You are absolutely correct - having Guidelines are very important. It would be even better if they were co-produced with the statutory agencies and some carers - who are ususally involved in making best interest decisions. Despite having to admit I, as a carer have not read our local guidelines - therefore not sure we have some - practice seems to work well in this area - well, at least for my daughter it does. Most best interest decisions are made regarding her health or medical care and I think the discussion around why we decide what we decide is thorough. Sometimes I think we are required to record decisions too frequently - particularly around some medical treatment which she has every year - the rationale stays the same. But generally practice around health decisions is good. I would like to see more recording of the major decisions in other parts of her life - those involving non-health options - but that is not yet common practice here. A carer in Hull.