When a relative loses the ability to make decisions about their own care — through dementia, a stroke, or another condition — the Mental Capacity Act 2005 sets out exactly who can make decisions on their behalf, and how those decisions must be reached. Most families only learn about it once it is already needed.
Capacity is decision-specific, not global
A person is not simply "lacking capacity" across the board — capacity is assessed for each specific decision at the time it needs to be made. Someone may lack capacity to manage complex finances but retain capacity to decide where they want to live, or vice versa. Any capacity assessment should relate to the specific decision in question.
Who decides if there is a Lasting Power of Attorney
If your relative set up a Lasting Power of Attorney (LPA) for health and welfare while they still had capacity, the named attorney can make care decisions on their behalf once capacity is lost, guided by the principles of the Act. This is the cleanest route — see our separate guide on setting up an LPA before a crisis.
Who decides if there is no LPA
Without an LPA, decisions are made in the person's "best interests" by whoever is providing care or treatment — typically the care team in consultation with family — following a structured best-interests process the Act sets out: consulting those who know the person, considering their past wishes and values, and choosing the least restrictive option that meets their needs.
When the Court of Protection gets involved
For significant or disputed decisions — a contested move into care, a major medical treatment decision family members disagree on — the Court of Protection can be asked to make or authorise the decision. This is a formal legal process, generally used when informal best-interests consultation cannot resolve a genuine disagreement.
What this means practically for a care-home move
If your relative can still meaningfully take part in the decision to move into care, involve them as fully as possible even with reduced capacity — the Act requires all practicable steps be taken to support their own decision-making before treating them as unable to decide. Document the reasoning behind a best-interests decision, since care homes and local authorities will often ask for this at admission.
How to use this guide in practice
Don’t read this as general information — use it as a worksheet. Write down the details of the person who needs care, the current limits of the situation at home, the monthly budget, the documents you already have, whether a local-authority financial assessment may apply, and who you’ve already spoken with. Then turn every unclear point into a specific question. A family that arrives with a clear picture usually gets more useful answers than one calling under stress with scattered information.
Keep one simple rule: anything about admission, cost, funding, timelines and whether a care home fits must be confirmed directly with the care home or the competent authority serving your area. This guide prepares the search — it does not replace official decisions.
Want a clear shortlist before you start calling?
If you don’t know which care homes to contact first, Curalune Care Help can prepare an ordered shortlist of 3–5 suitable options — with CQC ratings, contacts, useful links and a ready-to-send inquiry.
The service helps you organise the search.£69, one-off. If you don't receive at least 3 homes matching the area and criteria you gave us, we refund you in full. It does not replace the care home’s own assessment and does not guarantee admission, price or bed availability.
Important limit
Curalune offers practical help with the search and orientation. Admission, pricing, bed availability and the final assessment always rest with the care homes and the competent authorities (the local authority, the NHS, the Care Quality Commission).
