Positive Risk-Taking, Capacity and Consent in Acquired Brain Injury Support

Capacity and consent considerations are fundamental to positive risk-taking in acquired brain injury services. Fluctuating capacity, executive dysfunction and communication barriers mean that providers must apply the Mental Capacity Act carefully while still enabling choice and independence.

This article explores how ABI providers can apply capacity and consent principles to positive risk-taking. It should be read alongside Person-Centred Planning & Strengths-Based Support and Positive Risk-Taking & Risk Enablement.

Why capacity is complex in ABI

ABI may affect decision-making ability in specific contexts without removing overall capacity.

Commissioner and inspector expectations

Expectation 1: Decision-specific assessments. Inspectors expect capacity assessments to be decision-specific.

Expectation 2: Least restrictive practice. Commissioners expect restrictions to be justified and proportionate.

Operational example 1: Decision-specific capacity tools

An ABI service introduced decision-specific capacity tools aligned to everyday risk decisions.

Supporting informed consent

Accessible information and supported decision-making are essential to lawful risk enablement.

Operational example 2: Visual risk information

A provider used visual tools to support understanding of risk choices and consequences.

Best interests and positive risk-taking

Best interests decisions should enable participation and autonomy wherever possible.

Operational example 3: Best interests panels

A service established multidisciplinary panels to review complex risk decisions.

Evidencing lawful decision-making

Providers should evidence:

• Decision-specific capacity assessments
• Recorded consent discussions
• Clear best interests rationale

Lawful enablement in ABI services

When applied correctly, capacity and consent frameworks actively support positive risk-taking.

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