Mental Capacity Assessment
Mental Capacity Assessment for Health and Welfare Decisions
Specialist health and welfare capacity assessments across England and Wales
A health and welfare capacity assessment considers whether a person can make a specific decision about care, support, medical treatment, hospital discharge, daily routines, information sharing, safeguarding or other welfare arrangements.
£600 + VAT
Standard fee, stated before instruction
5 working days
Typical turnaround
England and Wales
Nationwide coverage
Decision-specific
Assessed to the right standard
Nellie Supports is England and Wales' largest identified specialist private social work and mental capacity assessment practice, delivered by a permanent full-time team. Services are provided by employed, multidisciplinary professionals, not an ad hoc associate, contractor or referral-panel model. We have completed over 11,000 formal assessments and reports. This service sits alongside our full range of mental capacity assessment services.
When you may need this assessment
The assessor considers the person’s ability to understand, retain, use or weigh information about the specific health or welfare decision and to communicate their decision.
The report explains the instruction, evidence reviewed, relevant information, practicable steps, assessment findings and MCA reasoning.
The legal test for Health and Welfare Decisions capacity
A Health and Welfare Decisions capacity assessment applies the Mental Capacity Act 2005 to the specific decision. The question is whether, at the time the decision needs to be made, the person can:
Understand the information relevant to the decision about Health and Welfare Decisions
Retain that information long enough to make the decision
Use or weigh that information as part of making the decision
Communicate their decision by any means
A person may have capacity for some decisions but not others. Health and welfare capacity must therefore be assessed by reference to the actual decision in question.
Framework: Mental Capacity Act 2005 ss 1 to 4, including the best interests checklist, and the Code of Practice.
For more, read our guide: Mental Capacity Act 2005 explained.
Our assessment process
Initial enquiry and triage
Contact us by phone, email or website form. We gather the key details, explain how the assessment works, and confirm the specific decision to be assessed.
Quotation and booking
Once we understand the scope, we provide a clear quotation including VAT and any applicable travel costs, and arrange an appointment as quickly as possible.
Assessment appointment
A qualified assessor meets the person face to face, or remotely where appropriate, and carries out a decision-specific capacity assessment.
Report preparation and peer review
The findings are written up in a clear, structured report and reviewed by a second qualified professional for quality, consistency and legal robustness.
Secure delivery
Your completed report is delivered securely, usually within your stated turnaround period, with reasonable minor amendments or clarification available after delivery.
What the assessor evaluates
A well-reasoned assessment explains how the conclusion has been reached, rather than simply stating an outcome, tied to the actual decision in issue.
The specific decision being assessed
Whether the person was given the relevant information in a way they can understand
Whether they understand the information relevant to the decision
Whether they can retain that information long enough to decide
Whether they can use or weigh the relevant information
Whether they can communicate their decision by any means
Whether any inability is because of an impairment or disturbance of the mind or brain
The support provided, the person's views, and the reasoning behind the conclusion
Fees and timescales
£600 + VAT
Standard fee. VAT at 20% and travel costs are not included. Enhanced assessment from £3,500 + VAT.
Assessment appointment options
Gentle, professional assessment
Decision-specific approach
Mental Capacity Act compliant
Relevant information for health and welfare
Written capacity report
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Standard or Enhanced, which does your case need?
A standard assessment is right for most cases where the decision is clear and undisputed. Where the case is complex or contested, an enhanced assessment provides a deeper, more defensible evidential foundation.
Standard Assessment
£600 + VAT
- Decision-specific assessment of the exact decision
- Completed in line with the Mental Capacity Act 2005
- MoCA where appropriate
- Court-ready report
For most cases where the decision is clear and undisputed.
Enhanced Assessment
£3,500 + VAT
- Extended, multi-layered assessment
- Structured analysis of vulnerability and undue influence
- Broader evidential framework for likely challenge
- Robust reporting where the decision may be disputed
For complex or contested cases.
A full-time, multidisciplinary team
Nellie Supports is built on an employed, permanent team: registered social workers, a Chartered Psychologist and specialist assessors working together to one standard, with every report peer reviewed by a second qualified professional. Your assessment is never passed to an associate bank or referral panel.
The right professional for the decision
Capacity questions range from care and residence to complex cognition and prognosis. A multidisciplinary team means the discipline is matched to the decision, not to whoever is available.
One consistent standard
The team works together full time, so every assessment follows the same methodology and peer review is built into every report rather than bolted on.
Accountability you can name
Your report is signed by an employed professional who answers for their work, and the practice stands behind it.
Continuity, not hand-offs
The people who take your enquiry, carry out the assessment and review the report all work in one practice, so nothing is lost between stages.
How this works in practice
Care, support or residence disagreement
This assessment may be needed where relatives or professionals disagree about whether a person can decide about their care, support, residence, discharge plan or day-to-day arrangements.
Treatment, discharge or safeguarding concerns
A health and welfare decision can become complex where there are concerns about medical treatment, discharge from hospital, neglect, abuse, coercion, refusal of support or serious risk.
Court of Protection or public body decision-making
Professionals may need a clear report where health and welfare arrangements are being considered in a best interests process, safeguarding meeting or Court of Protection application.
This is an illustrative example. It does not describe any individual client.
Why families, solicitors and professionals choose Nellie Supports
Decision-specific, not generic
Focused on the exact decision in issue and the information relevant to it, not a broad opinion about capacity overall.
Court-ready reporting
Reports structured for solicitors, the Court of Protection and other professionals who need to rely on them.
Therapeutic assessment interviews
A calm, supportive conversation that helps the person engage as fully as possible.
Nationwide coverage
A permanent team covering England and Wales, in person or by video where appropriate.
Peer reviewed as standard
Every report is reviewed by a second qualified professional before it is issued.
Employed, not outsourced
A permanent full-time team, not an ad hoc panel of associates.
Health and welfare capacity assessment FAQs
What is a health and welfare capacity assessment?
A health and welfare capacity assessment considers whether a person can make a specific health or welfare decision at the relevant time. It may relate to care, support, residence, discharge from hospital, medical treatment, daily routines, sharing health and care information or safeguarding arrangements. It is not a general judgement about the person’s capacity overall.
What decisions can a health and welfare assessment cover?
It can cover decisions such as accepting or refusing care, choosing where to live, moving to a care home, agreeing to a discharge plan, consenting to or refusing treatment, deciding on daily routines, sharing information about health and care, or understanding particular safeguarding risks. The exact decision must be identified before the assessment.
Is a health and welfare capacity assessment the same as a best interests decision?
No. The capacity assessment asks whether the person can make the decision for themselves. If they lack capacity, a separate best interests process may be needed. A capacity report can inform that process, but it does not replace it.
Can one report cover more than one health and welfare decision?
Yes, where appropriate. Each decision should be listed separately, with its own relevant information and reasoning. A report should avoid blending care, residence, treatment and contact decisions into one broad conclusion unless the instruction and evidence justify that approach.
Can this assessment be used for Court of Protection matters?
Yes, where the instruction requires this and the evidence is suitable. Health and welfare capacity reports may assist solicitors, deputies, local authorities, NHS bodies or the Court of Protection, including where a COP3 or other structured evidence is required.
What if the assessment does not reach the conclusion we hoped for?
Our assessments are independent, and that independence is what gives the report its value. We do not begin from a preferred answer. We assess the specific decision on its merits and record the reasoning, whatever the conclusion. A report that only ever confirmed what was hoped for would carry no weight with a solicitor, the Court of Protection or anyone else relying on it.
Related mental capacity guides
Mental Capacity Act 2005 explained
A plain English guide to the key MCA principles and the two-stage capacity test.
What is relevant information in a capacity assessment?
Explains why each capacity decision must be assessed using information specific to that decision.
How to prepare for a mental capacity assessment
Practical guidance on documents, context and support before an assessment appointment.
Remote versus face-to-face capacity assessments
Explains when remote assessment may be suitable and when face-to-face assessment may be preferable.
What makes a capacity report court-ready?
Explains the features of a clear, reasoned and decision-specific report.
Other assessment types
If a different decision needs to be assessed, our team can help across the full range of mental capacity assessments.
COP3 mental capacity assessment
For Court of Protection deputyship applications.
Capacity to Manage Finances
Independent, decision-specific assessment of capacity to manage money, property and financial affairs.
Enhanced mental capacity assessment
A deeper, multi-layered assessment for complex, high-value or contested cases.
Nellie Supports provides independent social work assessment, evidence and advocacy support. We do not provide regulated legal advice, and where a legal remedy is needed we will say so and support your solicitor's work.
Need a health and welfare capacity assessment?
Contact Nellie Supports to discuss a health and welfare capacity assessment. We will confirm the decision, the evidence needed, the likely timescale and whether a face-to-face or remote assessment is suitable.
Written by Ben Slater, Founder and Managing Director, Nellie Supports. Read our editorial policy.