Mental Capacity Assessment- tips
• It is crucial that the practitioner clearly identifies what decision needs to be made, otherwise the exercise will be pointless
• Saying that someone lacks capacity is meaningless. It is about assessing a specific decision at a point in time and not a person’s ability to make decisions in general
• A crucial step in assessing capacity is to prepare for the assessment rather than going in with a blank canvas. Plan how you are going to ascertain an individual’s wishes and feelings and assess their capacity. Consider how you will structure your assessment and analyse the information you gather to reach a decision
• Gather information relevant to the specific decision to be made, for example, in relation to available options
• Consider how you will ensure that you communicate in an effective and reliable manner
• Consider the time of day, place of assessment and factors that could be influencing the person’s capacity
• Gather as much information as possible about the person before completing the assessment
• Identify key people to speak to, such as family and professionals who spend a lot of time with the person
• Assess an individual by visiting them on more than one occasion and consider the venue as they may respond differently in different settings
• Make sure that you have made a thorough attempt to help a person make a decision for themselves taking all practical steps, that will make that possible. This would include things like making sure that the person is made to feel at ease, speaking loudly, making good eye contact and sitting close to the person and considering background noise and interference
• It is important to acknowledge the difference between ‘Unwise decisions’ which a person has the right to make, and ‘Decisions based on a lack of understanding of risks or inability to weigh up the information about a decision’
• Practitioners need to demonstrate that they have reasonable belief about a persons’ mental capacity. Following from the five statutory principles of the Mental Capacity Act ‘a person must be assumed to have capacity unless it is established that they lack capacity’. To evidence that a person lacks mental capacity, to make a specific decision at a specific time, reasonable steps must be taken and recorded.
• There must be objective reasons for believing a person lacks capacity to make a particular decision
• Practitioners need to consider applicable ‘How, Why and What Questions’ to help them decide whether a person has mental capacity to make a particular decision at a particular time. Such questions encourage an open-ended response rather than a simple yes or no. For example, if assessing an individual’s mental capacity regarding management of finances the following ‘How, Why and What Questions’ may be helpful:
1. What income do you receive monthly?
2. How do you pay your monthly household bills?
3. Who helps you buy your weekly shopping?
4. Why do you need some help to purchase your weekly shopping?