Supporting Individuals in Making Decisions: A Guide for Social Care Workers

Supporting people to make their own choices is at the heart of good social care. It’s not about doing things for someone, but doing things with them – helping them feel informed, confident, and in control of their own life.

Research from Praxis Care, Mencap NI and Queen’s University Belfast highlights how people with mental ill health or intellectual disabilities experience decision-making support, and how social care workers can make that process more empowering and humane.

What People Say They Need

The research found that most people value having the time, space, and encouragement to make their own decisions, even when those decisions are small.

However, they also described moments where this support was missing or rushed.

Key themes include:

• Time and patience: People often need longer to weigh up choices, ask questions, or revisit options.
• Clear information: Jargon and complex explanations can create confusion or dependence. Simple, honest communication helps people feel included.
• Respect for autonomy: Feeling pressured – even by well-intentioned supporters – can make people feel powerless. Respecting their pace and choices is essential.

Creating Conditions for Good Decisions

Good decision-making doesn’t just happen during formal assessments; it happens in everyday interactions – choosing what to eat, how to spend the day, or who to spend time with. Social care workers play a crucial role in making these moments empowering rather than directive.

Building trust is the foundation. Consistent, empathetic relationships create a space where people feel safe to express preferences and try new things. Encouraging small, everyday choices –  like what to wear or how to arrange a personal space – builds the confidence to make more complex decisions later.

Practical support also matters. This might include helping someone organise appointments, manage finances, or remember information. Such small steps can have a big impact on autonomy.

Balancing Support and Independence

One of the biggest challenges in social care is finding the right balance between offering support and promoting independence. Too little support can leave people feeling lost; too much can undermine their confidence and sense of control.

The right level of support will always vary – it depends on the person, the situation, and the type of decision being made. Effective social care workers develop the sensitivity to know when to step in and when to step back – a judgement shaped by trust, experience, and an understanding of each individual’s circumstances.

Learning and Collaboration

Organisations play a crucial role in creating environments where supported decision-making can thrive.

Recommendations from the research include:

• Continuous training on supported decision-making, communication strategies, and legal frameworks.
• Supervision and reflection to help staff navigate complex decisions with confidence.
• Peer and family collaboration, where appropriate, to create networks of consistent support.
• Embedding co-production, ensuring those supported shape how decision-making support is offered in practice.

The Bottom Line

Good decision-making support can turn uncertainty into empowerment – one thoughtful conversation at a time.

References:

• Webb, P., Davidson, G., Edge, R., et al. (2020). “Service Users’ Experiences and Views of Support for Decision-Making.” Health & Social Care in the Community, 28, 1282–1291. https://doi.org/10.1111/hsc.12961.
• Davidson, G. et al (2010) Supporting decision-making–experiences, approaches and preferences. Belfast: Praxis Care, Mencap and Queen’s University Belfast.