Assisted Decision-Making (Capacity) Act: Training Healthcare Staff in Ireland

This guide covers Ireland. For the UK equivalent, see our guide: Liberty Protection Safeguards (LPS): What Care Staff Need to Know.

The Assisted Decision-Making (Capacity) Act 2015 changed how Irish health and social care services think about capacity, consent and support for decision-making. For managers planning assisted decision-making capacity act training for healthcare staff in Ireland, the practical questions are what the Act and its codes of practice say about staff, what the HSE itself offers, and how to build training that fits each role. This guide covers what the official pages say, notes where they are silent, and labels our own suggestions.

This is a workforce and compliance guide, not clinical or legal advice. For advance healthcare directives specifically, see our separate guide to advance healthcare directives for care staff.

Where the Act stands

According to Citizens Information (page last edited 7 April 2026), the Act came into effect on 26 April 2023. Decision support arrangements under the Act apply only to people aged over 18. The page explains that capacity is assessed functionally, for a specific decision at a specific time, and that "you are always presumed to have capacity". A person lacks capacity for a decision only if they cannot understand, retain or weigh the relevant information, or cannot communicate their decision.

The same page says that since 26 April 2023 new applications to make an adult a ward of court can no longer be made, and that existing wards are to have their wardship reviewed by the courts. It also refers to a 2026 amending Act that allows extensions of up to 18 months in total, but not beyond 25 October 2027. Because this area is changing, check the current position on the Citizens Information and Decision Support Service pages before relying on any date.

One older official page is worth flagging. The gov.ie publication page for the Act was last updated on 22 December 2021 and speaks of the provisions being commenced on a phased basis. It predates commencement, so do not use it as a statement of the current position.

The Decision Support Service and codes of practice

Citizens Information says the Decision Support Service promotes the rights and interests of people who may need support with decision-making, registers and supervises decision support arrangements, maintains a panel of experts and handles complaints. According to a Decision Support Service news item dated 24 April 2023, the Director published 13 codes of practice, which took effect when the Act became operational on 26 April 2023. Ten were approved by the Minister for Children, Disability, Equality, Integration and Youth, and three healthcare-related codes by the Minister for Health.

The codes most relevant to healthcare employers are:

• the Code of Practice for Healthcare Professionals;
• the Code of Practice for Supporting Decision-Making and Assessing Capacity;
• the Code of Practice on Advance Healthcare Directives for Healthcare Professionals; and
• the Code of Practice for Designated Healthcare Representatives.

The news item says the codes are meant for new decision supporters and also guide healthcare, legal and financial professionals, independent advocates and anyone who works with people who may need support to make decisions.

What the Code of Practice for Healthcare Professionals says

The Code of Practice for Healthcare Professionals (dated April 2023) says it should be read together with the Act, and that where there is a conflict the Act prevails. It says professionals must read the separate code on supporting decision-making and assessing capacity first, and that as an intervener they are required to comply with that code. In summary, the code states that:

• you must presume a person has capacity to make a decision at the time it needs to be made;
• a person must not be considered unable to make a decision until all practical steps to support them have been taken;
• an unwise decision is not evidence that the person lacks capacity;
• if capacity is questioned, you should check whether a decision support arrangement exists and whether it covers the decision;
• you must have a valid reason before assessing someone's capacity, and the assessment focuses on how the person makes the decision, at a specific point in time; and
• you should make and keep a full and detailed written record of the steps taken.

These points matter for training because they are about everyday practice: who asks the question, who records it, and who knows where to look for an arrangement. They are not restricted to doctors. The code is addressed to healthcare professionals, but the way a service organises its records and escalation affects care assistants, administrators and managers too.

What the HSE offers staff

The HSE staff page on the Act says it came into force in April 2023 and lists two sets of training on HSeLanD. The programme "Assisted Decision-Making (Capacity) Act 2015 - Guidance for Healthcare Workers" has three modules: guiding principles, working with decision supporters, and advance healthcare directives. A separate HSE National Consent Policy eLearning has two modules, general principles and working with children and young people, and the page says healthcare workers should complete it. The page shows no publication date.

An HSE resources document dated June 2023 also lists a second e-learning suite, "Supporting Decision-Making in Health and Social Care", covering supporting a person to make decisions, planning for the future and an introduction to functional assessment of capacity. It also lists recorded webinars, case-study webinars, FAQs and links to Decision Support Service codes. The document notes that its FAQs should not be relied upon as legal advice. The HSE resources are aimed mainly at HSE healthcare and social care staff, so other providers should check what is accessible to them.

What the pages do not say

None of the pages we read states a legal requirement that every healthcare employer must put all staff through a defined training course on the Act. The HSE pages direct staff to e-learning and webinars, and the Code of Practice sets out how professionals are expected to act. We did not find a Health Information and Quality Authority page that sets out training expectations on the Act specifically. Where HIQA inspects your service, check the regulations and standards that apply to it and how it expects rights and consent to be reflected in practice. Our guide to staff training and HIQA inspections explains how inspectors approach training evidence more generally.

A practical approach to training your team

Our suggestion, which is not a legal requirement, is to treat this as role-based training rather than a one-size module.

• Everyone who supports adults: the presumption of capacity, why unwise decisions are not evidence of incapacity, and how to support communication.
• Clinical and care leads: the functional approach, what counts as a valid reason to assess, and how to record the steps taken.
• Managers and administrators: how to find out whether a decision support arrangement or advance healthcare directive exists, where it is filed, and who to contact at the Decision Support Service.
• Safeguarding leads: how capacity questions interact with safeguarding concerns. Our overview of safeguarding vulnerable adults training sets out the wider safeguarding context.

Another practical step is to review your policies and forms. Consent forms, care plans and incident templates may use language from before the Act. Update them with the help of your clinical governance or legal advisers, and train staff on the updated versions. Keep a record of who has completed which module, and when a refresher is planned.

Dublin employers with staff across several sites can find it useful to run a short discussion session after the online modules, using anonymised scenarios from their own service. This is where staff can ask how the principles apply in their setting, which an online module cannot answer.

Learnsignal's offices are off Baggot Street in Dublin, and we offer in-person training from there. For current details, see our CPD pages.

Frequently asked questions

When did the Assisted Decision-Making (Capacity) Act come into effect?

Citizens Information (page last edited 7 April 2026) says it came into effect on 26 April 2023. The HSE staff page also says it came into force in April 2023.

Is training on the Act mandatory for healthcare staff?

The pages we read do not state a general legal requirement to train all staff. The HSE directs its staff to e-learning on HSeLanD, and the Code of Practice for Healthcare Professionals sets out what professionals are expected to do. Check your employer policy, regulator and funder for any requirement that applies to you.

Does the Act presume that adults have capacity?

Yes. Citizens Information says you are always presumed to have capacity, and the Code of Practice for Healthcare Professionals says you must presume capacity at the time the decision needs to be made.

Where can staff find the codes of practice?

The Decision Support Service published 13 codes of practice, including ones for healthcare professionals, on supporting decision-making and assessing capacity, and on advance healthcare directives. Check the Decision Support Service website for the current versions.

Does this article give legal advice?

No. It summarises official pages and flags our own suggestions. Take legal advice on specific cases.

The safest way to approach this Act is to train by role, keep the written record the code asks for, and keep checking the official pages as the position develops.