Adult support and protection: guidance for GPs and primary care teams

Appendix X

Decision-Specific Screening Tool

First read the Communication and Assessing Capacity Guide.

Name of Adult

Swift Number:

Worker Details

Date

Capacity is the ability to understand information relevant to a specific decision or action and to appreciate the reasonably foreseeable consequences of taking or not taking that decision or action.

This tool aims to assist the practitioner consider the various elements involved in the decision making process. It could be used to gather evidence of an adult having or lacking capacity in relation to non- medical decisions and to consider whether a more formal, health capacity assessment is required in order to pursue measures under the Adult with Incapacity (Scotland) Act 2000. It is not suitable for medical or complex decisions

Details of the Decision to be made or action to be taken

Who was consulted in forming your opinion of the Adult's decision-making ability

Name

Relationship with Adult

Contact Details

Consider: Does the Adult repeatedly make seemingly unwise decisions which place her/him at significant risk or serious exploitation? Is she/he making a decision which defies all notion of rationality and/or is markedly out of character?

An unwise or eccentric choice doesn't necessarily mean the person is unable to make a decision – consider the person's views, values, preferences and previous decisions.

Q1: Does the Adult have a mental disorder (diagnosed or suspected) or is unable to communicate because of a physical disability?

Yes

No

Not Sure

Condition (Dementia, learning disability, brain injury, personality disorder, neurological condition,)

Q2 Do you consider the Adult able to understand the information relevant to the decision and that this information has been provided in a way that he/she is most probably able to understand?

Yes

No

Not Sure

An elderly widow who has never dealt with money matters may need to receive the information in as simple a manner as possible and helped to understand it. It may be that she will learn to manage her finances with support.

Q3 Do you consider the Adult able to retain the information for long enough to use it in order to make a choice or an effective decision?

Yes

No

Not Sure

It may take several visits going over the information to see if the response is consistent (even if the person cannot remember being asked before). A consistent response may indicate sufficient capacity to understand the decision in hand.

Q4 Do you consider the Adult able to use or weigh that information as part of the process of making the decision?

Yes

No

Not Sure

Certain types of disorders (brain injury, neurological conditions) cause people who are able to understand information, to act impulsively regardless of the information available and their understanding of it.

Q5 Do you consider the Adult able to communicate the decision?

Yes

No

Not Sure

Every effort should be made to facilitate communication including talking mats.

Q6 Do you consider the Adult able to act upon the decision?

Yes

No

Not Sure

An individual may not be able to act on a decision because they trust, fear or feel responsible for another person. A mother who is being physically threatened or abused by her son may not be able ask him to leave her home

Any Further Comments

If you have answered YES consistently to Q2-Q6, the Adult is considered on the balance of probability, to have the capacity to make this particular decision at this time.

Sign/date this form and record the outcome within the Adult's records

If you have answered NO or NOT SURE to any of the questions proceed to Q7.

Q7 Overall, do you consider on the balance of probability that the impairment or disability noted in Q.1 is sufficient that the adult lacks the capacity to make this particular decision?

Yes

No

Not Sure

On the balance of probability the Adult lacks capacity to make this specific decision at this particular time.

If you have answered 'Not Sure' to any questions, please consider a referral for a Specialist Health Assessment

Signature

Date Assessment Completed