Capacity assessments are a legal and ethical cornerstone of health and social care practice. Under frameworks such as the Mental Capacity Act (or equivalent legislation internationally), professionals must determine whether an individual has the ability to understand, retain, weigh, and communicate decisions relating to their care, treatment, or daily living. These assessments protect a person’s autonomy while ensuring that decisions made in their best interests are lawful, proportionate, and respectful of human rights.
Capacity, however, is decision-specific and time-specific, meaning that frontline workers must navigate complex situations such as fluctuating mental states, communication barriers, learning disabilities, neurodiversity, cultural differences, and undue influence. In practice, many healthcare workers feel underconfident or default to assumptions—either presuming incapacity or granting unsafe autonomy—both of which carry risks of safeguarding breaches, legal liability, or human rights violations.
