If a person has been assessed as lacking capacity then any action taken, or any decision made for, or on behalf of that person, must be made in his or her best interests. The person responsible for making decision, also known as the “decision maker” is normally:

• the carer responsible for the day-to-day care,
• a doctor, nurse or social worker responsible for making decisions about treatment, care or accommodation

What is “best interests”?

As outlined on the Social Care Institute for Excellence website, the Mental Capacity Act provides a checklist of factors that the decision maker must work through when deciding what would be in the persons best interest, these include but are not limited to:

• take into account all relevant circumstances
• if faced with a particularly difficult or contentious decision, it is recommended that practitioners adopt a ‘balance sheet’ approach
• will the person regain capacity? If so, can the decision wait?
• involve the individual as fully as possible
• take into account the persons past and present wishes and feelings, and any beliefs and values likely to have a bearing on the decision

All best interest decisions must be recorded and be evidence based to ensure that should your record or decision be challenged at a later date.