What to do if we have concerns about mental capacity?

As a first step, concerns about capacity and discussion should take place with advice and support from line managers. All decisions and rationales should be recorded on the digital system. 

Mental Capacity and safeguarding enquiries:

Where there are concerns about mental capacity, a referral should be made to Camden’s Adult Social Care team. Under Section 68 of the Care Act 2014, there is a duty to arrange for an Independent Advocate to support an adult who is the subject of a Safeguarding Enquiry (Section 42) or a Safeguarding Adults Review (SAR). 

The duty is mandatory if both of the following conditions are met: 

Substantial Difficulty: The adult would experience substantial difficulty in being fully involved in the safeguarding process (i.e., difficulty understanding, retaining, using, weighing information, and/or communicating views).

No Appropriate Person: There is no other appropriate person (such as a willing and able friend or family member) to represent and support the adult's involvement. Note: An individual who is paid or professionally engaged in providing care or treatment to the adult is automatically excluded from being an 'appropriate person'.

For a person who lacks mental capacity when certain decisions are being made by the Council or NHS Provider, the local authority must an Independent Mental Capacity Advocate (IMCA). An IMCA provides an independent safeguard to support vulnerable people who lack the capacity to make certain important decisions and who have no-one appropriate who can act for them. You can find more information about IMCAs at Camden here and a referral flowchart for professionals here. A referral form can be found here.  

Mental Capacity and Housing Decisions:

Where there is reason to believe that someone lacks capacity, we are duty bound to ensure that mental capacity assessment is completed. If there are concerns that an individual does not have capacity to make a housing-related decision, we should pause or not commence activities until capacity has been confirmed, and arrangements have been made. For example, we cannot accept an application for homelessness assistance from a person who lacks the mental capacity to make it.

Where there are concerns, we will:

Pause or not commence activities;

Complete a safeguarding alert and alert Adult Social Care and request a capacity assessment;

Flag any immediate needs to Adult Social Care, i.e., need for safe interim housing;

More information and guidance on mental capacity can be found in the Government’s Mental Capacity Act Code of Practice and the London Multi-Agency Safeguarding Procedure.