What does a good mental capacity assessment look like?
Every day in social care, workers make decisions that affect people’s lives—from supporting someone with their medication to helping them choose where to live. The Mental Capacity Act 2005 (MCA) provides the framework to ensure these decisions are made lawfully, respectfully, and in a way that protects people’s rights. But what does a good mental capacity assessment actually look like in practice?
1. Start with the Principles
Before assessing, always remember the five key principles of the MCA:
1. Assume capacity unless proven otherwise.
2. Support decision-making—give information in ways the person understands.
3. Don’t judge unwise decisions—risky or unusual choices don’t equal lack of capacity.
4. Act in best interests if someone truly lacks capacity.
5. Choose the least restrictive option available.
A good assessor has these principles front of mind throughout the process.
2. Be Decision-Specific
Capacity is not “all or nothing.” Someone may lack capacity to sign a tenancy agreement but still have capacity to decide what they want for lunch. A good assessment is always about one decision at one time, not a blanket judgment.
3. Provide the Right Support
A person might understand better with plain language, pictures, or extra time. Assessors should do everything possible to remove barriers. Skipping this step risks drawing the wrong conclusion about a person’s capacity.
4. Apply the Capacity Test
This is an area that has developed significantly through case in the Court of Protection. Best practice now considers there to be three elements to an assessment of capacity.
· One: Is the person unable to:
o Understand the relevant information, and/or
o Retain it long enough, and/or
o Use or weigh it to make a decision, and/or
o Communicate their choice?
· Two: Is there an impairment or disturbance in the mind or brain? This includes permanent, progressive or temporary conditions.
· Three: Is the person unable to make the decision as a direct result of the impairment or disturbance e.g. a person living with advanced dementia cannot understand or retain the relevant information because of the effects dementia has on their memory.
A good assessment clearly records evidence for every element of this test.
5. Record Clearly and Respectfully
Good recording means more than ticking boxes. Write down:
· What steps you took to support the person,
· What the person said or showed you,
· How you reached your conclusion.
Always use respectful language, focusing on the person’s strengths as well as challenges.
Final Thought
A good mental capacity assessment isn’t about denying freedom—it’s about protecting rights while enabling choice. By following the principles, giving proper support, and recording clearly, social care staff can ensure decisions are made fairly, lawfully, and in the person’s best interests.