Involving people in decisions

Getting informed consent

People who live in care homes have the same right to be involved in decisions about their care and treatment as anyone else. Sometimes people need help with this. People working in health and social care (health and social care practitioners) should make sure that people who live in care homes can get the support they need to help them take a full part in decisions about their treatment and care. This includes considering any mental health problems, any health problems (such as sight or hearing problems), any difficulties reading or speaking English, or any cultural differences that might mean extra help is needed. These should be recorded and should be checked regularly.

Health professionals who prescribe medicines (for example, pharmacists, doctors and nurses) should assume that people who live in care homes can make decisions about their own medicines. However, if they are concerned that a person may not be able to make these decisions, they should check whether the person understands why a new medicine is needed before offering it. This is known as assessing capacity to give informed consent. The Mental Capacity Act (2005) explains how an adult's capacity to give informed consent should be checked. Once the health professional has carried out the assessment of capacity, they should record the results in the person's care record.

When a person refuses to take a medicine

Sometimes a person refuses to take a medicine. If this happens, staff in the care home should record what has happened and why (if the person will give a reason) in the person's care record and in the record of their medicines. If the person agrees, staff should also tell the health professional who prescribed the medicine.

Making decisions for people who are not able to make decisions themselves

If someone is not able to make decisions about medicines by themselves, a decision may be made for them if it is in their best interests. However, health and social care practitioners should still make sure that people who live in care homes are involved as much as possible by:

  • finding out how they feel about taking their medicines and what they understand about them

  • including them in meetings at which decisions are made about their medicines whenever possible

  • talking to people who know them well, including family members or carers and friends, as well as staff in the care home

  • providing care and treatment in a way that helps them to have as much control and choice as possible.