Social care and health professionals should support people to make decisions

Posted on: January 10th, 2018

Social care and health professionals should support people to make decisions if they have capacity but find it difficult, NICE says.

Professionals should support those who find it difficult to make decisions, NICE says in new draft guidance. They should do so even if they make a decision that they may disagree with. Making an ‘unwise’ or ‘risky’ decision does not mean that a person is unable to make a decision for themselves or that it needs to be made on their behalf, the draft guidance adds.

Having mental capacity means that someone is able to make their own decisions. If someone is assessed as lacking mental capacity, services should take all reasonable steps to help people be involved in decisions made on their behalf, the draft guidance says.

A person can lack mental capacity to make a specific decision about their care or treatment due to an illness or condition, such as dementia or a brain injury. Professionals make decisions on their behalf which will be in their best interest in line with the Mental Capacity Act 2005. However, professionals may some times overlook the view of individuals, particularly if they make a decision which they do not agree with.

NICE recommends using visual aids or involving friends and family can help a person communicate their wishes.

Professor Gillian Leng, deputy chief executive at NICE, said: “Our advice, once final, will support government legislation and make sure all steps are taken to keep people at the centre of the decision-making process.”

The draft guidance is not ground-breaking with the content already well covered in the Mental Capacity Act and its Code of Practice; however it does provide some helpful reminders about good practice and will provide easy reference for those in the care sector.

Some helpful reminders include:

  • Support the person with decision-making even if they wish to make an unwise decision.
  • Health and social care organisations should monitor and audit the quality of mental capacity assessments.
  • Organisations should ensure that assessors should be able to seek advice from people with specialist condition-specific knowledge.
  • Organisations should have clear policies or guidance on how to resolve disputes.

A public consultation on the draft guidance on decision-making and mental capacity is open until 5 February 2018. Members of the public are invited to comment.

Spencer Gardner is an Associate Solicitor in our Court of Protection team.