Understanding Mental Capacity Level 1

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MC4 Doing an assessment

The last section of this lesson provides an opportunity for you to consider a mental capacity assessment of Roger. Read the below transcript and make notes about how Tracey conducts the assessment and the skills she uses. Consider how Tracey gets a true picture of Roger’s capability.

  • Background
    • In this scenario we meet Roger, a man with learning disabilities living in supported housing. Roger has recently moved with the help of Tracey a social worker, and does not have an appointee to look after his benefits. Tracey is concerned that the staff at Roger’s home may be crossing a line between supporting Roger to decide how he spends his money and making some financial decisions for him. Tracey is meeting Roger to assess his capacity to make decisions about his money. One outcome could be to apply for an appointee. At the same time, Tracey is trying to find out if Roger would like more help to make his own financial decisions. Roger and Tracy role play this situation. Extracts are shown of what would be a longer process.
  • TRACEY
    • The reason I’ve come to talk with you today is to have a chat about what you understand about your money, the money that you have coming into you, the money that is spent and to have a discussion about how you do that and how people help you with that. OK?
  • ROGER
    • Yeah.
  • TRACEY
    • And to see if there’s any ways that we can improve how that works.
  • ROGER
    • Yeah.
  • TRACEY
    • OK. So I won’t be writing very much, but sometimes I might need to do that so that I don’t forget things.
  • ROGER
    • Yeah.
  • TRACEY
    • OK. First of all, can you just tell me a little bit about who in the house helps you with things around money?
  • ROGER
    • Miss– the support workers, they ca– they– they help me with my money.
  • TRACEY
    • Can you think of some of the things that they help you with?
  • ROGER
    • They help me sometimes with my budgeting. Yeah.
  • TRACEY
    • What does that mean? How do they help you with that?
  • ROGER
    • Well, sometimes I have to go to the Building Society to– it’s in town– to– if I want something, I have to– if it’s not much…
  • TRACEY
    • And the support workers come with you then?
  • ROGER
    • Yeah. They go with me.
  • TRACEY
    • And when you get there, what do you have to do? Do you have to pay for anything when you get to the bank?
  • ROGER
    • I have a bank book. I get help with the counter.
  • TRACEY
    • So you take your bank book. Is that to–
  • ROGER
    • To get the money out.
  • TRACEY
    • To take money out. OK. So the support worker comes with you to the Building Society and you take your bank book.
  • ROGER
    • Yeah.
  • TRACEY
    • And take some money out. Who decides how much money to take out?
  • ROGER
    • Before we set on a journey, or– I ask before how much– how much money to get out.
  • TRACEY
    • So can you tell me the kind of things that you need to use that money for? What do you spend it on?
  • ROGER
    • Some of the money I have to use for food con– food contribu–
  • TRACEY
    • Food contribution?
  • ROGER
    • Yeah. I have to pay rent, and I get money for if I go anywhere out important to different places.
  • TRACEY
    • You do quite a lot of different activities, don’t you?
  • ROGER
    • I do, yes.
  • TRACEY
    • So do you need a bit of money for each of those activities?
  • ROGER
    • Starts in my house has a lot me to… too– have some money on me. Yeah. For different things.
  • TRACEY
    • OK.
  • ROGER
    • Yeah.
  • TRACEY
    • I know that you’re very interested in going out on your own.
  • ROGER
    • Yes.
  • TRACEY
    • And you do that quite often.
  • ROGER
    • Yeah.
  • TRACEY
    • Yeah? OK. So I want to ask you about how much money you take if you went out on your own. For example, if you went out to go and have some lunch, is that something you do? Isn’t it?
  • ROGER
    • Yeah.
  • TRACEY
    • So if you were going out to have some lunch without a support worker, do you know how much money you might take with you?
  • ROGER
    • Sometimes I take 4 pound If I don’t have 4 pounds in my tin, they let me have 10 pounds for lunch,
  • TRACEY
    • OK. So what would be one of your favourite lunches? What do you like to have when you go to your cafe?
  • ROGER
    • I like to– I know it’s not very healthy, but I do like fish and chips.
  • TRACEY
    • Do you? OK.
  • ROGER
    • Yeah.
  • TRACEY
    • Do you have a drink when you have your fish and chips?
  • ROGER
    • Yeah. Yeah. With me I like a hot drink. I love tea or if they don’t serve tea, I ask could I have a cup of coffee.
  • TRACEY
    • OK. So you like to have a hot drink with you.
  • ROGER
    • Yeah.
  • TRACEY
    • OK. If you had fish and chips and a tea, could you guess how much that might cost?
  • ROGER
    • Some of the cafes are a dear.
  • TRACEY
    • Some are dear and some are not so dear. So would it be– what would a dear one be I wonder? If you had to pay 5 pounds for your fish and chips and tea, would that be dear or not dear?
  • ROGER
    • No. I don’t mind.
  • TRACEY
    • You don’t mind that, 5 pounds.
  • ROGER
    • No.
  • TRACEY
    • That seems quite reasonable, doesn’t it?
  • ROGER 
    • Yeah.
  • TRACEY
    • Fish and chips and a tea.
  • ROGER
    • Yeah.
  • TRACEY
    • Have you got– you told me earlier about each day you have your money, your support worker helps you to puts it in your money bag.
  • ROGER
    • Yeah.
  • TRACEY
    • You’ve got that with you?
  • ROGER
    • Yeah.
  • TRACEY
    • Would you mind getting it out and showing me what you’ve got there?
  • ROGER
    • I’ll put this down.
  • TRACEY
    • Excellent. Right. So let’s have a look. Can you open it up?
  • ROGER
    • I can open it.
  • TRACEY
    • Right. So what’s that note there you’ve got?
  • ROGER
    • I have 5 pounds now.
  • TRACY
    • You’ve got a 5. OK. 5. And what else have you got there? Can you count it out for me? Are you able to?
  • ROGER
    • That’s 5 pounds. 6.
  • TRACEY
    • 6.
  • ROGER
    • 7.
  • TRACEY
    • 7.
  • ROGER
    • 7.50
  • TRACEY
    • 7. 50. Excellent.
  • ROGER
    • Yeah.
  • TRACEY
    • OK. So that would be enough then–
  • ROGER
    • For–
  • TRACEY
    • So if you spent a 5 for your fish and chips and your tea, what have you got left there?
  • ROGER
    • 2 pounds 50.
  • TRACEY
    • 2.50. So say you you’ve been out for your lunch and then you’re on your way home, and you fancied something from the shop. Do you ever pick up anything from the shop on the way home?
  • ROGER
    • Buy a Mars sometimes.
  • TRACEY
    • A Mars?
  • ROGER
    • A Mars bar.
  • TRACEY
    • Yeah? How much is a Mars bar these days?
  • ROGER
    • Oh, it’s 50 or 60.
  • TRACEY
    • Is it? Would you like to have the chance to take more out with you in case you might see something that you fancied like a– I don’t know– something a bit bigger?
  • ROGER
    • Yeah.
  • TRACEY
    • Do you ever go clothes shopping?
  • ROGER
    • Clothes shopping. Yeah. I go with him Mister.
  • TRACEY
    • You do. OK. That’s something you do with them. All right then. Well, maybe that’s something that we can talk to the support staff about.
  • ROGER
    • Yeah.
  • TRACEY
    • Because you do seem to be– I’m sure you’re quite careful with your money when you go out.
  • ROGER
    • Yes.
  • TRACEY
    • And you seem to know how much you need to spend and how much you’ve got in your bag there. OK. Well, that’s been really helpful talking about that, Roger. Do you ever get to see the information about what’s going in your bank account or the Building Society account? It’s called your statement. Do ever see those?
  • ROGER
    • I get shown where that is.
  • TRACEY
    • OK. So you look at that?
  • ROGER
    • I look at that.
  • TRACEY
    • OK. So it sounds like the support workers at your home–
  • ROGER
    • Yeah?
  • TRACEY
    • They’re quite helpful to you?
  • ROGER
    • Yes.
  • TRACEY
    • And they’re quite involved in helping you to make decisions about getting your money from the Building Society and helping you to decide what you need to do.
  • ROGER
    • Yeah.
  • TRACEY
    • How much you’re going to need each day when you go out.
  • ROGER
    • Yeah.
  • TRACEY
    • Yeah. Is there some ways that the support workers could help you to make even more decisions about how to use your money?
  • ROGER
    • Yeah. Yeah.
  • TRACEY
    • I wonder what might be helpful to you.
  • ROGER
    • Yeah.
  • TRACEY
    • Do you feel that you can– if– for example, if you wanted to spend something– go and buy, I don’t know. You like listening to music, don’t you? Do you ever go and buy music?
  • ROGER
    • I do. I do.
  • TRACEY
    • So if you wanted to go and buy some music, or even if you wanted to buy something bigger like something to listen to your music on, would you feel able to make a decision on that?
  • ROGER
    • I would have to talk it through first.
  • TRACEY
    • OK. So it sounds like the support workers help you quite a lot.
  • ROGER
    • Yeah.
  • TRACEY
    • Yes.
  • ROGER
    • Yeah. Yeah.
  • TRACEY
    • And is that something that you’re happy with?
  • ROGER
    • Yes Yeah. I wouldn’t know where the money was going to.
  • TRACEY
    • OK OK. Is there anything that you’d like to learn to do with your money or anything you’d like to learn about managing your money that you don’t do now?
  • ROGER
    • [INAUDIBLE] to know sometimes where with the money going to.
  • TRACEY
    • That these are the things that– the ways in which your money is being spent that you don’t usually see.
  • ROGER
    • No.
  • TRACEY
    • OK. Would this be things like how much is going on the rent and bills and things like that?
  • ROGER
    • Yeah.
  • TRACEY
    • OK. So maybe there’s a way that we could talk with the support workers about involving you more in seeing what money’s coming out of your account and what it’s being spent on.
  • ROGER
    • Yeah. Yeah. Yeah.
  • TRACEY
    • OK. Well, that sounds like a really good idea.
  • ROGER
    • Yeah.
  • TRACEY
    • Because it is your money, isn’t it?
  • ROGER
    • Yes.
  • TRACEY
    • Yes. All right, Roger. It’s been really, really helpful having this chat with you this morning about your money and how you manage it.
  • ROGER
    • Yeah.
  • TRACEY
    • That’s really good. And there’s some things that we can talk to your support workers about.
  • ROGER
    • Yeah.
  • TRACEY
    • Is there anything else that you wanted to say to me?
  • ROGER
    • I do like having– I like having money here to–
  • TRACEY
    • You like having money on you.
  • ROGER
    • Yeah. Yeah. It would be– If I didn’t– if I didn’t have any money, I’d be a bit lost.
  • TRACEY
    • Yes. Oh, good. Well, that’s important. That’s important for you to have your own money, be able to go out when you choose, and spend it on the things that you want to spend it on. Yeah. Good. That’s really important.
  • ROGER
    • Yeah.
  • TRACEY
    • All right, Roger. Well, if there’s nothing more that you want to say or tell me, then I think we’ve spoken enough about that today. All right. Thank you very much.
  • ROGER
    • Yeah.

Tracey, the social worker in the scenario, demonstrated a number of skills:

  • She involved Roger as much as she could. This added time to the interview.
  • She planned the timing carefully.
  • She assumed Roger had mental capacity throughout.
  • She listened to what he was saying.
  • It is likely that she reminded herself of the concept of reasonable belief.

The scenario details a shortened version of what actually happened. It may be that in real-life situations the interview for assessing mental capacity happens on more than one occasion.