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Capacity to Decide About Care and Support Arrangements
Specialist care and support capacity assessments across England and Wales
Nellie Supports provides specialist mental capacity assessments for care and support decisions across England and Wales.
A care and support capacity assessment considers whether a person can make a specific decision about the care, support or supervision they receive. This may include whether they can understand, retain, use or weigh information about their care needs, the support being proposed, who would provide that support, what may happen if support is accepted or refused, and what they can do if they are unhappy or unsafe.
Nellie Supports is England and Wales’ largest specialist mental capacity assessment provider and specialist private social work practice. Our assessments are delivered by a permanent full-time multidisciplinary team, not an ad hoc associate, contractor or referral-panel model. We have completed thousands of formal assessments, including care, residence, Court of Protection and deputyship-related assessments.
Our assessments are decision-specific, evidence-led and structured around the Mental Capacity Act 2005. They are prepared for families, solicitors, local authorities, care providers, deputies and professional referrers where required.
Trusted by Thousands. Guided by Experience. Committed to You.
100% Coverage
We provide 100% coverage across England and Wales, making it easier for families, solicitors, deputies and professionals to access specialist assessments wherever they are needed. Our service is designed to be responsive, consistent and available nationally.
100+Years Experience
Our team brings together well over 100 years of combined professional experience across social work, mental capacity, safeguarding, care planning and specialist assessment practice. This depth of experience helps us approach each assessment with confidence, clarity and professional judgement.
4.9 * Rating on Google
Rated 4.9 stars on Google, our reviews reflect the trust placed in us by families, solicitors, case managers and other professionals. We are proud to be recognised for clear communication, reliable support and high-quality assessment reports.
9500+ Assessments and Reports
With over 9,500 assessments completed, we have extensive experience supporting a wide range of decision-specific needs. Our reports are structured, evidence-based and prepared with the practical requirements of families, professionals and legal settings in mind.
What’s Included as Standard
Every Nellie Supports care and support capacity assessment includes the full assessment process that underpins our standard mental capacity work, adapted to the specific care decision being assessed.
Home Visit or Video Call
We arrange either a face-to-face visit or video assessment, depending on what is most appropriate for the person, the decision being assessed and the circumstances of the case.
Assessments may take place at home, in a care home, in supported living, in hospital where appropriate, at a professional location, or remotely where suitable.
Gentle, Professional Assessment
The assessment is carried out in a calm, respectful and professional way, with the person’s needs, presentation and communication style taken into account throughout.
Our aim is to support the person to participate as fully as possible, not to catch them out.
Decision-Specific Approach
The assessment focuses on the exact care or support decision that needs to be made, rather than giving a general view of whether someone can “manage care needs”.
This may include whether the person can accept or refuse a care package, decide what support they receive, engage with a Care Act assessment, accept support at home, or decide between different care and support options.
Mental Capacity Act Compliant
Every assessment is completed in line with the Mental Capacity Act 2005 and applies the legal test to the specific care or support decision in question.
The report considers whether the person can understand, retain, use or weigh the relevant information and communicate their decision, as well as whether any inability to decide is because of an impairment of, or disturbance in, the functioning of the mind or brain.
Relevant Information Clearly Identified
We identify the information the person needs to understand for the care or support decision being assessed.
This may include the areas where the person needs support, the type of support proposed, who would provide it, how often it would be provided, what may happen if support is refused, and what the person could do if they were unhappy, worried or unsafe.
Written Capacity Report
At the end of the service, you receive a written mental capacity report explaining the decision assessed, the relevant information, the practicable steps taken, the person’s responses, the evidence considered and the reasoning behind the conclusion.
The report can be prepared for families, solicitors, local authorities, deputies, care providers or Court of Protection use where required. No provider can guarantee how a court, public body or decision-maker will treat an individual report.
Care and Support Capacity Assessment Fees and Timescales
Standard Mental Capacity Assessment
Enhanced Mental Capacity Assessment
Travel time, where applicable
£600.00
£3500.00
£40.00 per hour
5 to 10 Working Days
Please note that VAT and travel charges are not included in the prices shown. If timing is important, please let us know at the enquiry stage and we will advise on the earliest available appointment and quickest turnaround.
Why people choose Nellie Supports for care and support capacity assessments
Choosing the right professional to complete a care and support capacity assessment matters. Decisions about care can involve personal safety, independence, dignity, family disagreement, safeguarding concerns, hospital discharge, self-neglect, care refusal and Court of Protection evidence.
At Nellie Supports:
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our care and support capacity assessments are decision-specific and focused on the actual care decision being considered
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our reports are prepared for families, solicitors, deputies, local authorities, care providers and professional referrers where required
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our assessments are delivered by permanent full-time members of the Nellie Supports team, not ad hoc associates or referral-panel professionals
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every assessment is structured around the Mental Capacity Act 2005 and the person’s ability to understand, retain, use or weigh the relevant information and communicate their decision
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we consider the person’s care needs, proposed support, risks, consequences, alternatives and ability to complain or seek help
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we take a calm, therapeutic and person-centred approach to the assessment conversation
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where appropriate, our assessors can use Montreal Cognitive Assessment screening as supporting evidence
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every report is reviewed before issue for quality, clarity and consistency
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our work is supported by the Nellie Standard™ and Professional Standards framework
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we have completed thousands of formal assessments across England and Wales
Whether the issue is refusal of care, self-neglect, safeguarding concern, hospital discharge, a proposed support package, family disagreement or a Court of Protection application, our role is to make the capacity evidence clear, structured and dependable.
No provider can guarantee how a court, public body or decision-maker will treat an individual report. Nellie Supports provides clear, evidence-led professional opinion within the scope of the instruction.
What happens during the assessment
We understand that decisions about care and support can be emotional, urgent and difficult. Our aim is to make the assessment calm, respectful and supportive, while still ensuring that the final report is clear, robust and properly reasoned.
A care and support capacity assessment will usually involve:
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confirming the exact care or support decision that needs to be assessed
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reviewing relevant background information
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identifying the person’s current care or support arrangements
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identifying the proposed care or support options
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identifying the relevant information the person needs to understand
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considering the person’s communication, sensory, cognitive and emotional needs
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explaining the purpose of the assessment in a way the person can understand
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giving the person practicable support to engage with the decision
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assessing whether the person can understand, retain, use or weigh the relevant information
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assessing whether the person can communicate their decision
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considering whether there is evidence of an impairment of, or disturbance in, the functioning of the mind or brain
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considering whether any inability to decide is because of that impairment or disturbance
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recording the person’s wishes, feelings, views and presentation
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explaining the reasoning behind the conclusion in a written report
The assessment is not designed to catch the person out. It is designed to give them a fair opportunity to show whether they can make the specific care or support decision themselves, with appropriate support.
Where appropriate, our assessors may use additional cognitive screening, such as the Montreal Cognitive Assessment, as supporting evidence. Cognitive screening does not replace the mental capacity assessment, but it may help evidence an impairment or disturbance where that is relevant.
For related services, see our Mental Capacity Assessments, Capacity for Residency and COP3 Mental Capacity Assessment pages.
What makes a care and support capacity assessment court-compliant?
A court-compliant care and support capacity assessment is prepared to help a solicitor, deputy, local authority, professional decision-maker or the Court of Protection understand whether a person can make the specific decision about their care or support arrangements.
It should not be a general opinion that someone “has capacity” or “lacks capacity”. It should identify the care decision being assessed, explain the relevant information, record the practicable steps taken to support decision-making, apply the Mental Capacity Act 2005 test, consider the diagnostic stage and explain the reasoning behind the conclusion.
A strong care and support capacity report should usually explain:
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what care or support decision needs to be made
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what care or support arrangements are being considered
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what information the person needed to understand
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what support was offered to help the person make the decision
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whether the person could understand, retain, use or weigh the relevant information
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whether the person could communicate their decision
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what evidence was considered
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whether there was an impairment of, or disturbance in, the functioning of the mind or brain
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whether any inability to decide was because of that impairment or disturbance
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why the assessor reached their opinion
Nellie Supports prepares care and support capacity assessments for families, solicitors, deputies, local authorities, care providers and professional referrers across England and Wales. Our assessments are delivered by a permanent full-time team and supported by the Nellie Standard™ and Professional Standards framework.
No provider can guarantee how the Court of Protection, a local authority, a public body or any other decision-maker will treat an individual report. Nellie Supports’ role is to provide clear, structured and evidence-led professional opinion within the scope of the instruction.
Documents and information to prepare
To complete a care and support capacity assessment properly, it helps to gather the relevant background information before the appointment.
This may include:
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the specific care or support decision that needs to be assessed
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the person’s current care and support arrangements
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the proposed care package or support plan
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details of any alternative care or support options
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information about the person’s daily support needs
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care plans, support plans or placement information
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Care Act assessment documents, where relevant
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hospital discharge summaries, where relevant
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local authority assessments, safeguarding records or best interests meeting notes, where available
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relevant medical records, diagnoses or GP information
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details of any known cognitive impairment, dementia, brain injury, learning disability, mental health condition or fluctuating presentation
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previous mental capacity assessments
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any Court of Protection paperwork, if proceedings are involved
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details of attorneys, deputies, solicitors, local authority professionals or key family members involved
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information about family disagreement, safeguarding concerns, pressure or undue influence, where relevant
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details of communication needs, interpreters, advocates or adjustments that may help the person engage
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information about the person’s wishes, feelings, beliefs and previously expressed views about care and support
The clearer the care decision is at the start, the easier it is to make sure the assessment is properly focused.
For example, the assessment may need to consider whether the person can accept or refuse a care package, engage with a Care Act assessment, accept carers at home, decide what support they receive, or choose between different care and support options.
Where the issue may involve Court of Protection proceedings, deputyship or formal professional evidence, please provide any relevant instructions, application details or documents before the appointment wherever possible.
For wider decision-specific assessments, see our Mental Capacity Assessments and COP3 Mental Capacity Assessment pages.
What happens if the person lacks capacity?
If the assessment concludes that the person lacks capacity to make the specific care or support decision, the report can be used to help inform the next lawful decision-making process.
A finding that someone lacks capacity does not mean that care can simply be imposed without proper consideration. It means that the decision must usually be made in the person’s best interests, following the Mental Capacity Act 2005 and taking account of the person’s wishes, feelings, values, relationships, risks and available options.
Depending on the situation, the next step may involve:
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a best interests meeting
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further discussion with family members or professionals
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review of the proposed care or support arrangements
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consideration of less restrictive options
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local authority, hospital or care provider involvement
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safeguarding consideration
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solicitor advice
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a Court of Protection application, where there is serious dispute, complexity or no agreement about what should happen
The capacity assessment does not make the best interests decision. It provides evidence about whether the person can make the care or support decision for themselves.
If Court of Protection involvement is required, the report may help the court understand the person’s ability to make the relevant decision, the evidence considered and the reasoning behind the conclusion. No provider can guarantee how the court, a local authority or any other decision-maker will treat an individual report.
Where the person lacks capacity, Nellie Supports aims to provide a clear, structured and evidence-led report so that families, deputies, solicitors, local authorities and professionals can understand the assessment outcome and decide what lawful steps may be needed next.
Who this assessment is for
Families and relatives
A care and support capacity assessment is for families who need clear evidence about whether a person can decide what care or support they receive.
This may be needed where there is disagreement about carers coming into the home, refusing support, accepting a care package, returning home with care, or moving to a more supported arrangement.
The assessment helps families understand whether the person can make the care decision themselves, or whether a best interests process may be needed under the Mental Capacity Act 2005.
Solicitors and deputies
A care and support capacity assessment is for solicitors, deputies and attorneys who need decision-specific evidence about a person’s ability to decide about care and support arrangements.
This may be relevant where the matter involves a Court of Protection application, deputyship issue, disputed care package, safeguarding concern, welfare decision or professional instruction.
The report can help clarify whether the person can understand, retain, use or weigh the relevant information about their care and support arrangements and communicate their decision.
Local authorities and professionals
A care and support capacity assessment can support local authorities, social workers, care providers, hospitals and professional referrers where there is uncertainty about a person’s ability to decide about care or support.
This may arise during hospital discharge, safeguarding work, care planning, self-neglect concerns, care refusal, placement review or disputes about whether a person can safely manage without support.
Nellie Supports provides independent, decision-specific assessments across England and Wales, delivered by a permanent full-time team.
When you may need a care and support capacity assessment
Refusing a care package
A care and support capacity assessment may be needed where a person is refusing carers, rejecting a proposed package of care, or saying they can manage without support.
The assessment focuses on whether the person can understand what support is being proposed, why it is being offered, who would provide it, what may happen if it is refused, and how the risks apply to their own situation.
A person should not be treated as lacking capacity simply because professionals disagree with their decision. The assessment must focus on whether they can make the specific care decision for themselves.
Self-neglect or safeguarding concerns
A care and support capacity assessment may be needed where there are concerns about self-neglect, medication errors, nutrition, hygiene, falls, exploitation, fire risk, unsafe living conditions or deterioration.
The assessment does not treat risk as automatic proof of incapacity. It considers whether the person can understand, retain, use or weigh the relevant information about their care and support needs, including the likely consequences of accepting or refusing support.
Where safeguarding concerns are present, the report can help professionals understand whether a best interests decision-making process may be required.
Hospital discharge or care planning disputes
A care and support capacity assessment may be needed where discharge from hospital, return home, care at home, residential care or supported living depends on the person’s ability to decide about care and support.
Care, residence and discharge decisions often overlap, but they are not always the same decision. Where needed, Nellie Supports can help clarify whether the assessment should cover care, residence, discharge, or more than one decision.
The assessment provides evidence about capacity. It does not decide what is in the person’s best interests.
What is a care and support capacity assessment?
A decision-specific assessment
A care and support capacity assessment considers whether a person can make a specific decision about the care, support or supervision they receive.
It is not a general assessment of whether someone “has capacity” or can “manage care needs”. The assessment must focus on the actual care decision being made at the relevant time.
For wider decision-specific assessment services, see our Mental Capacity Assessments page.
What the assessment considers
The assessment considers whether the person can understand, retain, use or weigh the relevant information and communicate their decision
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For a care decision, this may include the areas where they need support, the type of support proposed, who would provide it, what may happen if support is refused, and what the person could do if they were unhappy, worried or unsafe.
The assessment should be tailored to the person’s actual situation. It should not overwhelm them with irrelevant information or reduce the decision to a simple preference about whether they “want carers”.
What the report explains
The final report explains the decision assessed, the relevant information, the practicable steps taken, the person’s responses, the evidence considered and the reasoning behind the conclusion.
Where required, the report can be prepared for families, solicitors, deputies, local authorities, care providers, hospitals or Court of Protection use.
No provider can guarantee how a court, public body or decision-maker will treat an individual report. Nellie Supports’ role is to provide clear, structured and evidence-led professional opinion within the scope of the instruction.
The legal test for a care and support capacity assessment
The Mental Capacity Act test
A care and support capacity assessment must apply the Mental Capacity Act 2005 to the specific care decision in question.
The question is not whether the person has a diagnosis, appears vulnerable, makes risky choices or needs support generally. The question is whether they can make this particular decision about their care or support arrangements.
A person should not be treated as unable to make a decision simply because others think their decision is unwise.
Functional ability
The assessment considers whether the person can understand, retain, use or weigh the relevant information and communicate their decision.
If the person cannot do one or more of those things, the assessor must consider whether that inability is because of an impairment of, or disturbance in, the functioning of the mind or brain.
This is why the report must explain both the person’s functional ability and the causal link between any impairment or disturbance and the inability to make the decision.
Practicable support
Before concluding that someone lacks capacity, practicable steps should be taken to support them to make the decision where possible.
This may include using clearer language, visual information, extra time, breaks, communication support, hearing or visual aids, familiar settings, or support from someone who knows the person well.
Nellie Supports’ approach is designed to give the person a fair opportunity to show whether they can make the care or support decision themselves.
Why decision-specific matters
Capacity is not general
Mental capacity is not assessed in the abstract. A person may have capacity for some decisions but not others.
For care and support, the question is whether the person can make the specific decision about the care or support arrangement in issue, not whether they can manage every aspect of daily life, accommodation, finances, medication or safeguarding risk.
This distinction is important because care decisions can become confused with residence, hospital discharge, deprivation of liberty, safeguarding, family conflict or funding issues.
The relevant information must be clear
A useful assessment depends on identifying the relevant information for the actual care decision.
That usually means clarifying the support being proposed, who would provide it, the risks and benefits of accepting or refusing it, the likely consequences of each option, and what the person can do if they are unhappy with the care.
If the relevant information is unclear, the assessment may become too broad, too vague or less useful for families, professionals or the Court of Protection.
More than one decision may need assessing
Sometimes a care decision sits alongside a separate residence decision, discharge decision, financial decision, safeguarding issue or Court of Protection application.
Where more than one decision is being assessed, each decision should be identified and addressed separately.
Nellie Supports can help clarify whether the instruction should cover care only, residence only, or both care and residence.
What the assessor evaluates
The care or support decision
The assessor evaluates the exact care or support decision that needs to be made.
This may include whether the person can accept or refuse a care package, engage with a Care Act assessment, accept carers at home, decide what support they receive, or choose between different care and support options.
The assessment should focus on the real options available, not hypothetical choices that are not actually being considered.
Understanding and weighing information
The assessor considers whether the person can understand, retain, use or weigh the information relevant to the care or support decision.
This may include practical information about personal care, medication, nutrition, hygiene, safety, supervision, family support, paid carers, safeguarding concerns, and the consequences of accepting or refusing support.
The assessor records the person’s views, wishes, feelings and reasoning, not just whether professionals agree with their choice.
Evidence and reasoning
A strong report explains the evidence behind the conclusion.
This may include information from the assessment interview, records, care plans, hospital discharge information, previous assessments, professional views and relevant family or advocate information.
The conclusion should be reasoned, decision-specific and linked to the Mental Capacity Act 2005 test, rather than based on diagnosis, age, disability, appearance, care needs or general vulnerability.
Our Therapeutic Assessment Approach to Capacity to Manage Care Needs
This reflects two core principles of the Mental Capacity Act 2005: Principle 1, that a person must be assumed to have capacity unless it is established that they lack it; and Principle 2, that a person is not to be treated as unable to make a decision unless all practicable steps have been taken to help them do so without success.
In Capacity to Manage Care Needs assessments, our therapeutic assessment approach means the assessment interview is structured but not adversarial. The person should be supported to participate as fully as possible, with the assessor using clear language, appropriate pacing, reassurance, prompts or breaks where needed.
This is especially important because a capacity assessment is not designed to catch the person out. It is designed to understand whether, with appropriate support, the person can make the specific care or support decision being assessed. In this context, the conversation should support the person to explore their care needs, the support available, who would provide that support, the risks and practical consequences of accepting or refusing care, and what they could do if they were unhappy, worried or unsafe.
The therapeutic nature of the conversation does not reduce the evidential standard of the report. The written output has a different function: it records the decision assessed, the relevant information, the practicable steps taken, the person’s responses, the evidence considered and the reasoning behind the conclusion.
The written output serves a different function. Reports, reviews and written submissions are prepared to be evidence-based, decision-specific and clear, so that the reasoning can be understood by the person, family, professionals or formal decision-maker relying on the work.
How The Nellie Standard™ Applies to Care and Support Capacity Assessments
This service is delivered in accordance with The Nellie Standard™, Nellie Supports’ framework for evidence-led assessment, reporting and advocacy.
For Care and Support Capacity Assessments, The Nellie Standard™ means the assessment is approached as evidence-led, decision-specific and capable of professional scrutiny. The purpose is not simply to record an opinion, but to identify the exact care or support decision being assessed, clarify the relevant information, consider practicable steps to support the person, and apply the functional test under the Mental Capacity Act 2005.
In this service, particular attention is given to the person’s understanding of their care needs, the proposed support, who would provide it, the risks and consequences of accepting or refusing care, and what they could do if they were unhappy, worried or unsafe. The report should show what evidence was reviewed, what was observed during the assessment, what information came from records or collateral sources, and how that evidence supports the conclusion. A diagnosis, care need, risk concern or family disagreement is not treated as a substitute for analysis.
Where the matter is complex, contested or likely to be relied upon by solicitors, deputies, a local authority or the Court of Protection, the assessment may require fuller evidence review, careful consideration of limitations, and a clear explanation of the causal link between any impairment or disturbance and the person’s ability to understand, retain, use or weigh the relevant information or communicate the decision.
Evidence before opinion; Correct test first; Care-specific analysis; Supportive process; Transparent reasoning; Clear conclusions
Common Care and Support Capacity Assessment Questions
Yes. A person can refuse care even if professionals, relatives or services think the decision is risky or unwise. The key question is whether the person can understand, retain, use or weigh the relevant information about the care decision and communicate their decision.
A refusal of care may only indicate lack of capacity if the person cannot make the specific decision because of an impairment of, or disturbance in, the functioning of the mind or brain.
However, a capacitous refusal does not automatically remove the local authority’s duties where eligible needs have been identified. It may mean the local authority needs to consider whether those needs can be met in a different, less restrictive or more acceptable way, taking account of the person’s wishes, feelings, risks, wellbeing and available options.
No. Refusing a care package is not the same as lacking capacity. The assessment must consider whether the person understands what support is being offered, why it is being offered, who would provide it, what may happen if support is refused, and whether they can apply that information to their own situation.
Yes, but they are two different capacity decisions and should not be treated as interchangeable. Capacity to decide about care and support is not the same as capacity to decide where to live.
Where both issues arise, the report should identify each decision separately, set out the relevant information for each decision, and reach a separate conclusion for each. They may be factually connected, especially where a living arrangement affects the care available, but the assessment should not merge them unless there is a clear reason why the facts make them inseparable.
Even then, the report should explain the relationship between the two decisions carefully, rather than assuming that a finding about one automatically answers the other.
If the person lacks capacity, the relevant decision will usually need to be made in their best interests under the Mental Capacity Act 2005. The assessment does not make the best interests decision. It provides evidence about whether the person can make the care or support decision themselves. The next step may involve family discussion, professional review, a best interests meeting, safeguarding consideration, solicitor advice or a Court of Protection application.
Why families, solicitors and deputies choose Nellie Supports
Families, deputies and solicitors choose Nellie Supports when they need clear, independent and decision-specific evidence about whether a person can make decisions about their care and support.
Care decisions can involve difficult questions about safety, dignity, independence, self-neglect, safeguarding, hospital discharge, family disagreement, support at home or refusal of a proposed care package. Our role is to assess whether the person can make the specific care decision themselves, and to explain the evidence and reasoning clearly.
At Nellie Supports:
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assessments are delivered by a permanent full-time multidisciplinary team, not an ad hoc associate or referral-panel model
-
we have completed thousands of formal assessments across England and Wales
-
every care and support assessment is focused on the actual decision being considered
-
our reports are structured around the Mental Capacity Act 2005 and the person’s ability to understand, retain, use or weigh the relevant information and communicate their decision
-
we consider the person’s care needs, proposed support, who would provide it, the consequences of accepting or refusing support, and what the person could do if they were unhappy or unsafe
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we take a calm, respectful and person-centred approach to the assessment conversation
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every report is reviewed before issue for quality, clarity and consistency
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our work is supported by the Nellie Standard™ and Professional Standards framework
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reports can be prepared for families, solicitors, deputies, local authorities, care providers or Court of Protection use where required
Nellie Supports is England and Wales’ largest specialist mental capacity assessment provider and specialist private social work practice. Our scale, permanent team model and assessment experience help us provide a consistent, responsive and dependable service for complex care and support decisions.
No provider can guarantee how a court, public body or decision-maker will treat an individual report. Nellie Supports provides clear, structured and evidence-led professional opinion within the scope of the instruction.
Our care and support capacity assessment process
We keep the care and support capacity assessment process clear, respectful and decision-specific from the outset. Whether you are a family member, deputy, solicitor, local authority professional, case manager or care provider, we guide you through each stage carefully, from confirming the correct decision to be assessed to arranging the appointment, preparing the report and delivering clear written evidence.
Initial enquiry and triage
Contact us by phone, email or through our website form. We gather the key details, explain how the assessment process works and confirm whether a care and support capacity assessment is the right next step.
We will usually ask about the person’s current care arrangements, the proposed care or support decision, any refusal of support, safeguarding concerns, hospital discharge issues, family disagreement and who needs the report.
Quotation and booking
Once we understand the scope of the assessment, we provide a clear quotation, including VAT and any applicable travel costs.
If you would like to proceed, we arrange a suitable appointment as quickly as possible. Assessments can take place at home, in a care home, in supported living, in hospital where appropriate, at a professional location, or remotely where suitable.
Assessment appointment
A qualified assessor meets the person and carries out a decision-specific mental capacity assessment focused on the care or support decision in issue.
The assessor considers whether the person can understand, retain, use or weigh the relevant information and communicate their decision. The assessment is carried out calmly and respectfully, with practicable support provided where appropriate.
Report preparation and peer review
The findings are written into a clear mental capacity report explaining the decision assessed, the relevant information, the practicable steps taken, the person’s responses, the evidence considered and the reasoning behind the conclusion.
The report is reviewed before issue for quality, clarity and consistency, in line with the Nellie Standard™ and Professional Standards framework.
Secure delivery
Your completed report is delivered securely by email. Where needed, we can also respond to reasonable clarification requests about the report.
The report can be used by families, deputies, solicitors, local authorities, care providers, hospitals or professional referrers to help inform the next lawful decision-making process. No provider can guarantee how a court, public body or decision-maker will treat an individual report.
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Frequently Asked Questions
This depends on availability, location, urgency, the person’s circumstances and whether the relevant background information is ready. If the matter is urgent, for example because of hospital discharge, safeguarding concerns or a time-sensitive care decision, please tell us at the enquiry stage so we can advise on the earliest available appointment.
Yes, where appropriate. Some care and support capacity assessments can be completed by video call, depending on the person’s communication needs, presentation, the decision being assessed, the available evidence and whether a remote assessment would give the person a fair opportunity to participate.
A care and support capacity assessment may be requested by families, deputies, attorneys, solicitors, local authorities, case managers, care providers, NHS professionals or other professional referrers. We will clarify who needs the report, what decision is being assessed and whether the instruction is appropriate before booking.
Helpful documents may include care plans, support plans, Care Act assessments, hospital discharge summaries, safeguarding records, medication information, previous capacity assessments, medical records, Court of Protection paperwork and details of the proposed care or support arrangements.
If the person is reluctant or refuses to take part, the assessor will consider whether there are practicable steps that may help them engage. This may include clearer explanations, a different time, a familiar setting, support from a trusted person, or communication adjustments. If the assessment cannot be completed, we will explain the limitations clearly.
No. The assessment considers whether the person can make the specific care or support decision themselves. It does not decide what care package should be provided, what is in the person’s best interests, or what services a local authority, NHS body or care provider must arrange.
The final report is usually sent securely to the person or organisation that instructed the assessment, unless different arrangements have been agreed. Where solicitors, deputies, local authorities, care providers or family members are involved, we will clarify report-sharing arrangements before the assessment is completed.
A care and support capacity assessment can cover a specific decision about the care, support or supervision a person receives. This may include whether they can accept or refuse a proposed care package, decide what support they receive at home, engage with a Care Act assessment, or make a decision about support following hospital discharge.
The assessment should not be framed as a broad question about whether someone can “manage care needs”. It should identify the actual care or support decision that needs to be made.
Care and Support Capacity Assessment Guides
Our care and support capacity assessment guides explain how mental capacity applies to decisions about care packages, support at home, Care Act assessments, refusal of care, self-neglect, safeguarding concerns and hospital discharge planning.
These guides are written for families, deputies, attorneys, solicitors, local authorities, care providers and professionals who need clear, practical information about care and support capacity under the Mental Capacity Act 2005.
We also provide mental capacity assessments for other decisions
If you need a mental capacity assessment for a different decision, Nellie Supports can help. Our permanent full-time team provides decision-specific assessments for COP3 and Court of Protection applications, residence decisions, property and financial affairs, Lasting Power of Attorney decisions, testamentary capacity, statutory will matters, trustee decisions, litigation, gifting and other complex or disputed matters across England and Wales.
For the full range of services, visit our Mental Capacity Assessments page.