Introduction Since the introduction of the Mental Capacity Act (MCA) in 2005, there has been much debate what constitutes an adequate MCA assessment. It is important to keep comprehensive documentation of MCA assessments as they can be challenged. Hospices (along with other healthcare services) need to ensure their staff are competent in conducting MCA assessments and that their documentation is clear and consistent.

Aims To evaluate the quality of MCA assessment and documentation for patients under the care of the hospice.

Methods All MCA assessments conducted in a 34-bed hospice over a six -month period were reviewed retrospectively using an audit tool developed by the British Psychological Society.

Results and Recommendations 44 assessments for 20 patients were analysed. Assessments were generally well documented: the rationale was clear (91%); the decision to be made was clearly stated (95%) and the diagnostic and functional tests were specifically addressed (91%). Areas where practice could be improved included: assessing capacity for one decision at a time; documenting any communication difficulties and how these are overcome; clearly documenting recommendations as a result of the assessment; and identifying the need for repeat assessments. As part of a multidisciplinary discussion, amendments have been made to the MCA assessment documentation template. Results have been disseminated and an education session held to increase awareness, and the hospice documentation template updated, prior to re-audit in August 2017.

Conclusions MCA assessment documentation was generally clear and appeared to show staff understood the basic principles of the MCA. It is hoped that updating the documentation template, in addition to staff education, will address the areas requiring improvement.