Push to improve skills for making 'best interest' decisions

The Mental Capacity Act should be revised to give health and social care workers the appropriate skills needed for making effective decisions on behalf of people lacking the capacity to make decisions themselves.

The call has been made in a report published by the Mental Health Foundation based on research carried out by the Norah Fry Research Centre, and the Centre for Applied Social Research at the University of Bristol.

Over 1 million people (including individuals with dementia and learning disabilities) are estimated to lack the ability to make their own decisions. 

Research was carried out as part of the Department of Health’s investigation into the effectiveness of the Act and its Code of Practice, particularly when making decisions in the best interest of clients about social care, health, property and financial affairs.

Key findings from the report show:

• a significant minority of best interest decisions are made for people who have capacity and who could be supported to make these decisions with help, or who have been wrongly assessed as lacking capacity
• different ways of making successful best interest decisions have been identified which are not currently reflected in the training and guidance available to health and social care staff
• lack of awareness of Deprivation of Liberty Safeguards in some cases
• many staff find the MCA helpful in balancing the autonomy and protection of individuals lacking capacity
• practitioners value guidance and training  relevant to their own practice, although some admitted the situations they face are more complex than currently reflected in the guidance. 

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