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Mental Capacity in Practice

The Mental Capacity Act in practice.

Supporting capacity: Young man in wheelchair

Preparing questions for a complex Mental Capacity Assessment

In our last blog, we considered the complex case of ‘P’ – an individual being assessed for mental capacity with respect to their change in accommodation, as well as their wish to take responsibility for managing their inheritance.

The case study highlighted several major issues in the way the original mental capacity assessment had been completed, including concerns around the lack of support to help P communicate autonomously, and the lack of documentation around P’s condition and capacity.

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Assessing complex cases: Disabled man using eye tracking software

Mental capacity assessments for complex decisions

In this blog, we will work through an example mental capacity assessment for an individual making a complex decision. This case study is based on a real-life example reviewed in the wake of the Covid pandemic. At each stage we will present the information as it was presented to us, followed by specific comment relating to the assessment process and steps that could and in some cases should have been taken to improve the quality of outcomes.

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Retaining information: man looking out of window

What is retention?

When it comes to Mental Capacity Assessments, ‘retention’ refers to an individual’s ability to recollect relevant information relating to a specific decision. However, in assessing for retention, it is also important to take into account the second principle of the Mental Capacity Act, which states that we should actively support capacity wherever possible. Therefore, as assessors, we should provide sufficient support to enable retention where possible – be it through labelled items, social stories, easy read guides or so on.

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Insight and understanding: Elderly woman smiling as she looks into the distance

What is ‘understanding’?

At its most basic level, ‘understanding’ refers to ‘comprehension’ or ‘insight’ – the ability to apply knowledge to a specific topic or situation. However, in terms of the criteria for Mental Capacity Assessments, these definitions are perhaps a little broad. This is because when we test for capacity, we are not looking for an in-depth understanding of a specific topic, but rather an ability to ‘grasp’ the concept within the context of the individual’s own situation.

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Supporting capacity with augmentative communication aids

Supporting capacity with augmentative communication aids

There are many different forms of communication, both verbal and non-verbal in nature. While many of us will take communication for granted, others need a little more support. Thankfully there are a range of relatively low-tech aids available to support those with complex communication needs. These include Makaton, PECS and Talking Mats – all of which are put to good use across education and healthcare settings to promote inclusion and person-centred care.

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