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Archived: The Chestnuts Nursing and Dementia Care Home

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All reports

Inspection report

Date of Inspection: 18 July 2011
Date of Publication: 29 September 2011
Inspection Report published 29 September 2011 PDF

Before people are given any examination, care, treatment or support, they should be asked if they agree to it (outcome 2)

Meeting this standard

We checked that people who use this service

  • Where they are able, give valid consent to the examination, care, treatment and support they receive.
  • Understand and know how to change any decisions about examination, care, treatment and support that has been previously agreed.
  • Can be confident that their human rights are respected and taken into account.

How this check was done

Our judgement

Systems were in place for people to give consent to their care and treatment. They were not always fully used to ensure that peoples’ best interests were promoted and maintained at all times.

User experience

People told us that they take part in their care and would do so directly or with the support of their relatives. We saw that some people were unable to make decisions and their relatives acted as advocates on their behalf with regard to consenting to their care and treatment. However, there was one case in which there was no evidence that a critical decision made by a person’s relative, followed appropriate ‘Mental Capacity Act’ or ‘deprivation of liberty’ safeguards. In this respect there was no evidence that a best interest meeting had taken place. As such, the provider could not demonstrate that the outcomes for the person concerned were in their best interests. The fact that the person was refusing key aspects of previously agreed care meant that they ended up without it. Alternative methods of providing the relevant care and support to the person were not fully explored.

Other evidence

There were systems in place to ensure that people gave consent to their care and treatment. We saw that for people sharing rooms, consent was sought on every occasion. We noted that the manager and staff did have training in the Mental Capacity Act and Deprivation of Liberty Safeguards. We spoke to staff who understood the importance of promoting and protecting peoples’ rights.