Mental Capacity Assessment for Residency: Deciding Where to Live
When someone you care about can no longer decide where they should live—whether staying at home, moving to supported living, or entering residential care, a mental capacity assessment for residency becomes essential. Not just for legal compliance, but for protecting their dignity, autonomy, and right to make their own choices.
Nellie Supports has completed over 6,000 mental capacity assessments, including hundreds for residency decisions. We understand exactly what courts, local authorities, hospitals, and families require when placement decisions are contested or unclear. Our assessments are court-ready, peer-reviewed by a second qualified professional, and delivered within 10-14 working days.
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What Is a Mental Capacity Assessment for Residency?
A mental capacity assessment for residency evaluates whether someone has the mental capacity to decide where they should live. It answers a critical question: does this person understand the decision about their residence well enough to make it themselves, or does someone else need to make that decision in their best interests?
Under the Mental Capacity Act 2005, capacity is decision-specific. Someone might have capacity to decide what to eat but lack capacity to weigh the complex risks and benefits of moving from their family home into residential care. We assess capacity for the specific residency decision in question—whether that's returning home from hospital, moving into supported living, entering a care home, or remaining in their current home with increased support.
Why These Assessments Matter
Mental capacity assessments for residency are commonly needed when:
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Hospital discharge disputes: Hospitals want to discharge someone to a care home, but the person or their family believes they can return home safely with appropriate support.
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Family disagreements: Siblings or relatives disagree about whether someone can remain at home or needs residential care, and independent evidence is required to resolve the dispute.
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Local authority placements: Social services propose a move to residential care, but capacity to consent to that move is unclear, or the person is refusing the placement.
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Returning home from care: Someone in temporary residential care wants to return home, but professionals question whether they understand the risks of living independently or with reduced support.
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Court of Protection applications: Best interests decisions are needed when someone lacks capacity to decide where to live, and the court requires formal, CPR Part 35 compliant capacity evidence.
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Safeguarding concerns: There are concerns about someone's safety at home (risk of falls, self-neglect, exploitation), but it's unclear whether they have capacity to understand and weigh those risks.
When, Where, Who & How Much — Your Residency Capacity Questions Answered
Where We Carry Out the Assessment
We come to you, wherever is most comfortable and appropriate for the person being assessed.
Face-to-face assessments (95% of our cases):
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At home: The most common choice. We conduct the assessment in familiar surroundings where the person feels comfortable and secure.
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In a care home or nursing facility: We work with care staff to find a quiet, private space at a time when the person is at their cognitive optimum.
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In hospital: If the person is medically stable and free from acute illness or infection that could temporarily affect capacity, we can conduct the assessment in a hospital setting.
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At our office: Available if preferred, though less common for residency capacity assessments.
Remote video assessments: Available where appropriate, though we recommend face-to-face for most residency capacity assessments. Video assessments work best when:
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The person is comfortable with technology
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They have a quiet, private space for the call
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Their communication needs can be met remotely
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Face-to-face is genuinely impractical (e.g., geographic distance, urgent timeline)
Why face-to-face matters: Residency capacity assessments often involve discussing complex, emotionally charged decisions about home, safety, independence, and care. Face-to-face allows us to observe non-verbal communication, adapt our approach in real-time, and ensure the person is not disadvantaged by the assessment method.
Nationwide coverage: We operate across England and Wales with no geographic restrictions.
When You'll Need a Residency Capacity Assessment
You should consider a residency capacity assessment when:
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A move is being proposed (e.g., returning home, entering residential care, supported living) and there's doubt whether the person can make that decision themselves
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Professionals (hospital discharge team, care coordinator, local authority) or family members disagree about whether remaining at home is safe
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You need clear, legally defensible evidence for a Court of Protection application, best interests meeting, or dispute resolution
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The decision involves a change in environment, care support, or daily living arrangements that carries significant risk
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Someone is being pressured to move and you need independent evidence of whether they understand the decision
Timing matters: Most families contact us when a crisis hits: a hospital demands immediate discharge, a local authority threatens safeguarding action, or family conflict escalates. The sooner you act, the sooner you can protect your relative's rights and resolve the dispute with clear evidence.
Cost / Pricing
A capacity for residency assessment is priced at £469.00 (exclusive of VAT and assessor travel).
This includes:
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The full assessment interview (in person or, where appropriate, mixed methods)
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A legally robust, peer-reviewed report in accordance with the Mental Capacity Act 2005 and CPR Part 35 standards
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Advice or clarifications to stakeholders based on findings
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Electronic delivery (PDF) with wet-signature copy available for a small admin fee (approximately £15 to 20)
Travel time (if applicable): £40 per hour
Complex cases: If the case is particularly complex (e.g., contested setting changes, multiple location options being weighed, extensive liaison with professionals), we will provide a written estimate of any extra cost before proceeding. You'll always get a written fee confirmation before work begins.
Payment terms: Invoice issued upon booking. Payment due before report delivery. We accept bank transfer, credit/debit card, and payment from solicitors' client accounts.
Why our pricing is fair:
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Expertise: Registered social workers with specialist training in mental capacity law and years of practical experience
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Quality: Court-ready, CPR Part 35-compliant reports with a 99% court acceptance rate
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Speed: 10 to 14-day turnaround compared to weeks or months waiting for NHS or local authority assessments that may never materialise
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Independence: Our assessments are impartial and objective, not constrained by budget pressures or service backlogs
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Transparency: No hidden fees. What you see is what you pay.
Who Can Conduct It & What Makes Us Different
A valid residency capacity assessment must be conducted by a suitably qualified and experienced professional, such as:
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Registered social workers trained in the Mental Capacity Act 2005
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Medical doctors (e.g., GPs, psychiatrists)
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Occupational therapists with capacity assessment experience
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Suitably qualified and experienced professionals with background in cognition or psychology
At Nellie Supports, our assessors are full-time, in-house professionals specialising in capacity assessments. Because they work within a multidisciplinary team, your assessment benefits from:
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Rigorous peer review: Every report is reviewed by a second qualified professional for quality assurance and CPR Part 35 compliance
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Specialist expertise: Our team includes registered social workers, psychologists, a forensic scientist, and an SRA solicitor
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Continuity and reduced delay: We're not constrained by NHS or local authority backlogs. We deliver reports within 10 to 14 days
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Court-ready reports: 99% court acceptance rate. Our reports are routinely accepted by the Court of Protection, local authorities, and hospitals without challenge
What sets us apart: We're the UK's largest private social work practice and the largest provider of mental capacity assessments nationally. We've completed over 6,000 assessments. We understand the legal requirements, the human complexities, and what courts and professionals need to see.
Why Families Choose Nellie Supports
Every residency capacity assessment is fully compliant with the Mental Capacity Act 2005 and CPR Part 35, making them suitable for Court of Protection applications, best interests meetings, and disputed placement decisions. Our reports are peer-reviewed by a second qualified professional before delivery, ensuring they withstand legal scrutiny.
Our assessors include registered social workers, chartered psychologists, and healthcare professionals, all specialists in mental capacity law and residency decisions. Because we work as an in-house team (not a referral network), your assessment benefits from rigorous quality assurance, peer review, and consistent standards across every case.
We know residency decisions are often time-sensitive, hospital discharge pressures, family disputes, or urgent Court of Protection deadlines. Reports are delivered within 10-14 working days as standard, with expedited service available when you need answers faster. No months-long waiting lists.
£469 + VAT for a full residency capacity assessment, with no hidden costs. You'll receive a written fee confirmation before any work begins. If your case is particularly complex (multiple location options, extensive liaison, or contested circumstances), we'll provide a clear written estimate of any additional costs upfront, never after the fact.
Residency decisions are life-changing. Our assessors take time to understand the person's wishes, feelings, and lived experience, not just tick boxes. We adapt our approach to communication needs, cognitive abilities, and emotional state, ensuring every individual has the best opportunity to demonstrate their capacity and be heard.
Our Process – Step by Step
Call Us to Discuss Your Needs
Get in touch with our friendly team to discuss your situation. We’ll answer your questions, explain the process, and confirm whether a residency assessment is the right next step.
Book a Face-to-Face Appointment
We’ll arrange a convenient time for one of our experienced assessors to meet the person being assessed. Assessments can take place at home, in hospital, or in residential care — wherever the person feels most comfortable.
Assessment and Report Writing
The assessor carries out a full MCA 2005–compliant assessment, supported where appropriate by the Montreal Cognitive Assessment (MoCA). The findings are then documented in a detailed, plain-English report. All reports are written to be CPR Part 35 compliant, so they can be relied on in legal proceedings if required.
Report Delivered Within 10–14 Days
Your completed report is securely delivered within 10–14 working days of the assessment. If required, urgent turnaround is available. The report will give clear conclusions, supported by evidence, that can be shared with professionals, local authorities, or the Court of Protection.
Understanding Mental Capacity: The Legal Framework
Imagine a friend who wears a T-shirt on a frosty morning and a heavy coat on a scorching afternoon. You would naturally wonder if they really understood how to match their clothing to the weather. Mental capacity assessments work in a similar way, but for life's far more important choices. They explore whether a person can truly understand, process, and decide about specific matters such as managing finances, signing a will, or consenting to medical treatment.
Under the Mental Capacity Act 2005, capacity is always decision-specific. A person may be perfectly able to make some decisions yet struggle with others. For example, someone might have full capacity to decide what to eat for breakfast but lack capacity to manage complex investment decisions. This is why every assessment must be tailored to the exact decision in question.
The Two-Stage Test: How Mental Capacity Is Assessed
Following case law (A Local Authority v JB [2021] UKSC 52), modern assessments use a functional-first approach. Here is how it works:
Can the person do all of the following?
Can the person understand, retain, use or weigh, and communicate the information? If yes to all four, they have capacity. If they struggle with any element, we move to Stage 2.
If the answer to all four questions is yes, the person has capacity for that specific decision. If they struggle with even one element, we move to Stage 2.This second stage confirms whether any lack of capacity is due to a medical or psychological condition, as required by the Mental Capacity Act 2005. Conditions might include dementia, learning disabilities, brain injury, mental health conditions, or the effects of medication or alcohol.
What Questions Are Asked in a Mental Capacity Assessment for Residency?
The options available:
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Where you're living now and what other options are being considered
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The type of accommodation, facilities, and who you'd be living with at each place
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The difference between living somewhere (sleeping there every night) and just visiting
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What support or care you'd receive, and any rules or obligations at each location
Practical considerations:
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What activities you'd be able to do at each place
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How you'd see family and friends (distance, visiting arrangements, accessibility)
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That rent and bills would need to be paid (though this would be managed on your behalf)
Weighing the decision:
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The advantages and disadvantages of each option
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Any risks (such as falls, isolation, or managing medication at home) and how you feel about them
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What matters most to you about where you live
Making and communicating your choice:
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What you've decided and why
The assessor adapts their approach to your communication needs, using simple language, visual aids (such as pictures to show the difference between living and visiting), or allowing extra time. The goal is to give every person the best opportunity to demonstrate their capacity, not to catch them out.
Case Study: Supporting a Family Through Residency Dispute
When Mr H's family needed clarity about his ability to decide where to live, they first approached his GP for an assessment. After weeks of waiting, the GP declined, explaining that residency capacity was outside their remit. The local authority was then contacted, but their social care team confirmed they could not provide a private assessment for a
Court of Protection matter. With growing disagreement between siblings about whether Mr H could safely remain at home, the family faced rising tension and no clear route forward.
How Nellie Supports Helped
The family contacted Nellie Supports and were connected with a specialist coordinator the same day. Within 72 hours:
An experienced assessor with expertise in MCA residency decisions was appointed.
A home visit was arranged, with adjustments for Mr H's hearing and memory difficulties.
The updated 2024 Functional Test was applied, with both verbal prompts and practical examples tailored to residency decisions.
The full report was drafted, peer-reviewed internally for compliance with MCA 2005 and CPR Part 35, and securely delivered within one week.
The Outcome
The family received a clear, legally robust report that resolved their dispute and was accepted by the Court of Protection. Mr H's wishes were fully documented, and a lawful best-interests decision could then be made with confidence.
Key Takeaway
Statutory routes often decline or delay residency capacity assessments. Nellie Supports provides a fast, reliable, and court-ready alternative, giving families clarity when it matters most.
What Our Clients Say
Used Nellie Supports to provide a Mental Capacity assessment on a close family member and the assessor was very professional & patient throughout and showed the necessary empathy when things took a difficult turn during the assessment.
Nick Prince
Efficient and well-organised service. The assessor was thorough, professional, empathetic and produced a comprehensive report within 24 hours of the interview. Excellent service all round.
David Laws
The Team at Nellie Supports are always helpful. Always providing advice and information where necessary. Prompt in responding with quotes. I always recommend to others within my organisation.
Ann-Marie (solicitor)
Explore More on Our Blog
Looking for practical insights on the Mental Capacity Act and real-world examples of how residency decisions are handled? Our blog is full of guidance, case updates, and thought pieces written by our expert assessors. From breaking down the 2024 Functional Test to exploring recent Court of Protection rulings, you’ll find resources to help you understand the law and how it applies in everyday life.
Frequently Asked Questions
No. Under the Mental Capacity Act 2005, no one can be forced to move into a care home if they have the mental capacity to decide where they live. If someone lacks capacity to make this decision, any move must be made in their best interests, following a lawful best interests process that includes consulting family, considering the person's wishes and feelings, and exploring less restrictive alternatives. A residency capacity assessment establishes whether the person can make the decision themselves, protecting their autonomy and ensuring any placement is legally sound.
Family disagreements about residency are common, especially when safety concerns conflict with a person's wishes. A mental capacity assessment provides independent, objective evidence about whether the individual can make the decision themselves. If capacity is found, their decision stands, even if family members disagree. If capacity is lacking, the assessment report informs the best interests decision-making process, helping families and professionals reach a lawful resolution. In contested cases, our CPR Part 35 compliant reports are accepted by the Court of Protection.
From initial contact to receiving your completed report typically takes 10-14 working days. This includes arranging the assessment visit, conducting the face-to-face assessment (usually 60-90 minutes), writing the report, and peer review by a second qualified professional. For urgent cases, such as hospital discharge deadlines or Court of Protection timescales, we offer expedited service. The assessment itself is never rushed, we take whatever time is needed to ensure the person has every opportunity to demonstrate their capacity.
Yes. Mental capacity is decision-specific and time-specific, meaning it can fluctuate depending on the person's condition, medication, time of day, or stress levels. Someone may have capacity to decide where they live at one point but lose it later due to illness progression, or regain it if their condition improves. If circumstances change significantly, a new assessment may be needed. Our reports clearly document the person's capacity at the time of assessment and note any factors that might affect future capacity.
This is one of the most common and difficult scenarios we assess. Our role is to determine whether the person has the mental capacity to make the decision, not whether we agree with their choice. If someone understands the risks of returning home, can weigh those risks against their wish for independence, and can communicate their decision, they may have capacity, even if professionals consider the choice unwise. If capacity is lacking, safety concerns are considered as part of the best interests decision, but the person's wishes and feelings must still be given significant weight.
A residency capacity assessment must be conducted by a suitably qualified professional with training and experience in the Mental Capacity Act 2005. This typically includes registered social workers, medical doctors, occupational therapists, or psychologists with capacity assessment expertise. At Nellie Supports, all our assessors are full-time, in-house professionals who specialise in mental capacity law. Every assessment is peer-reviewed by a second qualified professional before delivery, ensuring consistency, accuracy, and legal robustness.
Yes. All our residency capacity assessments are written to CPR Part 35 standards, making them suitable for use as expert evidence in Court of Protection proceedings. Our reports include detailed reasoning, clear conclusions, a statement of truth, and comply with all legal requirements for expert witness reports. We regularly provide assessments for contested deputyship applications, best interests disputes, and placement challenges, and our reports are accepted by courts, local authorities, and hospitals across England and Wales.
A residency capacity assessment costs £469 + VAT. This includes the face-to-face assessment visit, a full MCA 2005 compliant report, peer review by a second qualified professional, and any reasonable post-assessment queries or clarifications. Assessor travel time is charged separately at £40 per hour. If your case is particularly complex (for example, multiple location options, extensive liaison with professionals, or contested circumstances), we will provide a written estimate of any additional costs before proceeding. You will always receive written fee confirmation before any work begins.
A capacity assessment determines whether someone can make the decision themselves. A best interests decision is what happens when someone lacks capacity. If our assessment finds the person has capacity, they make the decision, and it must be respected (even if others disagree). If the person lacks capacity, a best interests decision must be made on their behalf, following the MCA 2005 best interests checklist. Our assessment report provides the foundation for either outcome, documenting the person's wishes, feelings, values, and beliefs to inform any best interests process.
The vast majority of residency capacity assessments (over 95%) are conducted face-to-face, as this allows the assessor to observe the person in their current environment, assess non-verbal communication, and build rapport. However, in some circumstances, remote assessment via secure video link may be appropriate, for example if the person is shielding, in a remote location, or specifically requests it. We discuss the most suitable approach during your initial consultation. All remote assessments are conducted via our secure, legally compliant platform and meet the same rigorous standards as face-to-face visits.
If someone refuses to engage with a capacity assessment, this does not automatically mean they lack capacity. Under the Mental Capacity Act 2005, a person is assumed to have capacity unless proven otherwise. Our assessors are trained to explore the reasons for refusal, is it a capacitous decision based on their values and preferences, or does the refusal itself indicate an inability to understand or engage with the decision? We adapt our approach, offer alternative times or locations, and work sensitively to give every opportunity for participation. If meaningful assessment proves impossible despite reasonable adjustments, we document this clearly and advise on next steps, which may include seeking Court of Protection guidance.
Yes. We regularly conduct assessments on hospital wards, particularly when discharge planning is underway and there is disagreement about whether someone can return home safely. Hospital environments can be challenging (noise, unfamiliarity, medication effects), so our assessors take extra care to find a quiet space, assess at the best time of day for the individual, and account for any factors that might temporarily affect capacity. We liaise with ward staff, review medical records, and ensure our assessment reflects the person's baseline capacity, not just their presentation during an acute hospital stay.
We assess capacity for all types of residency decisions, including moving into supported living, sheltered housing, moving in with family members, returning home from hospital or residential care, or remaining in the current home with increased support. The assessment is tailored to the specific decision being made, the level of support available in each setting, and what matters most to the individual. Whether the move involves 24-hour care or independent living with occasional support, we apply the same rigorous MCA 2005 standards.
Having dementia, a learning disability, or any other diagnosis does not automatically mean someone lacks capacity to decide where they live. The Mental Capacity Act is clear that capacity must be assessed for each specific decision, not assumed based on condition or diagnosis. Our assessors have extensive experience working with people with cognitive impairments, communication difficulties, and fluctuating conditions. We use accessible language, visual aids where helpful, and adapt our approach to ensure the person has every support to demonstrate their capacity. Many people with dementia or learning disabilities retain capacity for residency decisions when assessed properly.