Professionals in health and social care make countless important decisions every day.
It is essential that practitioners develop the skills and confidence to ensure the decisions they make are grounded in the principles of wellbeing, equity and rights.
Adult social care is a demanding profession. As the sector faces significant challenges, an increasingly high expectation is placed on professional judgement.
A suite of updated Research in Practice resources aims to support practitioners to improve their judgements and decision-making skills. In an accompanying podcast, a panel of experts and individuals with lived experience explore this topic further and consider how effective decision-making can be supported in practice.
Decision-making, wellbeing and equity
Local authorities in England have responsibilities in relation to decision-making that are set out in legal framework.
The Care Act 2014 places an emphasis on promoting the wellbeing of adults and carers, highlighting the importance of ‘beginning with the assumption that the individual is best-placed to judge the individual's well-being’.
It is the duty of local authorities to make sure that:
- Individuals participate as fully as possible in decisions about their care and support.
- Decisions regard all the circumstances of the individual (and are not solely based on age, appearance or any other condition or behaviour).
- The views, wishes, feelings and beliefs of the individual are regarded.
Additionally, the Equality Act 2010 outlines the duty of local authorities to provide appropriate provision to ‘advance equality of opportunity’ to people with protected characteristics.
To promote equity in decision-making, it is important to consider our own biases, and the biases of others, and how these may affect judgement. Critical reflection can help us to think about our own personal and professional values, and how these might influence decisions.
Embedding an intersectional approach can help professionals to understand how different aspects of a person’s identity intersect, and how previous experiences of inequity or discrimination have impacted them. By addressing the complex needs of individuals with intersecting identities, this approach can lead to better, more equitable outcomes.
What is defensible-decision making?
Defensible decision-making (sometimes referred to as justifiable decision-making) refers to a process of gathering, analysing and evaluating information to take the most appropriate course of action. This is a decision that should meet reasonable expectations, and can be explained and make sense to the people who will be affected.
There are six key principles to defensible decision-making. These are:
- All reasonable steps are taken.
- Reliable assessment methods are used.
- Information is thoroughly evaluated.
- Decisions are recorded and carried through.
- Processes and procedures are followed.
- Practitioners and managers are investigative and proactive.
This approach doesn’t mean the decision will always yield perfect results. It also doesn’t mean ‘defensive’ – a decision that primarily covers our own professional backs. Instead, the aim is to make the best decision in the given circumstances. Particularly, the focus is on ensuring that the decision is able to withstand the scrutiny of hindsight bias, informed by balanced and proportionate risk considerations.
There is no ‘one-size-fits-all’ solution to decision-making. Instead, it’s important that professionals always consider the perspectives and preferences of individuals in decision-making processes.
Commission learning for your organisation on analytical and defensible decision-making in adult social care
We consider the above themes and more in a new workshop for organisations on making and evidencing defensible decisions. The workshop will consider the balance of intuitive and analytical approaches, sharing tools to support and record defensible decision-making.
As a result of attending this workshop participants will be able to:
- Explain what defensible decision-making is and why it is important in adult social care.
- Link defensible decision-making with the principle ‘nothing about us, without us’, and person-centred practice.
- Be alert to different forms of bias and how they can manifest in decision-making.
- Feel confident in using De Bono’s hats and can appreciate the role of perspective in decision-making.
- Understand the importance of reflection and reflective supervision in making and evidencing defensible decisions.
- Outline the importance of the written record and how it should evidence defensible decision-making.
Research in Practice Partners can use their membership allocation to book this workshop. Link Officers can use the booking request form to book this workshop.
For further information or if you are interested in commissioning an online workshop, please contact our learning team.
Find out more information about this workshop and other Research in Practice workshops.
Good decision-making in adult social care
Explore an updated resource that aims to support practitioners working with adults and carers who draw on care and support. It covers key topics in decision-making, along with examples, exercises and summaries.
Good decision-making - New resources to support adult social care
What does good decision-making look like? Explore a new Research in Practice resource to improve judgments and decisions when supporting adults and carers.
Good decision-making - Practical guidance for practice dilemmas
The decisions that people who work in adult social care make every day directly affect people’s lives. However, decision-making is complex, nuanced, and often presents dilemmas. Gerry Nosowska introduces new resources to support good decision-making in adult social care.
Good decision-making in adult social care
This resource aims to support practitioners working with adults and carers who draw on care and support, to improve their judgements and decision-making so that experiences and outcomes are better for people who draw on social care.
Good decision-making in adult social care
This podcast explores good decision-making in adult social care and highlights the key themes. It also introduces the recently updated good decision-making resource, providing practitioners with guidance on navigating the new resource and advice on implementing it effectively.
Making and evidencing defensible decisions
Explore the characteristics of analytical and defensible decision-making in adult social care.