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Pointers for Practice: Assessing Mental Capacity

When assessing whether an adult at risk can give consent the following should be considered:

  • What evidence is there that the adult at risk of harm does not have mental capacity? Remember the individual does not need to have the same degree of understanding as a professional in order to make a decision.
  • Are presumptions being made about capacity based on age, appearance, condition or behaviour?
  • Is the adult able to make decisions about any aspect of the process? Remember that capacity is specific to a particular decision being made’

Example: they may not have the capacity to make a decision as to whether a referral should be completed but they may be able to indicate where they would like any subsequent assessment to take place and who they would like to be present.

  • Has every attempt been made to encourage participation? What practical support has been given to enable the adult at risk make a decision? Why was this not successful?
  • Has the adult at risk been provided with appropriate methods of communication for example, an interpreter, augmentative communication tools?
  • Do the concerns about capacity exist because the individual has made what others consider to be an unwise decision? This alone does not mean they do not have capacity.
  • Is the loss of capacity temporary due for example to drugs? Would a deferral until they have regained capacity put them at increased risk of harm?
  • What do we know about the adult at risk’s past history? Does this tell us anything about their past and present wishes, feelings, beliefs and values?

(Adapted from NHS Mental Capacity Act)


Further information:

NHS Mental Capacity Act, (Accessed 21/7/2019)

Henke R, Shepherd, l and O’Callaghan, A (2019) A Practitioner’s Guide. Basic Legal Principles NISB Wales