Mental Capacity Act (MCA) & Deprivation of Liberty (DoLs) Practice Quiz.

Check your understanding of the MCA and DoLs. This quiz covers key concepts, legal responsibilities, and real-world scenarios to help you apply your knowledge confidently in practice.

MCA and DoLS Practice Quiz

Section 1: MCA Principles and Core Concepts

1. When was the Mental Capacity Act (MCA) implemented in full force in England and Wales?

a) 2005
b) 2006
c) 2007
d) 2009

2. Who does the MCA apply to?
a) Only older people with dementia
b) Only people with learning disabilities
c) Only people who have a mental illness
d) Everyone aged 16 and over

3. What is the fundamental starting point of the MCA?
a) Assume the person lacks capacity until proven otherwise
b) Presume the person has capacity unless it is established they do not
c) The doctor makes the decision about capacity
d) Family members decide if a person has capacity

4. According to the second principle of the MCA, what must be done before concluding a person lacks capacity?
a) Consult a solicitor
b) Get agreement from their family
c) Document the decision immediately
d) Take all practicable steps to help the person make the decision themselves

5. A person makes a decision that seems highly risky or unwise. Under the MCA, what does this indicate?
a) They definitely lack capacity
b) A person is not to be treated as lacking capacity just because they make an unwise decision
c) Their capacity must be immediately revoked
d) You must stop them from making that decision

6. Any decision made on behalf of a person who lacks capacity must be made in their…
a) Best financial interest
b) Care provider’s interest
c) Best interests
d) Doctor’s interest

7. The fifth principle of the MCA states that any act done for a person who lacks capacity should be the…
a) Most cost-effective option
b) Easiest option for staff
c) Option preferred by the family
d) Least restrictive option to their rights and freedom

8. What does “capacity” refer to in the context of the MCA?
a) A person’s physical strength
b) A person’s ability to make a specific decision at a specific time
c) A person’s general intelligence
d) A person’s willingness to cooperate

9. Can a person have capacity for some decisions but not others?
a) Yes, capacity is decision-specific and time-specific
b) No, capacity is a general state
c) Only if a doctor decides this is the case
d) Only if they are over 65

10. At what age does the MCA primarily apply for most decisions (excluding some specific areas like Advance Decisions)?
a) 14
b) 16
c) 18
d) 21

11. Who can assess a person’s capacity?
a) Only a doctor or psychiatrist
b) Only a social worker
c) Only a solicitor
d) The person who is making the decision or carrying out the action (usually the relevant professional)

Section 2: Assessing Capacity (The Two-Stage Test)

12. The capacity assessment involves a two-stage test. What is the first stage?
a) The functional test
b) The diagnostic test (identifying an impairment or disturbance in the mind or brain)
c) The best interests test
d) The “free to leave” test

13. What is the second stage of the capacity assessment?
b) The functional test (determining if the impairment prevents them from making the decision)
a) The diagnostic test
c) Consulting with family members
d) Documenting the decision

14. Which of the following is NOT one of the four functional tasks a person must be able to do to have capacity for a specific decision?
a) Understand the relevant information
b) Retain the information
c) Agree with professional advice
d) Use or weigh the information

15. To have capacity, a person must be able to retain the information for how long?
a) At least 24 hours
b) A week
c) Permanently
d) Long enough to make the decision

16. What must the professional establish a “causative link” between during the assessment?
a) The person’s age and their decision
b) The person’s decision and the cost of care
c) The impairment of the mind/brain and the inability to make the decision
d) The family’s wishes and the person’s decision

17. If a person cannot communicate their decision by any means (verbal, non-verbal, blinking), do they lack capacity?
a) No, they just need an interpreter
b) No, as long as they understand the information
c) Yes, communication is the final functional requirement
d) Not necessarily, an IMCA can decide for them

18. When assessing capacity, what must the assessor ensure regarding the information provided?
a) It is presented using only legal terms
b) It only focuses on the best-case scenario
c) It is presented in a way that is easiest for them to understand (e.g., simple language, visual aids)
d) The person understands all peripheral details

19. Can capacity fluctuate?
a) Yes, capacity can be temporary (e.g., due to delirium, medication) and should be assessed at the relevant time
b) No, once capacity is lost, it is permanent
c) Only in care homes, not hospitals
d) Only for financial decisions

20. What is an example of a “practicable step” to help someone make a decision?
a) Making the decision for them quickly
b) Telling them what their family wants
c) Using complex medical jargon
d) Delaying the decision until a time of day when their understanding is better

Section 3: Best Interests Decisions

21. When making a decision in a person’s best interests, whose views must the decision-maker consider?
a) Only their own professional opinion
b) Only the views of the person’s next of kin
c) Only financial implications
d) The person’s past and present wishes, feelings, beliefs, and values

22. What is the purpose of the “best interests checklist” in the MCA Code of Practice?
a) To tell the decision-maker exactly what to do
b) To provide a framework of factors that must be considered and weighed
c) To determine who pays for care
d) To speed up the decision-making process

23. When must the decision-maker involve the person lacking capacity in the best interests process?
a) They don’t have to; the person lacks capacity
b) Only if the person asks to be involved
c) As fully as possible
d) Only if family members agree

24. If a best interests decision needs to be made for someone with no family or friends to consult, who might need to be appointed?
a) A solicitor
b) An Independent Mental Capacity Advocate (IMCA)
c) A court-appointed deputy
d) A social worker (sole decision-maker)

25. What is the role of an IMCA?
a) To represent the person lacking capacity and ensure their views and rights are considered
b) To make the final decision about treatment
c) To act as a witness for the care home
d) To manage the person’s finances

26. When considering whether the person might regain capacity, what should the decision-maker do if possible?
a) Delay the decision until they might be better able to make it
b) Make the decision immediately using the least restrictive option
c) Apply for a DoLS authorization
d) Refer the case to the police

27. Using the “balance sheet approach” (weighing pros and cons) can be helpful in which scenario?
a) Routine daily care decisions
b) Particularly difficult or contentious best interests decisions
c) Assessing a person’s age
d) Deciding meal choices
Section 4: DoLS and Deprivation of Liberty

28. What does DoLS stand for?
a) Deprivation of Liberty Safeguards
b) Decisions on Living Standards
c) Duty of Care Liabilities Scheme
d) Dementia Outreach and Support

29. Why were the DoLS introduced?
a) To save money in the care system
b) To give doctors more power
c) To safeguard vulnerable people in hospitals and care homes and uphold their human rights (Article 5 ECHR)
d) To streamline hospital admissions

30. In which settings do the DoLS apply?
a) Private homes in the community
b) Registered care homes and hospitals
c) Supported living settings only
d) Any place where a person lives

31. When did the Deprivation of Liberty Safeguards come into force?
a) 2005
b) 2007
c) 1st April 2009
d) 1st April 2015

32. What is the “acid test” (from the Cheshire West Supreme Court judgment) for determining if a person is deprived of their liberty?
a) Are they happy with their care?
b) Are they allowed visitors?
c) Are they subject to continuous supervision and control AND not free to leave?
d) Do they have a diagnosis of dementia?

33. In the “acid test”, does the person’s apparent compliance or the “normalcy” of the situation matter?
a) Yes, if they aren’t trying to leave, they aren’t deprived of liberty
b) No, these factors are irrelevant to the legal test
c) Only if a family member agrees
d) Only if they are a self-funder

34. A person lacks capacity to consent to their care home placement. They are under continuous supervision and cannot leave the premises. Are they deprived of their liberty?
a) Yes, the “acid test” is met
b) No, it’s in their best interest to be there
c) No, they haven’t tried to leave
d) No, care homes are not legally restricted environments

35. Who is the “managing authority” responsible for applying for a DoLS authorisation?
a) The local authority
b) The person’s family
c) The hospital or care home where the person is staying
d) The GP

36. Who is the “supervisory body” that grants or refuses a DoLS authorisation?
a) The relevant local authority (for care homes) or NHS body (for hospitals)
b) The Court of Protection
c) The CQC
d) The police

37. If a standard authorisation is needed urgently to protect a person, what can the managing authority issue?
a) A 28-day holding order
b) An Urgent Authorisation (initially for up to 7 days)
c) An immediate court order
d) A verbal agreement with the family

38. Which Article of the European Convention on Human Rights (ECHR) is relevant to DoLS?
a) Article 3 (Freedom from torture)
b) Article 5 (Right to liberty and security)
c) Article 8 (Right to private and family life)
d) Article 14 (Prohibition of discrimination)

39. Can a young person aged 16 or 17 be subject to a DoLS?
a) Yes, the DoLS provisions apply to those aged 18 and over, but the inherent jurisdiction of the High Court covers 16/17 year olds, often using similar principles
b) No, the MCA only applies from age 18 for DoLS
c) Yes, they use the adult DoLS process
d) No, they fall under the Mental Health Act only

40. If a person subject to DoLS has no one appropriate to consult with, a specific person must be appointed to represent them. What are they called under DoLS?
a) Nearest Relative
b) Lasting Power of Attorney
c) Relevant Person’s Representative (RPR)
d) IMCA

Section 5: Roles, Powers, and Related Legalities

41. What is a Lasting Power of Attorney (LPA)?
a) A document that allows a person to make decisions for someone immediately
b) A court order appointing a deputy
c) A legal document where a person (the donor) names someone (the attorney) to make decisions on their behalf if they lose capacity
d) A will

42. For an LPA for Health and Welfare to be valid, when must the person (donor) have had capacity?
a) When they made and signed the LPA document
b) At the point the decisions need to be made
c) They never need capacity
d) Only if they are under 60
43. Who is a ‘deputy’ appointed by?
a) The local authority
b) A GP
c) The Court of Protection
d) The Secretary of State

44. A deputy is appointed to make ongoing decisions for someone lacking capacity. In what areas can a deputy make decisions?
a) Health and Welfare only
b) Property and Affairs only
c) Either Property and Affairs, Health and Welfare, or both, as specified by the court order
d) Only medical treatment decisions

45. What is an Advance Decision to Refuse Treatment (ADRT)?
a) A verbal statement refusing all future care
b) A decision made by a doctor on a person’s behalf
c) A legally binding written statement made by a person with capacity to refuse specific medical treatments in the future if they lose capacity
d) A general wish about end-of-life care

46. If a valid and applicable ADRT exists, must healthcare professionals usually follow it?
a) Yes, it has the same effect as a decision made by a person with capacity
b) No, the doctor can override it in an emergency
c) No, family members can consent to treatment anyway
d) Only if the Court of Protection agrees

47. Which court oversees the Mental Capacity Act and makes decisions about capacity disputes or complex best interests cases?
a) The Magistrates’ Court
b) The High Court
c) The Crown Court
d) The Court of Protection

48. What is Section 5 of the MCA?
a) It provides protection from liability for people providing care or treatment to someone who lacks capacity (if they reasonably believe the person lacks capacity and the action is in their best interests)
b) It outlines the right to liberty
c) It describes the DoLS acid test
d) It defines the role of the IMCA

49. If you have concerns that a person may be under duress or undue influence regarding a decision, does this satisfy the diagnostic test for the MCA?
a) Yes, this is an impairment of the mind
b) No, this is an issue of free consent, not mental capacity under the MCA
c) Yes, you should proceed with a best interests assessment
d) It depends on the person’s age

50. The Mental Capacity Act is a legal requirement in which parts of the UK?
a) All of the UK
b) Scotland only
c) Northern Ireland only
d) England and Wales

Mental Capacity Act (MCA) & Deprivation of Liberty (DoLs) Practice Quiz.

Here are the correct answers for all 50 questions:

1. c) 2007
2. d) Everyone aged 16 and over
3. b) Presume the person has capacity unless it is established they do not
4. d) Take all practicable steps to help the person make the decision themselves
5. b) A person is not to be treated as lacking capacity just because they make an unwise decision
6. c) Best interests
7. d) Least restrictive option to their rights and freedom
8. b) A person’s ability to make a specific decision at a specific time
9. a) Yes, capacity is decision-specific and time-specific
10. b) 16
11. d) The person who is making the decision or carrying out the action (usually the relevant professional)
12. b) The diagnostic test (identifying an impairment or disturbance in the mind or brain)
13. b) The functional test (determining if the impairment prevents them from making the decision)
14. c) Agree with professional advice
15. d) Long enough to make the decision
16. c) The impairment of the mind/brain and the inability to make the decision
17. c) Yes, communication is the final functional requirement
18. c) It is presented in a way that is easiest for them to understand (e.g., simple language, visual aids)
19. a) Yes, capacity can be temporary (e.g., due to delirium, medication) and should be assessed at the relevant time
20. d) Delaying the decision until a time of day when their understanding is better
21. d) The person’s past and present wishes, feelings, beliefs, and values
22. b) To provide a framework of factors that must be considered and weighed
23. c) As fully as possible
24. b) An Independent Mental Capacity Advocate (IMCA)
25. a) To represent the person lacking capacity and ensure their views and rights are considered
26. a) Delay the decision until they might be better able to make it
27. b) Particularly difficult or contentious best interests decisions
28. a) Deprivation of Liberty Safeguards
29. c) To safeguard vulnerable people in hospitals and care homes and uphold their human rights (Article 5 ECHR)
30. b) Registered care homes and hospitals
31. c) 1st April 2009
32. c) Are they subject to continuous supervision and control AND not free to leave
33. b) No, these factors are irrelevant to the legal test
34. a) Yes, the “acid test” is met
35. c) The hospital or care home where the person is staying
36. a) The relevant local authority (for care homes) or NHS body (for hospitals)
37. b) An Urgent Authorisation (initially for up to 7 days)
38. b) Article 5 (Right to liberty and security)
39. a) Yes, the DoLS provisions apply to those aged 18 and over, but the inherent jurisdiction of the High Court covers 16/17 year olds, often using similar principles
40. c) Relevant Person’s Representative (RPR)
41. c) A legal document where a person (the donor) names someone (the attorney) to make decisions on their behalf if they lose capacity
42. a) When they made and signed the LPA document
43. c) The Court of Protection
44. c) Either Property and Affairs, Health and Welfare, or both, as specified by the court order
45. c) A legally binding written statement made by a person with capacity to refuse specific medical treatments in the future if they lose capacity
46. a) Yes, it has the same effect as a decision made by a person with capacity
47. d) The Court of Protection
48. a) It provides protection from liability for people providing care or treatment to someone who lacks capacity (if they reasonably believe the person lacks capacity and the action is in their best interests)
49. b) No, this is an issue of free consent, not mental capacity under the MCA
50. d) England and Wales