top of page

Assessments of Mental Capacity, Continuing Healthcare and Care Needs Assessments

mental capacity assessment patient

About Socialscape

At Socialscape, we specialise in assessing mental capacity, Continuing Healthcare and Care Needs assessments. Our team of experts is dedicated to helping individuals and families navigate complex legal and personal situations by providing accurate and reliable assessments.

"The best way to find yourself is to lose yourself in the service of others."


Our Services

Senior Couple
Happy Doctor
Happy Family

Mental Capacity Assessment

Our mental capacity assessments look at a person’s ability to understand and make informed decisions related to specific situations. We use a standardised process to provide accurate and reliable results.

Continuing Healthcare

At Socialscope, we understand how daunting it can be to navigate NHS Continuing Healthcare. That's why we provide a variety of services to help guide and support you through the process, including offering advice, support with the assessment & reviews process, as well as guidance through the appeals and complaints process. We know that each individual has unique needs, and our team is dedicated to ensuring that those needs are met in a way that is both compassionate and effective. Contact us today to learn more about how we can help you.

Care Planning and Needs Assessments

Our team of experts is available to provide consultation services related to care planning, including needs assessments for care packages and care home placements, and support negotiating. We work with individuals, families, and legal professionals to provide accurate and reliable guidance.


"Socialscape provided us with expert guidance and support during a difficult situation. Their assessment was thorough and accurate, and we were able to make informed decisions as a result."

John D.

"The team at Socialscape was professional and compassionate throughout the assessment process. They answered all of our questions and provided us with clear guidance on next steps."

Jane S.

"I highly recommend Socialscape’s consultation services. Their team of experts provided us with valuable insights and guidance, and we were able to make informed decisions based on their recommendations."

Tom H.

  • What is a Mental Capacity Assessment ?
    A mental capacity assessment is a process employed to determine an individual's ability to make a specific decision. Different decisions necessitate an understanding of different aspects, a concept known as 'The threshold of understanding.' This threshold is established either through case law, as seen in instances like Banks v Goodfellow for decisions such as making a Will, or through legislative frameworks like the Mental Capacity Act (2005). Nature of Assessment: Contrary to the term 'test' that is sometimes used, a mental capacity assessment is not a formal examination. Instead, it is more akin to a conversation. The emphasis is on engaging with the individual to understand their thought processes and decision-making abilities. The objective is to create an atmosphere where the person feels comfortable and is able to respond without feeling pressured. The aim is to ensure a respectful and supportive interaction that allows for an accurate evaluation of an individual's capacity to make informed decisions.
  • Why do we need to know about clients financial situation in order to assess their capacity ?
    To thoroughly assess an individual's capacity to make decisions regarding their property and financial affairs, it is essential to share relevant financial information with the assessor. This is crucial because the capacity assessment must consider the person's specific financial position in order to provide a comprehensive understanding of their decision-making abilities in this domain. The inclusion of financial details enables the assessor to tailor the evaluation to the individual's circumstances, ensuring a more accurate and informed assessment of their capacity in matters related to property and financial affairs.
  • How long does a Mental Capacity Assessment take ?
    Beyond the time invested in gathering information about the individual in relation to the assessment and the decision at hand, the duration of a capacity assessment can significantly vary. It may span anywhere from 30 minutes to 2 hours. Several factors come into play, including whether the person relies on communication aids, if information needs simplification and repetition, the individual's chattiness, and their ability to provide direct responses or tendency to go off-topic. A recent assessment I conducted exemplifies this variability. The session extended beyond two hours as the gentleman being assessed had made life choices that his family disagreed with. During the assessment, he expressed a desire for me to understand the history and reasoning behind these choices. Recognizing the importance of this context in shaping his decision-making and, consequently, his mental capacity, I deemed it crucial to allow him the time to share his perspective.
  • When is a Mental Capacity Assessment required ?
    When faced with significant decisions and concerns arise about an individual's ability to consider pertinent factors for decision-making, a mental capacity assessment becomes necessary. It's crucial to acknowledge that there might be potential risks or losses if the person in question were to make a decision without taking into account essential factors. Beyond major decisions, routine aspects of daily life, including whether to receive care interventions, deciding when to go out, choosing activities, and managing prescribed medication, also warrant a capacity assessment.
  • Is it possible to carry out Mental Capacity Assessment via a video call ?
    Yes, we have experienced significant success in conducting mental capacity assessments through virtual platforms, such as Zoom or Teams. Our approach is flexible, utilizing a platform that suits the client's technological access. When necessary, we can coordinate the presence of a supporting person in the room with the client. Throughout our experience, we have not encountered major disadvantages in remote assessments; in fact, we find several advantages. We are confident in maintaining the same high standard of assessment remotely as we would in a face-to-face setting. Our commitment extends beyond the pandemic, and we plan to continue offering remote assessments for those who prefer this option even after social distancing measures are not longer in place. If you have any concerns about the virtual assessment process, we encourage you to discuss them with us. We are confident in our ability to troubleshoot any issues collaboratively. All our remote assessments via live video-link are scheduled at a time and location of your choosing. It can be any place where you feel comfortable and can ensure privacy. The majority of our assessments take place in the person's home or care home, providing a familiar and secure environment.
  • What is Mental Capacity ?
    Understanding Mental Capacity Definition: Mental capacity refers to an individual's ability to make decisions, contingent upon the presence of any impairment or disturbance of the mind or brain, such as mental illness, brain injury, stroke, or severe learning disability. These conditions directly influence the capacity to understand, retain, evaluate information relevant to a decision, and express thoughts, wishes, and feelings regarding the matter. Item-Specific Nature: Mental capacity is "decision specific," implying that it varies based on the nature of the decision. The cognitive demands to decide where to live, for instance, differ significantly from those needed to make a Will. Consequently, a person may possess the capacity to make some decisions but lack it in others. Time-Specific Dynamics: Mental capacity is also "time specific," acknowledging its tendency to fluctuate. It can either decline or improve depending on an individual's cognitive state at a given time. For example, someone recovering from a stroke may lack the capacity to make certain decisions shortly after the event but could regain it over time. Similarly, individuals with dementia may experience varying levels of confusion at different times of the day. Understanding these nuances is crucial for accurate assessments and decisions concerning an individual's ability to make informed choices.
  • What do Mental Capacity Assessments consist of?
    A mental capacity assessment encompasses three stages, with the 'face-to-face' element being of primary concern for most individuals. It's crucial to understand that the assessment aims to showcase you at your best, identifying strengths, weaknesses, and any necessary support related to the decision in question. During the 'face-to-face' component, one of our mental capacity assessors will either connect with you remotely via video link or will schedule a visit at your home, ensuring a one-on-one interaction at a time and place convenient for you. The assessor's role is to create a comfortable environment, clearly explaining the assessment's purpose and the specific criteria under consideration. We prioritize transparency and do not rely on trick questions. If any aspect is unclear, it's encouraged to communicate this to the assessor for clarification in a way that suits you. While the preference is for an individual assessment, having others around for introductions or initial support is acceptable. They can remain in close proximity, possibly in another room, allowing you to call on them if needed. Recognizing that a video link assessment might necessitate additional assistance or support, having someone with you throughout, such as an interpreter or caregiver, is entirely acceptable. As long as they are visible on the screen beside you at all times, it is considered appropriate.
  • What is the National Framework and where did it come from ?
    The NHS Continuing Healthcare (CHC) framework stands as a robust set of principles and guidelines meticulously crafted by the National Health Service (NHS) in the United Kingdom. This framework is the cornerstone for evaluating the health and care needs of individuals, ultimately determining their eligibility for full NHS funding for both care and accommodation. The developmental timeline of the NHS CHC framework unfolds through pivotal milestones: Inception in 1996: The Department of Health initiated the framework's formulation, issuing guidance to the 95 Health Authorities in England to establish the foundational criteria for determining eligibility for NHS Continuing Healthcare. Legal Landmark in 1999: The case of Pamela Coughlan marked a turning point, leading to a Court of Appeal decision challenging the denial of continuing healthcare funding. This prompted a comprehensive review of criteria to ensure alignment with the 'Coughlan compliant' standard. Post-Reorganization Directives in 2002: Following a significant NHS reorganization, the Department of Health provided clear directives to the newly formed Strategic Health Authorities (SHAs) to collaboratively define criteria within their respective geographical areas. Addressing Disparities in 2004: Recognizing regional disparities, the Department of Health took proactive measures to address the 'postcode lottery' issue. This resulted in the development of a unified national set of tools and assessment processes, ensuring consistency and fairness nationwide. Landmark Launch in 2007: A significant leap was made with the official launch of the National Framework for NHS Continuing Healthcare and NHS-Funded Nursing Care. This marked a pivotal moment where all NHS trusts were mandated to fully implement the framework, ensuring a standardized and equitable approach. Refinement Periods in 2009 and 2012: Subsequent to the framework's launch, refinement periods in 2009 and 2012 focused on enhancing toolkits and assessment processes while preserving the integrity of the core eligibility criteria. Holistic Approach in 2015: NHS England introduced the Operating Model for NHS Continuing Healthcare in 2015, emphasizing a holistic approach to assessment and care pathways. The model underscored the importance of fairness, efficiency, and cost-effectiveness in local service delivery. The NHS Continuing Healthcare framework remains dynamic, evolving in response to legal insights, stakeholder feedback, and the ever-changing landscape of healthcare policies and practices. Its unwavering goal is to uphold transparency, fairness, and consistency in evaluating eligibility for individuals with substantial health needs, aligning with the NHS's commitment to providing comprehensive and accessible care.
  • What is a DST ?
    A Decision Support Tool (DST) is a structured and systematic instrument used in the assessment process for NHS Continuing Healthcare (CHC) in the United Kingdom. It serves as a guide to help healthcare professionals evaluate an individual's health and social care needs comprehensively. The DST aids in determining whether an individual is eligible for fully funded care and accommodation by the National Health Service (NHS). Key features of a Decision Support Tool include: Structured Assessment: The DST provides a systematic approach to assessing an individual's care needs. It breaks down the assessment into various domains, such as behavior, cognition, mobility, and communication, ensuring a thorough evaluation. Scoring System: The tool often involves a scoring system where healthcare professionals assign scores based on the individual's level of need in each domain. These scores contribute to the overall assessment of whether the individual has a primary health need. Health professionals are more recently calling this a "level of need" rater than a "score". Evidence-Based: The DST relies on evidence gathered from various sources, including medical records, assessments by healthcare professionals, and input from the individual and their caregivers. This evidence helps paint a comprehensive picture of the individual's health and care needs. Multidisciplinary Approach: The assessment typically involves input from a multidisciplinary team of healthcare professionals, including nurses, doctors, social workers, and other relevant specialists. This collaborative approach ensures a holistic evaluation. Transparent Criteria: The DST is designed to align with the eligibility criteria for NHS Continuing Healthcare. It helps ensure transparency in the decision-making process and allows individuals and their families to understand how the assessment is conducted. Consistency: The use of a standardized tool promotes consistency in assessments across different regions and healthcare settings. This helps mitigate the risk of regional variations or a "postcode lottery" in determining eligibility. The Decision Support Tool is an integral part of the overall framework for NHS Continuing Healthcare. It provides a structured and transparent method for healthcare professionals to assess and determine whether an individual's care needs are primarily health-related, making them eligible for fully funded care and support by the NHS.
  • Does it take into account my financial situation?
    No, the eligibility for NHS Continuing Healthcare does not take into account a person's financial situation. NHS Continuing Healthcare is a fully funded package of care provided by the National Health Service (NHS) in the United Kingdom for individuals with significant health needs. The funding covers the entire cost of an individual's care and accommodation. The assessment for NHS Continuing Healthcare focuses on the individual's health and care needs rather than their ability to pay for care. The key consideration is whether the individual has a primary health need, meaning that the majority of their care needs are related to health rather than social or personal care. The financial situation of the individual, their assets, or income are not taken into account when determining eligibility for NHS Continuing Healthcare. This is in contrast to means-tested services provided by local authorities, where an individual's financial situation may be considered in assessing eligibility for support. If you or someone you know is in need of long-term care, it is advisable to seek guidance from healthcare professionals and social services to understand the specific eligibility criteria and financial implications in your particular situation. Equally we are happy to offer advice and guidance.
  • What is NHS Continuing Healthcare ?
    NHS Continuing Healthcare is a comprehensive package of care for adults over the age of 18 which is arranged and funded solely by the NHS. Those meeting the eligibility criteria are entitled to have the entirety of their care and accommodation expenses covered by the NHS. This service is accessible to any UK resident, subject to assessment that demonstrates a primary health need.
  • What is a Primary Health need?
    Continuing Healthcare eligibility hinges on the concept of a primary health need, a term lacking a clear definition and not explicitly outlined in primary legislation. If an individual is deemed to have a primary health need, their overall health and social care requirements surpass what social services could lawfully provide. Consequently, the NHS assumes the responsibility for meeting these needs. While social services can offer certain health services, they fall short when the predominant needs are health-related. Applying this concept in assessments poses challenges, leading to individual interpretations, even among professionally trained and experienced assessment teams. In essence, if the majority of an individual's care revolves around managing health needs or preventing further health issues, the NHS is obligated to cover all care needs and accommodation expenses. Defining a health need proves intricate. For instance, one might assume that an individual with dementia, immobility, and an inability to independently perform basic tasks, requiring continence care and a regulated medication regimen, has a primary health need. However, such needs are often categorized as social or personal care, emphasizing the importance of avoiding overgeneralization.
bottom of page