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