They don’t want them to have capacity’

Multi‐agency operationalisation of the Mental Capacity Act 2005 in England with adults who self‐neglect

Bibliographic Data

ID12288283
AuthorsElaine Aspinwall‐Roberts (0000-0003-1754-4496, Faculty of Health, School of Nursing and Allied Health Liverpool John Moores University Liverpool UK, corresponding author), Valerie Fleming (0000-0002-4672-4843, Faculty of Health, School of Nursing and Allied Health Liverpool John Moores University Liverpool UK), Rose Khatri (0000-0002-1018-5745, Faculty of Health, School of Nursing and Allied Health Liverpool John Moores University Liverpool UK), Paul A Jones (0000-0002-3295-7670, Faculty of Health, School of Nursing and Allied Health Liverpool John Moores University Liverpool UK)
Year2022
Volume30
Issue6
Pagese4395-e4404
Publication date2022-05-23
Open AccessYes
TypeARTICLE
VenueHealth & Social Care in the Community (JOURNAL)
Journal identifiersISSN: 0966-0410 • E-ISSN: 1365-2524
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hsc.13839
PMID35607758
OpenAlexW4282938932
LanguageEN
Citations received5
References cited29

The number of adults who self-neglect and thus fall under the aegis of local authority adult safeguarding procedures in England has increased substantially since the introduction of the Care Act 2014. The requirement for collaborative working between agencies dealing with these adults in a safeguarding context is explicit in government policy and legislation. Decisions made by the multiplicity of agencies that may work with people who self-neglect are largely guided by the Mental Capacity Act 2005 (MCA). The overall objective of this research was to develop a clearer understanding of how the range of agencies that might typically be involved in the life of a self-neglecting person work together. This article examines how agencies put the MCA into practice in their work with people who self-neglect, and how they understand their own and others' roles and responsibilities in so doing. This qualitative study took place in two local authorities in England from 2016 to 2017 and informed a wider action research study which was completed in 2019. Non-probability purposive sampling was used to recruit participants from the professional groups who might typically be involved with self-neglect cases. À total of 245 participants from across 17 different professional groups took part in semi-structured interviews, in a group, paired or individual format, decided by their customary working configuration. Data from the interview transcripts was analysed using thematic analysis. Three key themes in relation to how participants understood the MCA and multi-agency working emerged from the analysis of this data set. These were; a lack of understanding of the MCA by participants and other agencies; a reluctance to engage with MCA assessments; and a perception of manipulation of the MCA by other professionals. This study underlines the importance of the informed application of the MCA in working with people who self-neglect, and an urgent need to consider how this could be enhanced if the service user is not to experience intrusive interventions resulting from professional misinterpretation

Agency (philosophy · Child protection · Context (archaeology · Government (linguistics · Legislation · Local authority · Neglect · Nonprobability sampling · Political science · Population · Psychiatry · Public relations · Qualitative research · Safeguarding · Social science · Sociology · Thematic analysis · Elder Abuse and Neglect · Healthcare Decision-Making and Restraints · Healthcare innovation and challenges · Law · Medicine · Nursing · Psychology · Public Administration

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