BIAs, who are mostly social workers, will be expected to meet six capabilities when fulfilling their role under the Deprivation of Liberty Safeguards (Dols). The capabilities will not be enforced through regulations or legislation but are a set of good practice standards that councils who appoint BIAs will be expected to ensure that they meet.
BIAs’ role is to decide whether care home residents or hospital patients who lack the capacity to consent to their care are being deprived of their liberty and whether, if so, this is in their best interests or not, necessary to prevent harm to them and proportionate to the risk or likelihood of that harm. Their recommendations are not binding and it is up to the relevant local authority or primary care trust to decide whether to adopt them, in their role as the supervisory body in Dols cases.
By law, BIAs must be social workers, nurses, occupational therapists or psychologists with two years’ post-qualifying experience, who have completed an approved BIA course, had refresher training in the previous 12 months, have knowledge of the Mental Capacity Act 2005 and its code of practice, and possess sufficient record-keeping, report-writing skills and analysis skills.
The College capabilities framework is designed to build on the requirements of the regulations. The six capabilities are:
- The ability to apply in practice, and maintain knowledge of, relevant legal and policy frameworks;
- The ability to work in a manner congruent with the presumption of capacity;
- The ability to take all practical steps to help someone make a decision;
- The ability to balance a person’s right to autonomy and self-determination with their right to safety, and respond proportionately;
- The ability to make informed, independent best-interest decisions with the context of a Dols assessment;
- The ability to effectively assess risk in complex situations, and use analysis to make proportionate decisions.
Specific standards expected include the ability to competently assess capacity in complex cases (capability 2), make appropriate safeguarding referrals (capability 4) and challenge risk averse practice (capability 6).
“BIAs have such an important role to play in making sure individuals rights and best interests are observed,” said Daisy Bogg, the College’s membership services development officer. “These capabilities not only ensure that we have a consistent set of practice standards but also provide a development framework for continuing to reflect upon and improve practice.”