Exam Pass Notes

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Use these notes as a brief memory aid before the assessment. The Mental Capacity Act (MCA) applies in England and Wales; Scotland and Northern Ireland have different legal frameworks. The practical habits emphasised in the course — supporting decision-making, avoiding blanket assumptions, involving the person, recording clearly, and escalating risk when needed — remain relevant across UK care settings.

Key points to remember

• Presume capacity first: do not assume incapacity from diagnosis, age, behaviour, or convenience.
• Capacity is decision-specific and time-specific: someone may be able to make one decision but not another, or may be able to decide at a different time.
• Support before concluding incapacity: try communication aids, better timing, a calmer setting, and step-by-step explanations.
• Use the functional test: can the person understand, retain, use or weigh information, and communicate their decision?
• An unwise decision is not incapacity: adults can make choices staff disagree with.
• Best interests must be person-centred: involve the person, consider their wishes and values, consult relevant others, and avoid discrimination.
• Choose the least restrictive option: any restriction must be necessary, proportionate, and not mainly for staff convenience.
• Know who can decide: relatives do not automatically have decision-making authority; attorneys, deputies, IMCAs, and advance decisions each have specific roles.
• DoLS still matters: at the time of writing in April 2026, care homes and hospitals in England continue to use Deprivation of Liberty Safeguards; Wales also remains on the current DoLS framework pending reform.
• Record clearly and escalate safely: note the specific decision, what support was tried, what the person said or did, and who was informed.