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Mental Capacity Assessment

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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Communication is key: elderly couple sitting in the garden enjoying the sunshine

Communication to support capacity

Communication is an absolutely vital part of the Mental Capacity Act (2005). If we are to support capacity effectively then we should do everything in our power to ensure good, effective communication that is adapted to the needs of the service user. This may mean taking extra measures to aid the process of communication, to consider environmental and/or external factors, and also to make allowances for any fluctuations in an individual’s ability to understand.

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Assessing capacity: lady and man in wheelchair wearing coats looking into the distance

Common errors in Mental Capacity Assessments

I’ve been involved with the field of Mental Capacity for many years now, both as an assessor and an advocate. In this time, I’ve encountered a whole range of common errors and mistakes that come up time and time again.

These errors can have a major impact on a person’s quality of life, and ability to make decisions for themselves. Not only that, but they also leave open the risk that if the Mental Capacity decision is ever to be challenged, then it will quickly be dismissed and overruled by governing bodies such as the Court of Protection.

However, thankfully, most of these errors are easily avoidable and simple to resolve with adequate reflection, preparation and the correct training. 

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Lady in wheelchair facing away from camera, looking down a paved street

How to explain assessments to people who are being assessed

We all have a large amount of underlying assumptions or associations in all elements of our lives, which we are encouraged as working professionals to stop and reflect on in order to reduce the impact of these on our daily practices. Without this professional conduct we risk being biased, unprofessional, incur misunderstandings or cause offence. Whether it is surrounding age, gender, health conditions, political outlook, faith, religion, education or appearance.

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Elderly lady walking outside arm in arm with nurse. Photo by Cristina Serí on Unsplash.

Mental Capacity Assessments: Where to start?

From talking to colleagues, team members from different settings and other professionals across the board about the topic of the Mental Capacity Act and its Assessment, one of the most common stumbling blocks reported appears to be – where to start with an assessment, closely followed by the contents of completed assessments. It can leave some people feeling really overwhelmed and unsure of themselves, while others are thriving at the challenge, identifying ways to establish a “standard” for their own working environment. 

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Elderly gentleman and young man in red hat smiling and enjoying time together. Photo by Nathan Anderson on Unsplash.

Mental Capacity and consent

When I first started working in healthcare there was very little said about capacity yet there was a lot of emphasis said about consent, especially that of informed consent. Consent to treatment, consent to an intervention, consent to support with personal care, consent to speak to a family member, consent to take photos, consent to store information or share with the GP. The list is quite endless and is a staple of not just the health care system, but our society as a whole that has grown in importance over the years.

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