Reasons for decision making management practice

For this assessment criteria, you will be required to explain the reasons, purpose and benefits of why managers make decisions about strategy, policies and procedures in adult care practice that may or may not involve others, make decisions for those in receipt of care and support and why they might struggle with making management decisions.

Decisions about strategy, policies and procedures

Your organisation’s business strategy is comprised of the plans and roadmaps it follows and the goals it works towards. Policies and procedures are rules and guidelines that dictate how organisational operations are conducted. They are used to ensure that everybody works within the legal framework and follows best practices and will embed company values.

As a manager, you will need to make decisions about strategy, policies and procedures. For example, the COVID-19 pandemic meant that managers had to change policies and procedures to incorporate new legislation relating to social distancing, self-isolation and Personal Protective Equipment (PPE). If a particular service is a strain on resources and provides very little value, you may need to make the strategic decision to discontinue the provision and redirect the funds to higher-priority services.

These decisions may be made independently or collaboratively. Using the examples above, decisions relating to a change in legislation would be made independently because they are time-sensitive and mandatory. However, before making a decision to close a service, you may collaborate with the team members that work there and the clients that use it to look at ways costs could be cut or service provision could be improved.

When decisions are made independently, it is essential that you are able to communicate the changes to others effectively. This will involve being transparent about the decision-making process and being able to justify why the decision was made as well as being able to answer any questions you are asked.

Making decisions for those in receipt of care and support

There may be occasions where care managers must make decisions on behalf of those in receipt of care and support because they lack the mental capacity to make decisions for themselves.

The Mental Capacity Act 2005 says that individuals receiving care must be empowered and supported to make their own choices as much as possible. All care managers should be familiar with this legislation (read the Mental Capacity Act Code of Practice for guidance).

When there are doubts about an individual’s capacity to make a decision, a mental capacity assessment must be performed. As stated in the Code of Practice states: “It is also important that the person who does an assessment can justify their conclusions“.

The Care Quality Commission’s (CQC) guidance on the Mental Capacity Act 2005 states that:

Health and social care practitioners…must be involved when an assessment and/or decision has particularly significant consequences. These include when:

• There are disagreements with the person, their family or others about their capacity to make a decision
• The person’s capacity may be challenged by someone.
• The decision is about life-sustaining or other particularly significant medical treatment.
• Where a decision not to resuscitate someone is being considered.
• Reporting abuse or crime.
• Other people may be at risk.
• Considering whether the person should move to new accommodation or receive care, treatment or support at home.
• The decision has legal complications or consequences, such as liability.
• There are significant financial or property issues.

Any decisions made on behalf of an individual receiving care and support must be made in their best interests and be the least restrictive. Therefore, managers must be able to explain the steps that they took to reach their decision in order to justify it. A written record of the decision-making process must also be made.

Why managers may struggle with making management decisions

Managers may sometimes struggle with making management decisions when the choices are difficult, such as when there are no good options or if there are moral and ethical dilemmas. Some decisions may have a significant impact on the lives of others, which can put pressure on a manager to ensure that they make the right choice.

In these cases, it is important that managers are able to seek support from others – for example, family members of an individual receiving care and support or other healthcare professionals.

Management decisions should be made methodically and a written record maintained so that the decision-making process can be explained and justified at a later date if needed.