Making ‘best interests’ decisions

A short video drama in a residential school depicting scenes between a young man with severe learning disabilities, and both his key worker and social worker. The video introduces the principles of the Mental Capacity Act and emphasises the importance of consultation in best interests' decision-making.

Khurrum is 19 and has severe learning disabilities. His key worker is Julia and his social worker is Saleema. Khurrum is preparing to a residential care home for adults. Saleema has indentified a vacancy in a small group home close to his parents but Julia doesn’t believe this will truly meet his needs.

With the aid of computer software, Julia communicates with Khurrum. Khurrum is unable to make the decisions about where to move to for himself, so Julia and Saleema meet to discuss his best interests in relation to this. There is a frank exchange of professional views with Julia emphasising the importance of ensuring Khurrum is central to the decision-making process , even though he chose not to attend the meeting. The film demonstrates the importance of consultation in best interests’ decision-making.

Actors have been used in this short film.

Messages for practice

  1. The Mental Capacity Act (MCA) has five principles: principles 1 to 3 support the process of deciding whether or not someone lacks capacity. Principles 4 and 5 support the decision-making process to reach a best interests decision when someone lacks capacity.
  2. The person should be central to the decision-making process, whether or not they have capacity to make the decision.
  3. The MCA sets out a duty to consult with family and friends.
  4. The MCA includes a best interests checklist which should be used when considering a best interests decision.
  5. Cultural issues and beliefs may affect the outcome so these must be considered when decisions are being made on behalf of people who lack capacity.

Who will find this useful?

This film is aimed principally at front-line care staff who provide care and support on a daily basis to people who may lack capacity to make specific decisions. It will also be of interest to managers, commissioners and others working with people with care and support needs, and their friends and families.