Mental capacity assessments

What is a mental capacity assessment?

A mental capacity assessment looks at whether a person can make a particular decision at a particular time. It is carried out in line with the Mental Capacity Act 2005, which starts from the position that every adult has capacity unless it is shown otherwise, and that people must be given all practicable support to make their own decisions.

Capacity is decision specific and time specific. Someone may be able to make some decisions and not others, and their ability can change over time.

Who can ask for one?

Referrals are welcome from case managers, solicitors, families, GPs and other health and social care professionals. Self-referrals are welcome too. If you are not sure whether an assessment is needed, you can get in touch for an informal conversation first.

What kinds of decisions can it cover?

Common questions include:

• where someone lives and what care and support they receive
• medical or psychological treatment
• managing money, property and finances
• taking part in legal proceedings and giving instructions to a solicitor

Assessments are often requested where there are concerns about decision making because of acquired brain injury, dementia, other neurological conditions or mental health needs.

How does the assessment work?

The assessment is built around the specific decision being asked about. It usually involves:

• agreeing the exact question, who is asking and why
• reviewing relevant records or reports
• meeting the person, with support to communicate in the way that suits them best
• speaking with people who know them well, where appropriate
• weighing the evidence against the Mental Capacity Act test, which asks whether the person can understand, retain, use or weigh, and communicate information about the decision

The person is always at the centre. I explain clearly what the assessment is for, listen to their views and make every reasonable effort to support them to take part.

Can the assessment be done jointly with another professional?

Yes. Depending on how the person presents and the question being asked, the gold standard may be for me to carry out the assessment jointly with another professional, such as a speech and language therapist, an occupational therapist or a solicitor. I can arrange this. At the start we talk through what would suit the situation and who should be involved.

What will the report include?

You receive a clear, structured written report. It sets out the question asked, the information reviewed, the person’s own views, how the Mental Capacity Act test was applied and my conclusions, written so that it can support legal, clinical or case management processes.

How long does it take, and where does it happen?

The time needed depends on the decision and how complex the situation is. We agree an expected timeframe when you enquire, so you know what to plan for. Assessments can take place online or in person in Chiswick, Kensington or West Hampstead, and home visits can be arranged where the home environment is judged suitable, as can community visits, case by case. If a matter may be heading to court, please mention this at the start.