It is important to recognise that each adult at risk has their own needs and should be respected as an individual in their own right.
Assuming the adult has mental capacity, effective practice requires:
- identifying which practitioner has an established, positive relationship with the adult and, drawing on this, engages with the adult at risk and makes them feel comfortable about discussing their life;
- ensuring the adult understands the plan and believes it is designed to improve the quality of their life;
- balancing their opinions about their needs and services with safeguarding them from harm. This includes being able to justify actions that are not the adult at risk’s preferred option;
- allowing them to choose their means of communication, for example through an advocate;
- communicating using open ended rather than leading questions;
- actively listening;
- using close observation and recognising behaviours as a means of communication;
- seeing adults at risk, alone, if it is safe to do so;
- finding a place where the adult feels comfortable, safe and secure and meets their needs;
- ensuring they have access to an advocate if they so desire;
- being honest and providing accurate information about what is happening and what may happen.
If the adult at risk has been assessed and does not have mental capacity to make decisions about their safety needs, then a best interest’s decision should be made at each stage of the planning process. The person acting as decision-maker on behalf of the adult at risk should consider: ‘what is in their best interests at this stage of the process?’
The following should be taken into account:
- the best interests process means shared or supported decision-making with the adult at risk and their representative;
- that physical wellbeing and safety should be considered alongside the happiness and emotional wellbeing of the adult at risk;
- efforts should be made to assist the adult understand and express their desired outcomes, past experiences and what is important to them currently. This needs to be viewed within the context of the adult’s capacity to make decisions about their safety;
- it is important to really get to know the adult to ensure that any outcomes genuinely consider the concerns from the point of view of the adult at risk;
- the insights of those who know the adult at risk and may well have known them before they lost mental capacity are important.
(adapted from Szerletics, 2016)
For further information see:
Szerletics A (2016) Best interests decision-making under the Mental Capacity Act (Accessed 21/7/2019)