Positive Risk-Taking and Capacity: Supporting Decision-Making in Learning Disability Services
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Positive risk-taking in learning disability services cannot be separated from decision-making and capacity. Providers are expected to enable people to make choices about their lives, while ensuring those choices are informed, lawful and proportionate. Where capacity is unclear or fluctuating, risk enablement becomes more complex and requires structured, well-evidenced approaches.
This area of practice connects closely with person-centred planning in learning disability services and is frequently scrutinised through quality and governance frameworks. Commissioners and regulators expect providers to demonstrate how risk decisions align with the Mental Capacity Act and best interest principles.
The relationship between capacity and positive risk
Positive risk-taking assumes that individuals are supported to make their own decisions wherever possible. Capacity should always be decision-specific and time-specific. A person may have capacity to make some choices while needing support or best interest decision-making for others.
Risk enablement begins by asking whether the person understands the nature of the decision, the potential consequences and the available options.
Avoiding overuse of best interest decisions
One of the most common pitfalls in learning disability services is defaulting too quickly to best interest decisions where risk is present. This can unintentionally remove autonomy and undermine independence.
Good practice involves exhausting all practicable steps to support capacity, including accessible information, time to process decisions and involvement of trusted supporters.
Documenting supported decision-making
Where individuals require support to make decisions, providers should clearly evidence:
- how information was presented in accessible formats
- what support was offered to aid understanding
- how the person’s preferences were expressed
This documentation demonstrates that risk enablement was actively pursued rather than bypassed.
Best interest decisions and proportionate risk
When a person lacks capacity for a specific decision, best interest processes must still consider positive risk-taking. This includes weighing:
- the potential benefits of the activity
- the level of risk involved
- the person’s known wishes and values
Risk-averse best interest decisions that prioritise organisational safety over quality of life are increasingly challenged by commissioners.
Governance and oversight of capacity-related risk
Providers should ensure that complex risk and capacity decisions are supported by governance structures such as:
- multidisciplinary reviews
- management sign-off for high-risk decisions
- regular audits of capacity assessments
This ensures consistency and defensibility across services.
What regulators expect to see
CQC inspectors and commissioners look for evidence that capacity and risk are considered together, rather than in isolation. Services that demonstrate thoughtful, person-led decision-making are more likely to be viewed as enabling, ethical and well-governed.
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