According to the Mental Capacity Act, a person can be assessed as not capable of making a particular decision, in which case that decision should be made for him/her, according to his or her best interests. Although the Act gives guidance about how this should be done, we wanted to find out how best interests decisions were actually being made for those with dementia, mental health issues, brain injury or learning disabilities.
This research gave information on how the current guidance is being interpreted for different groups of people, and different types of decision (eg, health, legal or social care).
1. In order to have an overview of current practice, we used an online survey to get information from 392 people who have made best-interests decisions for someone who lacks capacity.
2. We carried out a telephone survey of 68 decision makers in four areas, about the experience of making particular best interests decisions.
3. We then interviewed the key people involved in 20-30 cases of best interests decisions, to find out more about the factors involved in good practice, the difficulties and conflicts, and the different models being followed. We also observed eight best interests meetings.
The research delivered practical recommendations by involving practitioners and users throughout the research, and by delivering a report and summaries, feeding into a national policy seminar.
Funder: Department of Health, Policy Research Programme.