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To promote the dignity of all individuals they should be fully involved in any decision that affects their care, including personal decisions, such as what to eat, what to wear and what time to go to bed and wider decisions about their care or support.

Choices can only be made if people have information. If they know the options, the risks and possible implications they can make the choice that is right for them. This is ‘informed’ choice. Sometimes decisions are difficult even when an individual has all the information they can. There are a number of ways that you could help the individual to make an informed choice. You can explain information, find people who can share their experiences or ask for the help of specialist workers. It might also support them to involve other people they trust like friends or relatives. An advocate might be an additional option to help someone to make a decision where they need additional help to understand and consider their options and the risks.

Sometimes an individual may not be able to understand and retain the information they need to make a decision or communicate their choice. If this is the case they may lack the mental capacity to make the decision.

The individual may be able to make day-to-day decisions for example what to wear and what they want to eat, but not able to make complex decisions for example about money or medical issues. In situations where you are not entirely sure about the individual’s capacity, please seek additional advice or guidance.

When looking at options, risk assessments are a legal requirement and will give clear guidance on how to keep people safe and prevent danger, harm and accidents. Every
individual should have a risk assessment as part of their care, support, rehabilitation or treatment plan. This will have information on the person’s daily care and support, for example, personal hygiene or mobility, and how best to protect them and others from harm. A risk assessment contains information on possible hazards to do with the care and support provided and steps that need to be taken to control any risks. We will look at risk assessing in other sections.

Everyone’s choices are shaped by things like their background, values, culture, religion or past experiences. Equally, everyone has the right to weigh up and take risks that they believe will make their life enjoyable and worthwhile. As a worker, you can give your view but it is the individual’s right to make a choice and take any risks once they understand all the information available and are fully aware of the risks. Risk enablement involves supporting individuals to identify and assess their own risks and then enabling them to take the risks they choose.

The person-centred approach in health and social care tries to involve the individual in the planning of their care and support as much as possible.

However, there might be times when someone is unhappy with decisions that have been made on their behalf or with the choices they are offered. If this is not within your power to change you should tell them about their right to complain and support them to follow the complaints procedure.