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Thematic Learning from Case Reviews – Mental Capacity Act and Making Safeguarding Personal

Date: Wednesday, 28th Jun 2023 | Category: Adults

Dudley Safeguarding People Partnership are undertaking a monthly thematic learning dissemination, which provides an opportunity for staff and partner organisations in Dudley to be made aware of the key learning from our quality assurance activity and case reviews along with offering information in relation to this learning.

During May the focus has been on Mental Capacity Act (MCA) and Making Safeguarding Personal (MSP) as this has been a recurring theme in our adults reviews.

How do we review multi agency practice and share learning?

DSPP seeks to promote a culture of continuous learning and improvement across the organisations that work together to safeguard and promote the welfare of children and adults, identifying opportunities to draw on what works and promote good practice

Our thematic learning plan is one of the ways we share learning to improve practice.


We would like to share reviews that have links to the theme of MCA and MSP:

DSPP are now using the West Midlands Safeguarding Adults Review Referral Form. To ensure that you always use the most up-to-date version of the form, we recommend that you access it using the link below and scrolling down to the section called West Midlands Adult Safeguarding SAR Policy.

To support partners, DSPP have put together a short video on What Makes a Good SAR referral – we hope you find this useful.

Helpful Resources

Mental Capacity Act

The Mental Capacity Act (MCA) is designed to protect and empower people who may lack the mental capacity to make their own decisions about their care and treatment. It applies to people aged 16 and over.  Please view the following resources to assist you in your practice:

  1. Everyone has the right to make their own decisions and has mental capacity unless proven otherwise.
  2. All practical help must be given before someone is treated as not being able to make their own decisions.
  3. People have the right to make decisions others might regard as eccentric or unwise. This isn’t a reason for lack of capacity.
  4. Anything done on behalf of someone who lacks mental capacity must be done in their best interests.
  5. Decisions shouldn’t restrict the freedom of someone lacking mental capacity for more than is necessary.

The MCA Code of Practice is a key part of practical guidance that will support the Act. It explains how the Act will operate on a day-to-day basis and offers examples of best
practice to carers and practitioners.

View the MCA Code of Practice here

39 Essex Chambers have produced a document to provide an overview of the law and principles relating to the assessment of capacity.

View the document from 39 Essex Chambers here

CQC have produced guidance to explain how the MCA affects the way that registered care, treatment and support services make decisions on behalf of people who do not have the capacity to make some decisions for themselves.

View the CQC guidance here

View information on the MCA on the NHS website

Resources are available from the Local Government Association in relation to MCA including DOLS and LPS

Dudley’s Centre for Professional Practice have produced a practice briefing around Deprivation of Liberty and the Mental Capacity Act, access this below:

CPP Practice Briefing 09/05/2023

Research in Practice have created guidance for when 16 and 17
year olds are to be considered to be deprived of their liberty and, in particular, the limits of the decision-making role of people with parental responsibility.

View the guidance here

The NICE guideline covers decision-making in people 16 years and over who may lack capacity now or in the future.

View the Guideline on the NICE website

An information source for people considering advance care planning has been created and can be viewed on the NHS website

NHS England also have guidance around Advance Care Planning for people with dementia in all care settings, view the guidance here

The National Centre for Post-Qualifying Social Work (via Bournemouth University) have information on Advance Decisions to Refuse Treatment

NICE have produced an easy read guide to Advance Care Planning that can be accessed through their website

Social Care Institute for Excellence (SCIE) have produced the following videos on using the Mental Capacity Act in practice:

Making Safeguarding Personal

The fourth edition of the MSP practice toolkit, produced in January 2020, outlines an approach to and effective application of safeguarding, alongside a range of resources and practice based case examples.

View the Toolkit on the LGA website

DSPP  have produced a good practice leaflet on promoting person-centred adult safeguarding practice in Dudley and can be accessed via our website

The MSP case studies from October 2019 illustrate outcome focused practice in safeguarding adults in line with the MSP approach. They are from nine council areas who put forward case studies, with local areas welcome to put forward further case studies.

Access the case studies from the LGA website

As part of the DSPP Self Neglect thematic review a number of resources to assist practitioners were developed:

  1. Capacity Assessment Examples
  2. Trauma Informed Practice Adults
  3. Person Centred Positive Approach
  4. Person Centred Positive Questioning

Training and Resources

The below DSPP courses are directly linked to the findings of our reviews:

Mental Capacity Act Awareness eLearning

This training has been designed to support your understanding of Mental Capacity Act and Deprivation of Liberty Safeguarding.

The knowledge that you will get from this course will help you understand the how to help people who may lack mental capacity and the implications of Deprivation of Liberty. It will help you to ensure that you are safeguarding their rights.

Access the MCA Awareness eLearning here

Safeguarding Adults Awareness eLearning

To raise awareness of the different types of abuse adults with care and support needs can experience, who abuses, where abuse can take place and how to report concerns

View the eLearning here

Professional Curiosity

This Multi-Agency training course will increase practitioner’s knowledge and confidence in practising ‘respectful uncertainty’ by thinking outside the box’, beyond their usual professional role, and considering individual’s and families’ circumstances holistically. It will also be an opportunity to explore how as professionals differences of opinion, concerns and issues that arise for practitioners at work and are resolved as effectively and swiftly as possible.

Book on the Professional Curiosity course through our booking system

Trauma Informed Practice

The training will equip practitioners:

  • To develop understanding of the theory and concepts behind the potential impact of ACEs and trauma across the life course
  • To understand what trauma-informed and trauma-responsive practice looks, sounds and feels like.
  • To gain a basic understanding into how an organisation can begin a journey towards a trauma-informed organisational culture. The session is structured to return to key ideas and reinforce core messages as take home learning

Book your place on our website

Safer7 Briefings

Seven minute briefings are based on a technique borrowed from the FBI. It is based on research, which suggests that seven minutes is an ideal time span to concentrate and learn. Learning for seven minutes is manageable in most services, and learning is more memorable as it is simple and not clouded by other issues and pressures. 

As part of the Thematic Learning from reviews we have promoted our Safer7 briefings which are directly linked to the findings of our reviews:

Executive function is an umbrella term used to describe a set of mental skills that are controlled by the frontal lobes of the brain. When executive function is impaired, it can inhibit appropriate decision-making and reduce a person’s problem-solving abilities.

Professionals assessing capacity in this patient group are faced with a number of obstacles that make determination of capacity more challenging. This can have significant implications because failing to carry out a sufficiently thorough capacity assessment in these situations can expose a vulnerable person to substantial risk.

View the Safer7 briefing here

Professional curiosity is having the capacity and communication skill to explore and understand what is happening with a child, adult with care and support needs or their family. It is about enquiring deeper and using proactive questioning and challenge. It is about understanding one’s own responsibility and knowing when to act, rather than making assumptions, or taking things at face value.

Access the Professional Curiosity Safer7 here

Sharing information is crucial to safeguarding children and adults – poor information sharing is repeatedly highlighted as an issue in CSPRs and SARs.

The most important consideration is whether sharing information is likely to safeguard and protect the child or adult with care and support needs.

View the Information Sharing Safer7

Disguised Compliance involves parents and carers appearing to co-operate with professionals to allay concerns and stop professional engagement (Reder et al, 1993). This can mean that social workers and other practitioners may be unaware of what is happening in a child’s or adult’s life and the risks they face may be unknown to authorities

View the Safer7 on disguised compliance

There are many ways in which a person or their family can become homeless or find themselves at risk of losing their home.  This includes being served with a valid notice by their landlord, a breakdown of a relationship or fleeing domestic abuse.

The Housing Act 1996, amended by The Homelessness Reduction Act 2017, imposes a legal duty upon Local Authorities to provide advice and assistance to anyone who is homeless or threatened with homelessness.

Access our Safer7 briefing on Homelessness