Capacity Assessments | The Edinburgh Practice

It should be assumed that a person has capacity unless a comprehensive assessment has been conducted by a professional which indicates otherwise. A clinician will deem an individual to have capacity if they are satisfied that the individual can:

Understand information given to them about a particular decision
Retain the information given for long enough to make a decision
Weigh up the information sufficiently to make a decision
Consistently communicate their decision

Our Expertise

Whilst there is no definitive, predetermined capacity assessment, there are practice guidelines and legal frameworks that inform the assessment and should be adhered to. These include:

Adults with Incapacity: Guide to Assessing Capacity (2008)
Guide to Best Interests Decision Making (2021)
The Adults with Incapacity (Scotland) Act 2000
The British Psychological Society: Supporting People Who Lack Mental Capacity: A

A capacity assessment is necessary to determine if you/your loved one is able to make decisions independently, or if assistance and support is required to ensure that decisions are made in your best interest. The ultimate goal is to protect and empower those who may lack capacity.

A person may lack capacity if they have:
A brain injury
A mental health condition
A stroke
Cognitive impairment
Dementia
Intellectual disability

However, having a diagnosis of any of these conditions does not necessarily mean that a person lacks capacity. Furthermore, capacity can fluctuate, and someone can lack capacity to make some decisions but still have the capacity to make others.

What areas of capacity can be assessed?

At The Edinburgh Practice, we can assess capacity in relation to the following areas:

Capacity to Decide Living Arrangements: An individual’s capacity to decide where to live.
Capacity to Manage Finances: An individual’s ability to make financial decisions.
Changes to or appointing Powers of Attorney: Appointing a Power of Attorney or changing the individual(s) that you have appointed to manage your affairs and make financial decisions on your behalf.
Gifting: An individual’s capacity to decide to gift assets or money to others.
Guardianship: Providing legal authority for an individual to make personal decisions on behalf of another.
Litigation Capacity: An individual’s ability to take legal action.
Testamentary Capacity: An individual’s ability to make or alter a will.

The Assessment Process

Broadly, the different steps of a capacity assessment will be as follows:

An initial consultation lasting approximately one hour. This would involve a clinical interview with the client. This will be conducted at the practice (home visits can also be considered). Further consultations with the client to assess capacity as appropriate.
Collateral information is gathered via phone call or in person, from someone who knows the client well and who is not related to the decision at hand. Collateral information is also gathered by family members/other individuals who know the client well.
A review of relevant medical records e.g. GP records.
Reviewing relevant legal documentation and requested amendments.
Discussion with relevant health care professionals.
Cognitive screening where appropriate.
A feedback session is offered to outline the outcome of the assessment.
A written report is provided, outlining the capacity assessment process and the clinical opinion and outcome.

Initial Meeting

An initial appointment involving a clinical interview will be arranged with the client at a time that is convenient to them. This will last approximately one hour and will be conducted at the practice. Home visits can also be considered. Further appointments will be offered to gather additional information and to assess the client’s capacity.

Gathering Additional Information

Collateral information will be gathered via phone call or in person, from someone who knows the client well. Collateral information will also be gathered from family members/other individuals who know the client well.

A review of relevant medical records (such as GP records) will be conducted. Additionally, a discussion will be organised with the client to ascertain what changes are being requested and review relevant legal documentation and requested amendments. A cognitive screening will be carried out where applicable.

Relevant healthcare professionals (such as GPs) will also be contacted for discussion and relevant medical records will be reviewed.

Feedback

Once all relevant information is gathered, a feedback session will be offered to discuss the outcome of the assessment.

Report

A written report outlining the capacity assessment process and the clinical opinion/outcome will be provided to all clients.

Our Fees

As the complexity of capacity assessment can vary fees are based on individual cases. Please get in touch via our self-referral form to request a capacity assessment and we will provide you with an estimate of fees.

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