Has Dad just refused to let the carers in again? Is Mum agreeing to things she doesn’t really understand? If questions like this are keeping you up at night, getting a private mental capacity assessment could be the next step to getting them the help they need, and peace of mind for you.
This guide explains what a mental capacity assessment is, why you might need a private one, who carries them out, what to expect, and how to find the right person for the job.
What is a mental capacity assessment?
The Mental Capacity Act 2005 is desgined to protect and empower people who may lack the mental capacity to make their own decisions about for example their care and treatment. It applies to people aged 16 and over.
It covers decisions about day-to-day things like what to wear or what to buy for the weekly shop, or serious life-changing decisions like whether to move into a care home or have major surgery.
A mental capacity assessment is the It’s a formal way of establishing whether a person can make a specific decision at a specific point in time – not whether they’re generally able to hold a conversation or manage throughout the day. You might notice your parent or relative can decide what they want for lunch, but struggle to understand the implications of selling their house. That might seem like a contradiction but it’s just how conditions like dementia, or the aftermath of a stroke, can affect the brain.
The mental capacity test looks at four things: can the person understand the relevant information, hold onto it long enough to make a decision, weigh it up, and communicate what they’ve decided?
Why would you need a private assessment?
There are a few situations where having an independent assessment is necessary.
Setting up a lasting power of attorney. A lasting power of attorney (LPA) lets your parent appoint someone they trust to make decisions on their behalf if they are no longer do so themselves. They have to have capacity at the point of signing and if there’s any doubt about that (a recent stroke, a dementia diagnosis, or a wobble in understanding would all count towards doubt), a mental capacity assessment would be proof the LPA was set up properly.
Applying for deputyship. If your parent has already lost capacity and there’s no LPA in place, the next step is usually a deputyship application through the Court of Protection. It’s more complicated than setting up an LPA, and a mental capacity assessment is a key part of the evidence the court needs to approve the decision.
Big financial or property decisions. Selling a home, making a large gift to the family, or restructuring savings are all big decisions that require the person to genuinely understand what they’re agreeing to. An assessment means nobody can later argue the decision was made without proper understanding.
Getting a second opinion. There might be times when you feel that a professional has got it wrong, either by assuming someone lacks capacity when they don’t, or the other way around. A private assessment gives you the evidence you would need to push back on their decision.
Who can conduct a mental capacity assessment?
There are actually quite a few people who can do a mental capacity assessment and finding the right one depends on what you need the assessment for.
For something relatively straightforward, like confirming capacity for an LPA, a GP or consultant is often enough. For anything more complex or legally sensitive such as Court of Protection proceedings, you’ll usually want a specialist, such as a consultant in old age psychiatry or neurology.
Independent social workers and occupational therapists (OTs) also carry out assessments, particularly where the decision relates to care or daily living. And some solicitors who specialise in this area are also qualified to assess capacity.
Whoever does it must be independent and they can’t have any personal or financial stake in the outcome.
What happens during an assessment?
It’s much less daunting than it sounds, so there is no need to be fearful going into an assessment. There’s no formal test or exam and it’s really just a structured conversation between the assessor and your parent, focused on a specific decision.
The assessor explains the relevant information, then explores whether they can understand what is being said, hold onto the information, and work through the implications. Family members or carers might be asked for background context, but the assessment itself is about the individual.
Afterwards, you get a written report with the assessor’s findings. That document becomes the evidence, for an LPA application, a court case, a dispute with a care provider, or whatever you specifically need it for.
How much does it cost?
Costs vary quite a bit depending on the professional, the complexity of the situation, and where you are in the country. A rough ballpark: anywhere from £500 to £2,000 or more. A GP-led assessment for a straightforward LPA question will usually be at the lower end. A specialist psychiatric assessment for Court of Protection proceedings will cost more.
Before you book anything, ask exactly what’s included. Some assessors charge separately for travel, report writing, or follow-up calls, so it’s worth being clear upfront.
How to find a mental capacity assessor?
A few good starting points:
- Your parent’s GP or consultant: they may be willing to do it themselves, or point you in the right direction. They’ll also have relevant background on your parent’s health.
- Association of Lifetime Lawyers: a national network of solicitors who specialise in later-life legal matters. They can often recommend suitable assessors.
- Independent social workers: find accredited practitioners through the British Association of Social Workers (BASW).
- Private psychiatry or neuropsychology clinics: especially useful if your parent has a complex condition like dementia.
Whoever you approach, ask specifically about their experience with the Mental Capacity Act and – if it’s relevant – the Court of Protection. And check how long the report will take, so there are no surprises.
Frequently asked questions about private mental capacity assessments
Can a GP refuse to do a mental capacity assessment?
GPs are not obliged to carry out capacity assessments, though many will do so, especially for established patients. If your parent's GP is unable or unwilling, ask for a referral to an appropriate specialist, or seek a private assessor independently.
Does my parent need to agree to the assessment?
Ideally, yes. A person who lacks capacity cannot meaningfully consent, but assessors are trained to work sensitively with individuals who are anxious or resistant. Where there is significant resistance, legal advice may be needed.
Can I use an NHS assessment instead of a private one?
NHS and local authority assessors can carry out capacity assessments, but access is not guaranteed and waiting times can be long. A private assessment gives you more control over timing, choice of assessor, and the format of the report.
Is a mental capacity assessment the same as a cognitive test?
No. A cognitive test (such as the MMSE or MoCA) measures general memory and thinking ability. A mental capacity assessment is decision-specific and legally focused – it's asking whether someone can make a particular decision, not giving an overall score.
What happens if my parent is found to lack capacity?
The assessor's report does not take away rights – it informs decisions. If your parent lacks capacity for a specific decision, the next step is usually to identify who holds LPA or, if no LPA exists, to consider a Court of Protection application for deputyship.
How long does the report take?
This varies by assessor, but most aim to produce a written report within 2 to 4 weeks of the assessment. If there's urgency (for example, a property sale is time-sensitive), raise this at the outset.
What to do next
If you think a mental capacity assessment might be needed – for an LPA, a property decision, or any other reason – don’t wait until a crisis point. The earlier an assessment is carried out, the more straightforward the process is likely to be.
Start by speaking to your parent’s GP if you’re not sure whether there are grounds for concern. If you’re clear that an assessment is needed, contact a solicitor specialising in later-life planning or an independent social worker with MCA expertise.
And if you’re supporting a parent who is resisting the process, try to frame it as something that protects their wishes – because that’s exactly what it does.
This article has been written using information from trusted organisations. Their guidance helps ensure the information here is accurate and reflects current UK law and best practice.
- Office of the Public Guardian (OPG): Oversees LPAs and deputyship in England and Wales.
- Mental Capacity Act 2005 Code of Practice: The official guide to how the Act works in practice. Available at GOV.UK.
- Association of Lifetime Lawyers: find a specialist solicitor for later-life planning.
- British Association of Social Workers (BASW): directory of accredited social workers.
- Court of Protection: Handles legal decisions about people who lack capacity.
- Age UK: General advice and support for older people and their families.
Our Dementia hub has lots of information including a guide to types of dementia and dementia care options.
