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Capacity assessments on medical in-patients referred to social workers for care home placement

Southbrook Road Mental Health Centre, London SE12 8LH, email: Sian.Ripley{at}slam.nhs.uk

Sarah Jones, Consultant Physician

Lewisham Hospital NHS Trust, London SE13 6LH

Alastair Macdonald, Professor of Old Age Psychiatry

South London and Maudsley NHS Trust, London SE13 6JZ

Declaration of interest

None.

AIMS AND METHODS

To investigate the feasibility of a clinical algorithm to assess capacity and examine the relationship between its results and the assessments of capacity by others involved in the decision of a patient to permanently enter a care home from a medical ward.

RESULTS

A total of 23 patients out of 38 (60.5%, 95% CI 44–77) had some mention of capacity in any type of record (medical, social work or nursing). At formal assessment 47% of older patients lacked capacity.

CLINICAL IMPLICATIONS

The absence of any recorded assessment in at least a third of patients is worrying, given the importance of the decision to the patients’ lives and their financial status. It is to be hoped that the implementation of the Mental Capacity Act (2005) will rectify this situation.