Using an anonymised case study (with written consent), we describe a process aiming to understand the impact a patient's learning disability, personality disorder and bipolar affective disorder each had upon her capacity to make decisions and to ascertain in which areas of her life the patient had the ability to take responsibility. This information was then used to plan an effective management strategy.

We have developed an approach to care planning in which we analyse management areas by defining which diagnosis is relevant and so deciding if the patient has capacity for that specific area of life. in this way we can be clear with patients when they have capacity and encourage greater responsibility and independence in their lives.