Mental Capacity Assessments

I’m sometimes asked by people if I can develop a tool that will help their staff assess a person’s mental capacity; a series of questions that they can use to ensure their mental capacity assessments are consistent. Now don’t get me wrong, I applaud anyone who wants to fine-tune their skills in this area and always happy to give guidance as to what questions might be a useful starting point. But in doing this there is a danger of reducing mental capacity assessments to something that has to be done to satisfy the Care Quality Commission. Rather than seeing the Mental Capacity Act as a framework for supporting people to make their own decisions and making best interest decisions if they can’t.

Over the years that I’ve been completing Mental Capacity Assessments, I have continued to learn that the process of assessing capacity is very different for different people.  After all, when any of us make a decision there are several factors that lead us to decide one way or another.  Too many for a standard set of questions to come even close to being adequate.  For instance, some people are able to communicate verbally and others not.  I visited a man not so long ago to assess his capacity and he had no verbal communication.  He was still able to communicate but only by nodding and shaking his head.  I assessed that he had capacity to make a particular decision but I would have probably come to a different conclusion if I hadn’t used closed questions (questions that can be answered with a ‘yes’ or ‘no’) because he wouldn’t have been able to answer me by nodding or shaking his head.

Over the coming weeks, I’m going to share some posts about various aspects of a mental capacity assessments that I hope you find of use when undertaking your own assessments. The first will explore communication in a little more detail.