Occupational Therapy and the Best Interest Assessor role – What and Why ??

Best Interest Assessors Working under the Mental Capacity Act Assess those who lack capacity and are ”deprived of their liberty” Deprivation ”imputed to the state” (e.g Care Home , ICU, supported living, psychiatric unit) Determine what is in the person’s best interests

What do Best Interest Assessors do ? Check the person meets “acid test” ? (2014, Supreme Court) Assess whether situation is in the person’s best interests Consult widely Compile independent report Authorise (or refuse) : set conditions Appoint Relevant Person’s Representative

Different ways of thinking …

Occupational Therapist perspective … very valuable No excuses !!!

Assessment format E5 - This is necessary in order to prevent harm to the person E6 - This is a proportionate response given the likelihood that the person will otherwise suffer harm and the seriousness of that harm E7 - This is in the person’s best interests. Note: you should consider section 4 of the Mental Capacity Act 2005, the additional factors referred to in paragraph 4.61 of the Deprivation of Liberty Safeguards Code of Practice and all other relevant circumstances. Remember that the purpose of the person’s deprivation of liberty must be to give them care or treatment. You must consider whether any care or treatment can be provided effectively in a way that is less restrictive of their rights and freedom of action. You should provide evidence of the options considered. In line with best practice this should consider not just health related matters but also emotional, social and psychological wellbeing.

Harry – 27 years old Strong family ties – especially with Grandpa Severe dystonia Some learning disability but very articulate at times Many placements broken down due to very challenging behaviour Minimal attention span Has been violent towards staff and other residents / patients Wide range of interests and potential occupations

Holistic approach ... CANADIAN MODEL OF OCCUPATIONAL PERFOMANCE

CMOP AREAS Reducing restrictions … some examples Spirituality What was core to Harry ? Affective Mood when with others , causes of dis-affect (minimise) Cognitive Areas where he could communicate well (football) Physical Dystonia , impact on restrictions Self –care Maximising independence to minimise restrictions Productivity Visiting shops , family events , participating in home life Leisure Going to football , time with Grandpa Own flat , restrictions on independence Institutional How care home managed restrictions . Legal framework Cultural Interaction with other residents , support for his sport Social Managed events with other residents in main house

Part of an MDT team ….

Very interesting legal cases and learning ….

Personal development …