The Mental Capacity Act 2005 requires practitioners to assume that a person has capacity unless there is evidence to suggest otherwise NICE NG108.
Capacity is decision-specific and involves being able to make a particular decision at the time it needs to be made NICE NG108.
To lack capacity, a person must be unable to understand, retain, use or weigh information related to the decision, or communicate their decision, due to an impairment or disturbance in the mind or brain NICE NG108.
Practitioners must ensure all practicable steps to support decision-making have been taken before concluding incapacity NICE NG108.
Effective assessment involves thorough, proportionate, and collaborative approaches, including involving communication aids and specialists if needed NICE NG108.
Supporting decision-making involves helping the person understand and weigh information without coercion, respecting their autonomy, and building trusting relationships NICE NG108.
Practitioners should document and update information about the person's wishes, beliefs, and preferences to inform assessments and support NICE NG108.
Decisions that are unwise do not automatically indicate incapacity; a person can make a decision that appears risky or unwise and still have capacity NICE NG108.