2.6 Explain what actions needs to be taken to ensure a worker acts in an individual’s ‘best interests’

This guide will help you answer 2.6 Explain what actions needs to be taken to ensure a worker acts in an individual’s ‘best interests’.

To act in an individual’s ‘best interests’ under the Mental Capacity Act 2005, workers need to follow specific guidelines and principles. These ensure that decisions made on behalf of a person who lacks capacity are both legally compliant and ethically sound.

Awareness of ‘Best Interests’

The concept of ‘best interests’ is specifically designed to protect those who cannot make their own decisions. It’s not just about what’s easier or more convenient. It involves a holistic approach to decision-making that considers the individual’s circumstances, values, and needs.

Key Principles of the Mental Capacity Act

1. Presumption of Capacity: Assume every adult has the capacity to make decisions, unless proven otherwise.
2. Support to Make Decisions: Provide support to the individual to enable decision-making whenever possible.
3. Unwise Decisions: Understand that making an unwise decision does not mean a lack of capacity.
4. Best Interests: Any decision made, or action taken, must be in the best interests of the person who lacks capacity.
5. Less Restrictive Option: Consider whether the decision could be made in a less restrictive way.

Steps to Determine ‘Best Interests’

Gathering Information

• Know the Individual: Understand their past and present wishes, feelings, beliefs, and values.
• Assess Circumstances: Take into account the person’s age, relationships, cultural background, physical and mental health.

Consultation

• Involve Others: Seek input from family, friends, carers, and anyone previously named by the individual.
• Consistent Communication: Engage with those who know the person best to gather varied perspectives.

Weighing Options

• Consider Alternatives: Look at all possible options and assess the risks, benefits, and implications.
• Respect Autonomy: Prioritise choices that align most closely with what the individual would have likely chosen.

Decision-Making Process

• Document Decisions: Record the rationale for each decision and how it serves the person’s best interests.
• Review and Reflect: Regularly review decisions, especially if circumstances change.

Use of Best Interests Checklist

To ensure a thorough approach, consider a best interests checklist:

• Involvement: Are all relevant parties involved?
• Preference: Have the individual’s preferences been considered?
• Scientific Evidence: Are the decisions supported by medical or expert evidence?
• Risk vs Benefit: Have you balanced risks and benefits?
• Rights and Freedoms: Are you respecting the person’s human rights and freedoms?

Addressing Disagreements

Sometimes, disagreements arise over what is in the best interests of the individual. When this happens:

• Mediation: Use mediation or a best interests meeting to discuss and resolve differences.
• Court of Protection: As a last resort, apply to the Court of Protection for a decision.

Practical Examples

Consider a scenario where an individual needs medical treatment but lacks the capacity to consent. You must:

• Consult Relevant People: Speak with their family and health professionals.
• Review Past Wishes: Consider any advance decisions or past verbal wishes.
• Balance Health Benefits vs Individual’s Wishes: Weigh the immediate health benefits against the individual’s known aversion to medical interventions.

Legal Obligations

Workers have a legal obligation to adhere to the Mental Capacity Act Code of Practice. This ensures protection and respect for those lacking capacity.

• Training: Stay up-to-date with training requirements.
• Supervision and Support: Seek supervision when needed, and ensure there are systems in place for support.

Final Thoughts

To act in an individual’s best interests requires careful consideration and structured decision-making. By following the principles outlined in the Mental Capacity Act and using a comprehensive approach, workers can ensure that the rights and autonomy of those lacking capacity are upheld. This fosters an environment of respect, dignity, and understanding, ensuring the individual’s well-being is always prioritised.