have recently taken a job as a staff nurse called Ralf.
You are getting to know your patients and you are given Gertrudeto be named nurse for.
There is a Care Programme Approach meeting taking place in 1 weeks time, and the team are looking for a discharge plan.
7. Autonomy
Advocacy
Mental Health Act 1983
Mental Capacity Act 2005
Risk
Right to freedom of choice
Team working and the MDT
Carer and service user involvement
Capacity Statements and Best Interest Assessment
Record keeping
Key words to think about when watching the Video
8. Get together in small groups
Talk about the video and ask yourselves:
What other information you need to care plan to Gertrude? And from whom?
What is in Gertrudes best Interests?
How to Advocate for Gertrude
Should Gertrudebe allowed to Leave Hospital.
Think about
Use a mind map to help you reach your decisions
Why? How? What? Where? When? and use the Key word terms to Prompt you.
Talk about your experiences of the Mental Health Act and the Mental Capacity act in the group.
9. Who are we meeting?
Gertrudehas been in hospital for 10 months.
She came in with extremely poor self care , she had scabies and lice and evidence of malnutrition.
She lives with her husband who is called Eddie. Her daughter (age 21) is called Jolene and her son ( age 26) is calledLeroy.None of the family work at present.
She had been cooking, cleaning and driving a car without supervision immediately prior to admission. Her family report on a holiday to Eastbourne just before coming into hospital, that she nearly killed them all while driving.
Gertrudewas aggressive towards her family and would chase them around the house, Jolene was so scared she had locked herself in the dining room until her brother had arrived home on one occasion.
Gertrudelikes cooking and looking after her family, she enjoys knitting and puzzles. Before she retired, she used to be a school cook.
10. Who are we meeting?
She recently scored 20 out of 30 on a Mini Mental State Examination. It showed that she was not orientated to time and place and that she has poor recall. Her speech is repetitive and she has extremely poor short term memory.
Her family have been encouraged to take her home over the recent Christmas holidays and they did not come and pick her up on Christmas day, this upset her.They have only taken her home for 6 hours in 10 months.
A recent Carer Assessment showed that the family are possibly able to care for her, but there is evidence of an unwillingness to take responsibility for her safety while she is at home and they are putting the block on any leave periods.
He daughter says she is still scared of her mum despite reassurance that she is no longer aggressive. Her husband has heart disease and COPD and is unwell himself.
Leroy says that he will help when he can, but is looking for a job working on the rigs.
There is evidence of Jolene already being a carer for Eddie.
11. Who are we meeting?
A recent Occupational Therapy assessment showed that Gertrudeneeds supervision to perform many tasks such as cooking ( she is fire risk because she thinks she can still cook).
She is at risk of getting lost if she left the house on her own.
She believes she can still drive a car . She believes herself to be a safe driver. Whenever you challenge her about her memory she states she will be alright and just wants to go home.
Her self care remains poor in hospital, she requires prompting to bathe but she is resistive and tells the nursing staff she has already performed tasks when there is evidence she has not.
Her aggression had diminished while she is in hospital and she is taking Aricept.
She is an informal patient.
Every ward round she asks to leave hospital and go home, she is convinced to stay and quickly forgets she has asked to leave.
12. Decision Making Tree
Are they detainable under the Mental Health Act 1983?
What is the question we are asking of MCA 2005? IS IT APPLICABLE?
Does the Service User have CAPACITY?
What assessments do we need?
Have we completed a Best Interest Assessment?
What about Service User and carer involvement?
What does the Service User want?
How severe are the risks?
Mental Health Act
Are the risks able to be managed at home?
Mental Capacity Act
Capacity Statement
Deprivation of Liberty ( DOLS)
Care Planning
IMCA
13. Checklist for Capacity
IMCA
Advocacy
Best Interest Checklist
DOLS assessments
14. What happened next? Alternative Endings
Alternative uses?
Physical Intervention
Refusing treatment
Contraception
Breaking confidentiality
Hyperlinks
Mental capacity Act 2005
www.legislation.gov.uk/ukpga/2005/9/contents
Bournewood enquiry
www.justice.gov.uk/consultations/docs/cp2307-easy.pdf
15. Conclusion
Mental Health Act
Mental Capacity Act
Best Interest Assessments
IMCA and advocacy
DOLS
Care Planning
Reflective Practice
Critical Analysis and reflection.
What have we learnt?