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

2. 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

3. 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

4. Different ways of thinking …

5. Occupational Therapist perspective … very valuable
No excuses !!!

6. 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.

7. 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

8. Holistic approach ...
CANADIAN MODEL OF OCCUPATIONAL PERFOMANCE

9. 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

10. Part of an MDT team ….

11. Very interesting legal cases and learning ….

12. Personal development …