Some decisions are controversial or complex so it is appropriate to hold a best interests meeting.
Best interests meetings can be formal or part of a multi-disciplinary meeting, for instance within a ward round. The decision-maker will need to consider what sort of meeting is appropriate and what sort of involvement and support is necessary for making and recording each particular decision.
A formal meeting will need to be chaired by someone other than the decision-maker. In Devon, this may be a Team Manager, or Senior Social Worker or Occupational Therapist. The Best Interest Meeting agenda outlines the issues that will be discussed in the meeting.
If a best interests meeting does not successfully resolve the issues, seek advice to discuss options. Your Team Manager may be the first point of contact in this.
A best interests meeting should include information from relevant professionals, family members and the person who lacks capacity. If these people don’t attend the meeting their views must be represented. This is a requirement in the best interests checklist. (s4 MCA) (Part 8: Best interests decisions)
Before the meeting the chair should liaise with the decision-maker to:
The agenda should cover:
After the meeting the chair should:
The MCA gives the power to make a decision to the decision-maker. (Part 7: Being a decision-maker)
Families often assume they can make decisions and may be upset and angry if their views are not followed. It is important to make sure people understand how and why decisions are made. It may be the role of the decision-maker to explain the law and their role to any family or friends. (Part 24: MCA and family and informal carers)
If professionals disagree about a decision, the decision-maker makes the final decision. There would need to be appropriate discussion of the issues and a clear record made of reasons why the decision is made.
It may be appropriate to consider referral for independent mediation. Seek advice from your Team Manager, the local MCA Lead or, if there is a risk of abuse or neglect, from the Safeguarding team.
The Court of Protection is a branch of the High Court, set up to protect people who lack capacity and it can make determinations concerning any decision. Referral to the Court of Protection should be a last resort. (Part 23: The Court of Protection)
If legal action may be necessary speak to your team manager, and with their agreement seek legal advice.
Make sure the priority remains the welfare and safety of the person whose best interests are being considered. Consider if their circumstances mean a referral should be made to the Safeguarding Adults process.
This page was last modified: 2nd Nov 2016