Coventry: Understanding Mental Capacity - Level 2 Mental Capacity Assessment Framework

The capacity assessment level 2 form must be used for capacity assessments requiring a greater level of formality, these include setting up and reviewing support packages, accommodation, adult safeguarding and serious medical treatment.

This Mental Capacity Assessment provides a framework to protect and restore power to those who may lack capacity, or who have reduced capacity to make a particular decision at a particular time. It places the adult who is being assessed at the centre of the decision making process.

The form is divided into the following sections:
1. Background Information:
  Biographical information, LPA, Court Appointed Deputies, COP, DWP, IMCA;
2. The Decision that Needs to be Made:
  The decision and decision maker;
3. Preparation for Assessing Capacity:
  Consulting relevant people, supporting and involving the person concerned, time and place for assessment, information giving, cultural needs;
4. Determining Mental Capacity under the Mental Capacity Act:
  Stage 1 - Can the person make the decision (functional test),
  Stage 2 - If not able to make a decision is this because of an impairment/disturbance of the mind or brain (diagnostic test and causative nexus).
5. Outcome of the Assessment & Disagreements
  Decision about capacity, disagreements, best interests;
6. Review
7. Feedback from the person being assessed and those supporting them during assessment
It also contains some guidance and links to explanatory information.

As the assessor, you should ensure you distinguish facts from opinion throughout the assessment.
There are three ways to complete this assessment:
- Complete this online process;
- Download an offline version to complete over time (click here to download - Microsoft Word required)
- Print off the offline version (as above) to use as a checklist.
Upon completion a copy of the information you've entered will be emailed to you.

None of the information entered into this online form will be stored by us. It will be sent directly to the email address provided.
Please enter your Email address:

2. The Decision that Needs to be Made
Describe the specific decision clearly.
Evidence – record the decision:
What is the relevant information for the decision to be made?

Here you are being asked to list the salient details for the decision to be made. This is the information the person needs to be given and understand about the decision they need to make. Salient details for various decisions, as determined by case law, can be found in the 39 Essex Street section of this page.
Evidence – record the salient details:
Who is the decision maker for this specific decision and why?
Evidence – record your reasoning:

3. Preparation for Assessing Capacity
Ensure that key parties are consulted prior to assessment.

For example carers, GP, doctors, district nurses etc. This should include interviews, records and discussions including past and present wishes of the person concerned, which should be attached/included in this assessment.
Evidence – provide names of professionals involved with the adult:
Does the person concerned want someone to support them during the assessment?
- Yes
- No
Name of person:
Telephone number of person:
Does the person concerned require support during the assessment from a translator, advocate or similar?
- Yes
- No
Details:
Describe the steps that you have taken to assist the adult to communicate, for example speech and language therapy, interpreters, support tools.
Evidence – record actions taken:
Describe the steps that you have taken to involve family and friends.
Evidence – record actions taken:
Ensure that the place and time of the assessment is suited to the needs of the adult / carer.

Check if there is a place or time of day that would most suit them.
Evidence – record place and time and reason for choosing:
Ensure that appropriate and relevant information was given and why the decision needs to be made is made clear

Including the reason that capacity is being questioned, the rationale and purpose of the assessment and possible outcomes.
Evidence – record information given:
Describe any cultural, religious or individual beliefs and how these were taken into account.
Evidence – record details:

The Five Principles
There are five principles that must guide all of the assessment and must be evidenced in your recording:
1. A person must be assumed to have mental capacity unless it is proved otherwise.
2. Until all practicable steps have been taken to help someone make a decision without success, they cannot be treated as lacking mental capacity.
3. An unwise decision does NOT in itself indicate a lack of mental capacity.
4. Any act or decision taken on behalf of someone lacking capacity must be in the person's best interests.
5. Any act or decision taken on behalf of someone lacking capacity should aim to be the less restrictive option in terms of the person's rights and freedoms.

4. Determining Mental Capacity under the Mental Capacity Act
4.1 Stage 1: The Functional Test
If you answer no to any of the following questions, the adult should be assessed as lacking the mental capacity to make the specific decision
Can the adult understand the information relating to the decision to be made?
Please choose Yes or No:
- Yes
- No
Evidence – record the evidence for your reasoning and identify any risks:
Can the adult retain the information for long enough for the decision to be made?
Please choose Yes or No:
- Yes
- No
How did you reach this decision? Record the evidence for your reasoning and identify any risks:
Can the adult use information to weigh up the pros and cons of the decision?
Please choose Yes or No:
- Yes
- No
How did you reach this decision? Record the evidence for your reasoning and identify any risks:
Can the individual communicate their decision, by any means possible?
Please choose Yes or No:
- Yes
- No
Evidence -

4.2 Stage 2: The Diagnostic Test
Is there an impairment or disturbance in the functioning of the brain or mind?
Please choose Yes or No:
- Yes
- No
Evidence – record your evidence / reasoning:
Is the person unable to make the decision because of the impairment or disturbance of the mind or brain?
Please choose Yes or No:
- Yes
- No
Evidence – record your reasoning by giving examples of the exact link - what does the impairment or disturbance make them unable to do?
For example, a person with dementia may have very poor recent memory and therefore is unable to retain the information you have given them, or a person with an acquired brain injury may have an executive functioning impairment and be unable to use and weigh information you have given them, as they are unable to think through the consequences of making a decision one way or another.:
Fluctuating capacity or temporary impairment or disturbance in the function of the brain or mind
Is the adult likely to regain capacity and if so can the decision be delayed until they do so?
Please choose Yes or No:
- Yes
- No
Evidence – record your evidence / reasoning:

5. Outcome of the Assessment & Disagreements
Does the adult lack capacity to make the specific decision at this specific time?
Please choose Yes or No:
- Yes
- No
Evidence - record your judgement as assessor, including any identified risks to the adult:
Has there been any disagreement with this assessment?
Please choose Yes or No:
- Yes
- No
Give details of the disagreement:
Will there be a formal Best Interests Meeting?
Please choose Yes or No:
- Yes
- No
If you are holding a formal best interests meeting you must use the template on Care Director.
When you are NOT proceeding to a formal best interests meeting, you are still required to record the best interests decision, so please complete the sections below.
Best Interests Decision

Who was consulted?
Who was consulted?
Click on the plus sign to add more people who were consulted.
Name: Relationship to person:
How did consultation take place? e.g. telephone, video call, in person
How did consultation take place? e.g. telephone, video call, in person
What options were considered?
What options were considered?
Decision reached
Decision reached
How this is the less restrictive available option?
How this is the less restrictive available option?

6. Review
Is there a plan to review this assessment?
Please choose Yes or No:
- Yes
- No
Evidence – record date of review:

7. Feedback from the person being assessed and those supporting them during the assessment
Did the person or their support provide feedback?
Please choose Yes or No:
- Yes
- No
Evidence – record the feedback:
Please tick the box below to authenticate your submission:

Level 2 Mental Capacity Assessment Framework – Online Form

Step 1 of 10

There are three ways to complete this assessment:

Upon completion a copy of the information you've entered will be emailed to you.

1. Background Information

2. The Decision that Needs to be Made

Describe the specific decision clearly.

What is the relevant information for the decision to be made?

Who is the decision maker for this specific decision and why?

3. Preparation for Assessing Capacity

Ensure that key parties are consulted prior to assessment.

Describe the steps that you have taken to assist the adult to communicate, for example speech and language therapy, interpreters, support tools.

Describe the steps that you have taken to involve family and friends.

Ensure that the place and time of the assessment is suited to the needs of the adult / carer.

Ensure that appropriate and relevant information was given and why the decision needs to be made is made clear

Describe any cultural, religious or individual beliefs and how these were taken into account.

The Five Principles

4. Determining Mental Capacity under the Mental Capacity Act

Can the adult understand the information relating to the decision to be made?

Can the adult retain the information for long enough for the decision to be made?

Can the adult use information to weigh up the pros and cons of the decision?

Can the individual communicate their decision, by any means possible?

Is there an impairment or disturbance in the functioning of the brain or mind?

Is the person unable to make the decision because of the impairment or disturbance of the mind or brain?

Is the adult likely to regain capacity and if so can the decision be delayed until they do so?

5. Outcome of the Assessment & Disagreements

Does the adult lack capacity to make the specific decision at this specific time?

Has there been any disagreement with this assessment?

Will there be a formal Best Interests Meeting?

Who was consulted?

How did consultation take place? e.g. telephone, video call, in person

What options were considered?

Decision reached

How this is the less restrictive available option?

6. Review

Is there a plan to review this assessment?

7. Feedback from the person being assessed and those supporting them during the assessment

Did the person or their support provide feedback?

Name:	Relationship to person: