The MCA establishes five key principles.

It is really important that care workers and their managers know these.

Working through the principles, 1 to 3 will support the process before or at the point of determining whether someone lacks capacity. If it is decided that capacity is lacking, principles 4 and 5 will support the decision-making process.

The 5 key principles are set out below together with short video clips from the Social Care Institute of Excellence (SCIE) with people talking about each principle:

Principle 1: A Presumption of Capacity

Every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise. 

This means that you cannot assume that someone cannot make a decision for themselves just because they have a particular medical condition or disability.

Principle 2: Individuals Being Supported to Make Their Own Decisions

A person must be given all practicable help before anyone treats them as not being able to make their own decisions. This means you should make every effort to encourage and support people to make the decision for themselves. 

If lack of capacity is established, it is still important that you involve the person as far as possible in making decisions.

Principle 3: Unwise Decisions

People have the right to make what others might regard as an unwise or eccentric decision. 

Everyone has their own values, beliefs and preferences which may not be the same as those of other people. 

You cannot treat them as lacking capacity for that reason. 

Principle 4: Best Interests

If a person has been assessed as lacking capacity then any action taken, or any decision made for, or on behalf of that person, must be made in his or her best interests.

Principle 5: Less Restrictive Option

Someone making a decision or acting on behalf of a person who lacks capacity must consider whether it is possible to decide or act in a way that would interfere less with the person’s rights and freedoms of action, or whether there is a need to decide or act at all. 

In essence, any intervention should be proportional to the particular circumstances of the case.

Did you spot the common theme running through the video clips about the importance of getting to know an individual? This is an important part of being able to support people to make decisions and making decisions in people’s best interests.