What are the key principles under the Mental Capacity Act 2005? (tick all that apply)

What questions do you need to consider when assessing capacity? (tick all that apply)

Ambulance staff are allowed to use ‘reasonable force’ for minimal restraint to ensure a best interest decision can be made for a patient deemed lacking in capacity?

You are called to an 84- year-old female who is refusing care against advice and currently is deemed to lack capacity due to an advanced dementia diagnosis. You speak to the daughter and she states she is on her way and is bringing legal paperwork to show she can make decisions on behalf of the patient in these circumstances, what paperwork are you expecting the daughter to turn up with?

If you deem a patient to be lacking in capacity under the Mental Capacity Act 2005, you can (potentially with additional help from police) remove a patient from their own home for immediate, emergency hospital treatment if it is in their best interest?

Under the Mental Capacity Act, if making a best interest decision for a patient deemed to be lacking in capacity, what factors should you consider? (tick all that apply)

You are called to a 24-year-old male late at night at their own home who has consumed 0.5cl of spirits and normally drinks this amount every day, they initially seem intoxicated but when you start asking questions you realise that they are fully conversant and are able to engage quite well. The patient is showing signs of an increasingly worse chest infection as their NEWS score is a 6. The patient states they now feel a lot better as you have arrived 3 hours after the initial call, but you are worried that this patient could deteriorate over the next couple of days if not treated promptly. You deem them to have capacity and they state they are refusing to go to hospital or have any other referral which may help them. You contact your senior clinician over the phone as you are unsure on the rules of capacity and really think this patient should seek further help. The senior clinician you speak to thinks that you can take the patient under the Mental Capacity Act due to consumption of alcohol and this takes away their capacity. Do you agree and what do you aim to do for this patient? You try to persuade them to seek help, but they are adamant they feel a lot better and refuse but will ring their own GP in the morning.

You are called to a 36-year-old female who has taken a concoction of medications in an intentional overdose only 15 mins prior to your arrival including diazepam and 30/500mg co-codamol. The husband who has called has stated the patient suffers with bipolar disorder and has taken overdoses in the past. He is unsure of the number of medications taken but thinks a lot have gone missing from a stockpile of medications she had. He is not sure where the empty packets have gone. The patient seems relatively calm and explains she is refusing all care as she ‘doesn’t want to live anymore’ and doesn’t really engage. You explain the need for a capacity assessment and after some persuasion she agrees for you to complete it. You deem her to have full capacity. The police are present, and you discuss the plan of action and start involving mental health professionals to help with this case. As you are waiting for the necessary call backs, you notice the patient start to deteriorate, you try to ask further questions, but you are unable to get straight answers and the patient is starting to become very drowsy. You complete another capacity assessment, and she is deemed to be currently lacking in capacity. What actions could you consider getting this patient the right care she needs?

You are called to a 39-year-old male with known schizophrenia who has been acting irrationally and extremely paranoid to the point he will not let his own family into the house. There are concerns for his mental wellbeing and he has mentioned the possibility of attacking people ‘who are coming to get him’ if they come into his house. What law can be enacted to help this patient to a place of safety and receive a mental health assessment (and treatment if required)?

How long can a patient be admitted to an appropriate facility for assessment and treatment under section 2 of the Mental Health Act?

The new codes of practice under the Mental Health Act 1983 requires that for the safety and dignity of the person, an ambulance should generally be used to transport the patient to a place of safety?

If the patient detained under the Mental health Act 1983 needs to be taken to a place of safety in a police vehicle due to increased risk of patient or emergency service workers, according to the code of practice under the Mental Health Act 1983, how should the ambulance crew support during transport?

Police stations are not classed as places of safety for persons under what age?

The police require a warrant when removing a patient to a place of safety under the Mental Health Act 1983 Section 136?

What conditions must be met so police can implement the Mental Health Act section 136 on a patient to take them to a place of safety? (tick all that apply)