Adult Social Care Glossary, v 0.6

Any decisions made, or anything done for a person who lacks capacity to make specific decisions, must be in the person’s best interests. There are standard minimum steps to follow when working out someone’s best interests. These are set out in section 4 of the Act, and in the non-exhaustive checklist in 5.13.

The Mental Capacity Act (MCA) provides a non-exhaustive checklist of factors that decision-makers must work through in deciding what is in a person's best interests. Some of the factors to take into consideration are:

- Do not discriminate. Do not make assumptions about someone's best interests merely on the basis of the person's age or appearance, condition or any aspect their behaviour.
- Take into account all relevant circumstances
- If faced with a particularly difficult or contentious decision, it is recommended that practitioners adopt a 'balance sheet' approach
- Will the person regain capacity? If so, can the decision wait?
- Involve the individual as fully as possible
- Take into account the individual's past and present wishes and feelings, and any beliefs and values likely to have a bearing on the decision
- Consult as far and as widely as possible.

Again, it is vital that you record your best interests decision. Not only is this good professional practice, but given the evidence-based approach required by the MCA, you will have an objective record should your decision or decision-making processes later be challenged.

For more detailed information you should refer to the Mental Capacity Act Code of Practice.

Best Interest – A Best Interest decision is made when an individual is deemed to lack capacity for a specific decision. This decision maker is usually the individual’s daily carer or care team, though may be a healthcare professional in the case of more complex decisions. The Best Interest decision should be included in the individual’s care plan and reviewed at regular intervals. For more details, see our guide to the Mental Capacity Act.

Other people should act in your 'best interests' if you are unable to make a particular decision for yourself (for example, about your health or your finances). The law does not define what 'best interests' might be, but gives a list of things that the people around you must consider when they are deciding what is best for you. These include your wishes, feelings and beliefs, the views of your close family and friends on what you would want, and all your personal circumstances.