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Heathfield (Horsham) Limited Good

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Inspection report

Date of Inspection: 18 April 2013
Date of Publication: 24 May 2013
Inspection Report published 24 May 2013 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

We looked at the personal care or treatment records of people who use the service, carried out a visit on 18 April 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information given to us by the provider.

Our judgement

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Reasons for our judgement

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We looked at the care files of four people using the service. Records contained no evidence that an assessment of capacity had been undertaken. We discussed this with the manager who told us it was unnecessary as everyone using the service had capacity to make decisions.

One person’s file contained a ‘Do not attempt resuscitation’ (DNAR) order completed by the person’s GP. We saw evidence that the decision had been discussed with the person and their relatives. The manager showed us several other DNAR orders completed by GPs, which also recorded that decisions were discussed with the person involved and their relatives.

We spoke with three members of staff about their understanding of consent. All demonstrated understanding of this. For example, one staff member said, "It’s quite simple; we ask people if it’s ok when we’re offering assistance. If they say no, we respect that, we don’t do it.” During our inspection we observed staff asking people if they wanted assistance and waiting for their response before taking any action. People using the service told us staff asked permission before undertaking any tasks.

We saw training records showing that staff had completed training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). However,the provider might find it useful to note that three staff we spoke with told us they did not understand what the MCA and DoLS meant. Their comments included, “Matron deals with those sorts of things” and “I’m just a carer, I don’t deal with that, it’s left to the seniors”.