Individuals can be supported and protected under the 2007 Act whether they have capacity or not – however it is often beneficial to assess the adult's capacity to inform risk assessment and aid decision making.
The BMA offer guidance around capacity online.
When assessing capacity the relevant legislation is the Adults with Incapacity (Scotland) Act 2000. For the purposes of the Act, incapable means incapable of:
- acting or
- making decisions; or
- communicating decisions; or
- understanding decisions; or
- retaining the memory of decisions
Capacity is not all or nothing. The Act recognises that a person may be capable of some decisions and actions and not capable of others. A person lacks capacity to take a particular decision or action when there is evidence that he/she is unable to do so. Please see the guide available from the Scottish Government website called Guide to Assessing Capacity.
The principles of the Adults with Incapacity (Scotland) Act must be followed to ensure that all decisions that are made are for the benefit of the adult. The principles that have to be followed in any decision taken for an incapable adult are outlined online.
Some of the key factors to consider when assessing capacity, and they are not exhaustive, are ;
- A person may not have capacity to make a particular decision at a certain time, but this does not mean that they will never have capacity to make that decision.
- That you consider your patient's ability with regard to each decision/task as to their ability to; act, or make a decision, or communicate decisions, or understand decisions, or retain the memory of decisions.
- Ensure that the assessment is decision and task specific.
- Listen to the adult and take their views into consideration.
- If practicable consult and take into consideration views of family members/carers.
- All practicable steps must be taken to assist the adult and help them understand and communicate.
Useful learning resources from Think capacity/Think consent can be found at capacity_and_consent-interactive.pdf (scot.nhs.uk)
Courtesy of Edinburgh City Council and NHS Lothian, Appendix X provides a basic screening tool to assist in your consideration of a patient's mental capacity. However please note it relies upon you having familiarised yourself with the Communication and Assessing Capacity Guide.