Principles of mental capacity

The five principles of mental capacity
How to know if you need help to make decisions

The five principles of mental capacity

For as long as you can make your own decisions, you’re in full control of what happens with your money and your care. But if there is any doubt over your ability to make a decision you're protected by these five principles set out in the Mental Capacity Act (MCA):

01

Presumption of capacity

Everyone is presumed to have mental capacity until it’s proven otherwise.

02

Support to make a decision

You should be given all possible support to help you make your own decisions.

03

Ability to make unwise decisions

Just because a choice seems eccentric or doesn’t make sense to someone else, it doesn’t mean it’s wrong or that you struggle to make decisions in general.

04

Best interest

If you cannot make a decision yourself, the people who know you best should work together and with professionals to make sure that any decisions they make for you are in your best interests.

05

Least restrictive

If you cannot make a decision yourself, any decision made on your behalf should be the one that limits your rights and freedoms the least.
How to know when help is needed

Being able to make and communicate decisions at the time you need to make them is called having mental capacity. It means you understand the decision you’re taking, why you need to take it, and the likely outcome.

There isn’t one single test to understand if you need help with decision-making; it depends on the situation. Choosing what to have for lunch may come easily, but bigger decisions, like whether to sell your home, may be difficult. Or maybe your ability to make decisions changes from day to day.

That’s why capacity is usually decided by the people involved at the time a decision is being made.

What help to make decisions looks like

If decisions ever need to be made for you, legal, health and social care professionals will work with the people who know you best to get it right. They’ll also work closely with anyone you’ve appointed to act on your behalf.

Example 1: help with medical choices

If a patient in hospital needs to take some medication, their doctor will ask some questions to understand if the patient is able to agree to it. If they don’t have the capacity to make a choice, medical professionals will take the decision that’s in their best interest.

Example 2: help with financial choices

When someone writes a Will, their solicitor will check they understand the consequences before setting it up.

Power of Attorney

Planning ahead at an early stage helps avoid decisions being made in a crisis. If you have family or close friends that you’d like to be involved in decisions about your health and finances, then you could consider setting up a Power of Attorney.

What is Power of Attorney?

Deputyship

While we do our best to prepare for later life, care needs can quickly escalate. If you've been unable to set up a Power of Attorney, you may want to apply for deputy powers.

What is Deputyship?

Need help?

Staying in your home

There are a range of housing options available that mean you could still live independently while having care close to hand.

Home care

Need legal advice?

Co-op Legal Services provide regulated legal advice on later life topics such as Powers of Attorney and Wills. Their Executor & Attorney Support Hub has further information.

Visit their hub

The cost of care

To make sure you're paying a fair amount for your care, and getting any financial support you may be entitled to, you should use our cost of care calculator.

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Understanding mental capacity

Find out what are the five principles of mental capacity and how to prepare in case you or a loved one need extra support to make decisions about health, care and finances in future.

The five principles of mental capacity

For as long as you can make your own decisions, you’re in full control of what happens with your money and your care. But if there is any doubt over your ability to make a decision you're protected by these five principles set out in the Mental Capacity Act (MCA):

Presumption of capacity

Everyone is presumed to have mental capacity until it’s proven otherwise.

Support to make a decision

You should be given all possible support to help you make your own decisions.

Ability to make unwise decisions

Just because a choice seems eccentric or doesn’t make sense to someone else, it doesn’t mean it’s wrong or that you struggle to make decisions in general.

Best interest

If you cannot make a decision yourself, the people who know you best should work together and with professionals to make sure that any decisions they make for you are in your best interests.

Least restrictive

If you cannot make a decision yourself, any decision made on your behalf should be the one that limits your rights and freedoms the least.

How to know when help is needed

What help to make decisions looks like