What is the Mental Capacity Act (MCA)?
The MCA helps and protects people who have limited mental capacity to make decisions. This includes people who have limited capacity due to illness, injury or disability. The MCA aims to help these people to make decisions or to be involved in decisions as much as possible.
The Independent Mental Capacity Advocacy service helps people who have no family or friends to consult about those decisions.
Main points about the MCA
Assessing capacity
There's a single test for assessing capacity. People can't be incapable' simply due to a particular illness, injury or disability or because of age, appearance, or any condition or behaviour leading to unjustified assumptions about capacity.
Deciding best interests
The MCA provides a checklist that decision-makers must work through to decide best interests. Individuals can put their wishes and feelings into a written statement which must be considered. Carers have a right to be consulted concerning best interests.
Code of practice
This is a legal code describing what people must do when acting or making decisions with, or on behalf of, individuals who lack the capacity.
Information booklets (all PDFs)
- pdf Short MCA information leaflet (754 KB)
- pdf MCA information for family, friends and unpaid carers (547 KB)
- pdf MCA information for people who work in social care (471 KB)
- pdf MCA information for advice workers (424 KB)
Information in community languages can be found below.
Independent Mental Capacity Advocacy (IMCA)
- The IMCA service is to help particularly vulnerable people who lack the capacity to make important decisions about serious medical treatment and changes of accommodation.
- It is available to people who have no family or friends to consult about those decisions.
When should the IMCA be involved?
Must be involved where:
- the decision is about serious medical treatment
- it is proposed by an NHS body or council that the person be moved into long-term care of more than 28 days in a hospital or 8 weeks in a care home (where that accommodation or move is not a requirement of the Mental Health Act 1983)
- a long-term move to different accommodation (8 weeks or more) is being proposed by an NHS body or council e.g. to a different hospital or care home
May be involved in:
- a care review if a change of accommodation that was arranged by the LA or NHS is being considered (and the person has already been in that accommodation for 12 weeks or longer).
- adult protection cases. In these cases alone, the requirement that the person has no one to consult does not apply. In both of these situations the council or NHS must be satisfied that it would be of particular benefit to the person to be represented by the IMCA. This will be decided by the Co-ordinator for Safeguarding Adults.
When can't the IMCA be involved?
- person who now lacks capacity previously named a person that should be consulted about decisions that affect them, and that person is available and willing to help
- the person who lacks capacity has appointed a court appointed attorney or deputy to act for them
What does the IMCA do?
- privately interviews or meets the person who lacks capacity
- examines any relevant records that the Act gives them access to
- obtains the views of professionals and paid workers
- and the views of anybody else who can give information about the wishes and feelings, beliefs or values of the person
- find out what support the person has had to help make a specific decision
- finds out what alternative options there are
- writes a report on their findings for the council or the NHS
Who provides Bristol's IMCA service?
Bristol Mind
Tel: 0117 980 0371
Fax: 0117 929 7644
Staff are advised to telephone Bristol Mind in the first instance to make a referral.
pdf Bristol IMCA referral form (81 KB) and the pdf IMCA information leaflet (93 KB) .
Court of Protection
The MCA created a new Court of Protection, to deal with decision making for adults who lack the capacity to make specific decisions for themselves. The Court of Protection is the final arbiter for capacity matters.
To find out more go to the Court of Protection page on the Ministry of Justice website.
Forms and Guidance
The forms and guidance for making Lasting Powers of Attorney and about the Court of Protection are available on the Office of the Public Guardian website.
Community language leaflets
- pdf Arabic (396 KB)
- pdf Bengali (221 KB)
- pdf Chinese (228 KB)
- pdf Gujrati (210 KB)
- pdf Hindi (202 KB)
- pdf Punjabi (214 KB)
- pdf Somali (280 KB)
- pdf Urdu (220 KB)
- pdf Vietnamese (269 KB)
- pdf Easy-read summary (279 KB)
Guidance and forms for professionals
Mental Capacity Act
- pdf Capacity Assessment Pathway form (54 KB)
- pdf Mental Capacity Act 2005 guidelines (35 KB)
- pdf Mental Capacity Act Pathway (22 KB)
Independent Mental Capacity Advocate (IMCA) Service
- pdf IMCA Service eligibility criteria (19 KB)
- pdf IMCA Service and Safeguarding Adults Enquiries (35 KB)
- pdf IMCA Services referral form (81 KB)
Peer Challenge Review
In February 2015 the Mental Act Pathway (from referral to point of completion of assessment) was reviewed by a Local Government Peer Challenge Review (PCR).
This PCR enabled the partners involved in delivering services to people requiring a mental health act assessment to identify areas for development and set the agenda for improvements.
The partners who took part in the PCR came together in June 2015 to develop an agreed action plan to take forward required improvements, which would be delivered under the governance of the Bristol Crisis Concordat.
- pdf Self Assessment overview (341 KB)
- pdf Peer Challenge Review: final letter from review group (91 KB)
- pdf Peer Challenge Review: Pesentation, summary of feedback (137 KB)
- pdf Peer Challenge Review: Presentation, updates since the review (178 KB)
- pdf Terms of Reference: Bristol Crisis Concordat: Peer Challenge Review (PCR) Mental Health Act Pathway Sub Group (21 KB)