Mental Capacity Act

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)

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.

Bristol IMCA referral form (pdf, 87 KB) (opens new window) (pdf, 88k) (opens new window) and the IMCA information leaflet (pdf, 93 KB) (opens new window) (pdf, 93k) (opens new window) .

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

Guidance and forms for professionals

Mental Capacity Act

Independent Mental Capacity Advocate (IMCA) Service

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.