Introduction
It is often argued that mental capacity assessments are crucial in safeguarding vulnerable adults, particularly when their decision-making abilities are in question. This essay examines the case of Gurpreet, a 61-year-old woman with early onset Parkinson’s disease, whose recent changes in behaviour and mobility have raised concerns about her capacity. The purpose of this analysis is to outline the process for conducting a mental capacity assessment for Gurpreet, applying relevant legislation, statutory guidance, and professional values. Key legislation, such as the Mental Capacity Act 2005 (MCA 2005), will be explored, alongside considerations of how adult safeguarding principles can be applied. The discussion will also address the steps and considerations involved in a capacity assessment, integrating professional standards as set by Social Work England. Through a critical lens, supported by academic literature, this essay aims to provide a comprehensive evaluation of the legal and ethical dimensions of Gurpreet’s case.
Legal Framework: The Mental Capacity Act 2005
It should be noted that the cornerstone of assessing mental capacity in England and Wales is the Mental Capacity Act 2005 (MCA 2005). This legislation establishes a framework for determining whether an individual has the capacity to make specific decisions. According to Section 1 of the MCA 2005, a person must be assumed to have capacity unless it is established otherwise. In Gurpreet’s case, her recent behaviours—such as forgetfulness, difficulties using a smartphone, and attempting to leave the house inappropriately dressed—suggest a potential impairment in decision-making, warranting an assessment.
Furthermore, Section 2 of the MCA 2005 stipulates that a lack of capacity must be linked to an impairment of, or disturbance in, the functioning of the mind or brain. Given Gurpreet’s Parkinson’s diagnosis and recent fall, which may have exacerbated neurological or cognitive decline, this criterion appears relevant. It is also required under Section 3 of the MCA 2005 that all practicable steps be taken to support the individual in making decisions before concluding that capacity is lacking. This principle underscores the need for tailored support for Gurpreet, perhaps through simplified communication or assistive technology, before any assumptions are made about her incapacity (Ryan-Morgan, 2022).
Process of Mental Capacity Assessment
It is widely recognised that a mental capacity assessment under the MCA 2005 follows a structured, two-stage test as outlined in the Mental Capacity Act 2005 Code of Practice (Department for Constitutional Affairs, 2007). Firstly, it must be established whether there is an impairment or disturbance in the functioning of Gurpreet’s mind or brain. As previously noted, her Parkinson’s diagnosis and recent behavioural changes provide grounds for this consideration. Secondly, the assessment must determine whether this impairment affects her ability to make a specific decision at the time it needs to be made. This decision-specific approach means that capacity must be assessed in relation to particular actions, such as managing personal safety during walks or understanding the consequences of leaving the house inappropriately.
The process should involve gathering relevant information about Gurpreet’s condition, possibly through consultation with healthcare professionals, such as her GP or a neurologist, to understand the impact of Parkinson’s on her cognition. Additionally, observations of her behaviour and direct engagement with Gurpreet are essential to assess whether she can understand, retain, and weigh information relevant to decisions, as well as communicate her choices (Brown, 2020). It cannot be denied that her recent forgetfulness and disorientation, such as forgetting to return library items or seeking a former home, indicate potential challenges in these areas.
Key Considerations in the Assessment
It is often argued that assessments must be conducted with sensitivity to the individual’s circumstances and values. For Gurpreet, her cultural background and personal history—evident in her pride in appearance and past independence—should inform how the assessment is approached. The MCA 2005 Code of Practice emphasises that assessors must avoid assumptions based on age, appearance, or condition (Department for Constitutional Affairs, 2007). Therefore, any decline in Gurpreet’s abilities must not be hastily attributed to ageing or Parkinson’s alone without thorough evaluation.
Moreover, the involvement of family, such as her son Vikram, who is her primary carer, should be considered. While Vikram’s full-time work commitments limit his availability, his insights into Gurpreet’s day-to-day functioning could provide valuable context. However, it should be pointed out that the assessor must remain independent to avoid bias, ensuring decisions are not unduly influenced by family perspectives (Brammer, 2024). Additionally, if capacity is deemed lacking for specific decisions, such as managing personal safety, advance directives or lasting power of attorney arrangements should be explored as part of future planning under Sections 9-14 of the MCA 2005.
Application of Adult Safeguarding Principles
It is the case that adult safeguarding legislation, notably the Care Act 2014, complements the MCA 2005 in protecting individuals like Gurpreet. Section 42 of the Care Act 2014 places a duty on local authorities to make enquiries where an adult with care and support needs is at risk of abuse or neglect. Gurpreet’s recent fall, reduced mobility, and risky behaviours—such as attempting to leave the house half-dressed—raise safeguarding concerns, particularly as she lives with limited supervision due to Vikram’s work schedule. A multi-agency approach, potentially involving social workers, healthcare providers, and community support services, should be initiated to ensure her safety and well-being (Carr and Goosey, 2024).
Professional Values and Social Work Standards
It will be recognised that professional values, as outlined by Social Work England, play a pivotal role in applying the law to Gurpreet’s case. Social workers must uphold principles of empowerment, advocating for Gurpreet’s rights and autonomy while balancing safeguarding duties. This involves ensuring that any assessment or intervention respects her dignity and promotes her independence wherever possible. Furthermore, social workers are expected to work collaboratively with other professionals and family members like Vikram, maintaining transparency and accountability in decision-making processes (Thompson, 2024). The ethical imperative to act in Gurpreet’s best interests, particularly if capacity is lacking, must guide all professional actions, as stipulated under Section 4 of the MCA 2005.
Conclusion
In conclusion, it is evident that assessing Gurpreet’s mental capacity under the MCA 2005 requires a structured, person-centered approach grounded in legal and ethical principles. The two-stage test, supported by detailed observation and multi-disciplinary input, must be applied to determine her ability to make specific decisions amidst her Parkinson’s condition and recent decline. Additionally, safeguarding duties under the Care Act 2014 highlight the need to protect Gurpreet from risks associated with her behaviours and circumstances. Professional values, as set by Social Work England, further underscore the importance of empowerment and dignity in this process. Ultimately, it is believed that a thorough and sensitive assessment will not only clarify Gurpreet’s capacity but also inform appropriate support mechanisms to enhance her safety and quality of life.
References
- Brammer, A. (2024) Social Work Law. 6th ed. Harlow: Pearson Education Limited.
- Brown, R. (2020) The Approved Mental Health Professional’s Guide to Mental Health Law. 5th ed. London: Learning Matters.
- Carr, H. and Goosey, D. (2024) Law for Social Workers. 17th ed. Oxford: Oxford University Press.
- Department for Constitutional Affairs (2007) Mental Capacity Act 2005: Code of Practice. London: The Stationery Office. [Accessed 10 October 2023].
- Ryan-Morgan, T. (2022) A Concise Guide to the Mental Capacity Act: Basic Principles in Practice. London: Routledge.
- Thompson, N. (2024) Understanding Social Work: Preparing for Practice. 6th ed. London: Bloomsbury Academic.
Statutes
- Mental Capacity Act 2005. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents. [Accessed 10 October 2023].
- Care Act 2014. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents. [Accessed 10 October 2023].
