Exam Pass Notes

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Key Takeaways

• Consent in adult social care is not only about forms or major treatment. It applies to everyday support such as personal care, medicines, mobility, room access, and information sharing.
• Valid consent should be informed, voluntary, specific to the decision, and treated as an ongoing process.
• People can communicate agreement or refusal in different ways, including words, gestures, facial expression, or actions.
• A person can refuse care if they have capacity for that decision, even if others disagree.
• Past agreement does not cancel the need to seek consent again today.

Supporting Consent in Practice

• Explain clearly: use plain language, one step at a time, and check understanding properly.
• Choose the right conditions: pain, noise, fatigue, poor timing, and unfamiliar staff can all affect decision-making.
• Watch during the task: ongoing consent matters, especially during intimate care, moving and handling, oral care, and medicines support.
• Pause when distress appears: pulling away, crying, or agitation may show that the person is no longer consenting or no longer understands.

Capacity, Best Interests, and Restrictions

• Capacity is decision-specific and time-specific: a person may decide some things but not others.
• The five Mental Capacity Act principles matter: presume capacity, support the decision, do not confuse unwise choice with incapacity, act in best interests if needed, and choose the least restrictive option.
• Assess what the person can do: understand, retain, use or weigh information, and communicate a choice.
• Restraint is not routine care: if ever used under the Mental Capacity Act, it must be necessary to prevent harm and proportionate.
• Think about DoLS or local safeguards: if a person lacks capacity to consent to arrangements, is under continuous supervision and control, and is not free to leave, legal authorisation or review may be needed.

Families, Records, and Escalation

• Family do not automatically decide: next of kin status alone does not give consent powers.
• Recognise formal authority: health and welfare attorneys, some deputies, IMCAs, and valid advance decisions may be relevant.
• Record facts, not labels: describe what was offered, what was explained, how the person responded, and what happened next.
• Escalate concerns early: repeated refusal of essential care, sudden changes in capacity, safeguarding concerns, disputes, or possible deprivation of liberty all need prompt review.