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Best Interest

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Best Interest Decisions in everyday practice: Part 1

A Best Interest Decision is the step that is taken if a person is found to lack mental capacity for a specific decision at a specific time. It is not a single action, but rather a dynamic process that aims to uphold the individual’s rights, keeping their thoughts, feelings, beliefs and values at its heart, while also consulting with all relevant parties to weigh up the viable options.

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Importance of wishes, beliefs and values in Best Interest decisions

A Best Interest decision (Section 4, Mental Capacity Act 2005) is a legally directed process that must be followed when a person has been assessed to lack capacity to make a specific decision at a specific time. By describing the process as ‘Best Interest’ it is purposeful reminder to all those involved that it is a decision that should be made in the Best Interest of the individual, and not any of the other involved parties.

With this in mind, it is therefore absolutely essential that the individual’s preferences, thoughts, wishes, values and beliefs are established before any Best Interest decision can be made.

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DoLS in focus: The role of the Best Interest Assessor (BIA)

The primary role of a Best Interest Assessor (BIA) is to complete the Mental Capacity Assessment and Best Interest Assessment steps within the DoLS process. These are recorded as part of Form 3.

They can also be commissioned by the Supervisory Body to complete ‘Age’ and ‘No Refusals’ steps if required.

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Two women interviewing / assessing a person wearing a checked yellow shirt.

The six key assessments for DoLS

The Code of Practice for DoLS (2008) directs that wherever possible, DoLS authorisations should be applied for in advance of a hospital or care home admission, in order to ensure that appropriate safeguards are in place from day one. As such, a DoLS application should really be made at the point where the individual is assessed prior to admittance, in order that the application be processed in time.

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DoLS restrictions and the right to object

In simple terms a deprivation can be described as a restriction, while a deprivation of liberty is a restriction on everyday living. The Mental Capacity Act enacts vital safeguards and protections an individual who can not consent to their care and treatment is is deprived of said liberties. It protects the individual through upholding their rights, monitoring any form of restriction in place and striving to ensure these are proportionate, justifiable and the least restrictive option. In today’s blog, we consider what these restrictions may include, and the importance of keeping the individual’s voice at the heart of any Best Interest decision.

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