What is the MCAST Support Tool?

This tool is designed to guide you through the different stages of the capacity assessment process, using a series of questions and prompts.

What will the Support Tool help me to do?

It will help you to prepare, carry out and document a holistic assessment that considers the person’s individual support needs (including communication needs) and document this in a robust way.

Who can I use the Support Tool with?

You can use the Support Tool to help you complete a capacity assessment for any person in any care setting. The tool was originally designed for use in England and Wales because it follows the requirements of the Mental Capacity Act (2005) and case law that relates to this law. However, the tool has been used by practitioners working in different health and social care settings across different jurisdictions. These people have told us they have found it helpful. We think it is up to you to decide whether you think its contents will be relevant to the setting in which you work. You need to base this decision on your understanding of any capacity law that applies where you work.

How do I use the Support Tool?

Pages 1 and 2 are designed to help you to complete important preparatory work prior to the actual capacity assessment. 

Page 1 prompts you to think about the decision the person is being asked to make and whether you need to carry out a capacity assessment for this person at this time. 

Page 2 prompts you to collect important information that you will need to provide to the person when you talk to them about the decision options available to them. Page 2 also contains prompts to help you to consider different factors that may affect the person’s decision-making. These include cultural, ethnic and religious factors, as well as any different support needs the person may have (e.g., due to communication, cognitive, mental health or emotional difficulties). Guidance is provided to help you to identify these different needs and ways to support them. For example, you might be prompted to seek specialist support from a colleague. You may be prompted to complete these actions before continuing to use the Support Tool during the capacity assessment itself.

Having completed pages 1 and 2, you can use the prompts and questions on pages 3 and 4 to carry out and record your capacity assessment. 

Page 3 includes prompts to help you to prepare the person and the assessment environment. 

Pages 3-5 include questions corresponding to the Mental Capacity Act (2005) 4-stage functional test of decision-making abilities and the diagnostic test. There is also space for you to record evidence to support your decision about whether the person is able to demonstrate each ability. 

Page 5 provides space for you to record your judgement about whether the person demonstrates capacity to make the decision and your plan for what needs to happen next (e.g., you may need to organise a Best Interests Meeting).

Pages 6 and 7 provide an optional document on which to record your assessment findings, if you do not have enough space on pages 3 and 4. It includes prompts taken from the NICE guideline “Decision-making and mental capacity” NG108 (NICE, 2018).