What is a mental capacity assessment?

A mental capacity assessment (MCA) evaluates a person’s ability to make decisions for themselves. This service helps determine the level of support a person needs, ensuring a decision is made in their best interests if they are unable to do so themselves.

The MCA covers all types of decisions, big and small. This may be day-to-day decisions, such as what to wear or eat, through to more serious or life-changing decisions, such as whether to have surgery or how to manage finances.

Is a person’s mental capacity fixed?

An MCA is time- and decision-specific. This means someone might not have mental capacity today, but they could do tomorrow. Equally, someone might not have capacity to decide on their finances, but they may have capacity to decide about where to live.

What are the key principles of a mental capacity assessment?

There are five key principles set out in the Mental Capacity Act 2005 that must be followed when carrying out an MCA. These are:

  1. Assume a person has capacity to make a decision themselves unless proven otherwise.
  2. Wherever possible, help people make their own decisions.
  3. Don’t treat a person as lacking capacity just because they make an unwise decision.
  4. Any decision made for someone who lacks capacity must be in their best interests.
  5. Treatment and care given to someone who lacks capacity should be the least restrictive of their basic rights and freedoms.

When might someone lack capacity to make a decision?

A person is unable to make their own decision if they can’t do one or more of the following four things:

  • Understand the information given to them
  • Retain the information long enough to be able to make a decision
  • Weigh up the information available to make a decision
  • Communicate their decision in some way

What happens if a person lacks capacity?

If a person lacks capacity to make a decision, the MCA says that someone else can make the decision for them, acting in their best interest. That is, unless the person has an advance directive that outlines their wishes for that specific decision.

Even if someone else is making the decision, the person should still be involved as much as possible in the decision-making process.

For important decisions, a formal MCA is carried out and documented by a professional, which may need to be presented to the Court of Protection.

Who carries out a mental capacity assessment?

Technically, anyone can complete an MCA. But for it to be appropriate, it should be carried out by someone involved in supporting the person. This could be a close friend or relative, but it might also include:

  • A GP or nurse
  • A social worker
  • An occupational therapist
  • A deputy appointed by the Court of Protection

For more major decisions, a suitable professional should carry out the MCA, such as a social worker, who will then provide a formal report of the assessment.  

Get in touch