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Archived: The Old Hall Good

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Inspection report

Date of Inspection: 6 January 2014
Date of Publication: 6 February 2014
Inspection Report published 06 February 2014 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 6 January 2014, observed how people were being cared for and sent a questionnaire to people who use the service. We talked with people who use the service, 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

We looked at how staff ensured that people who use the service were giving consent to their care. The five people we spoke with said that staff members would always ask their permission before offering them any form of care, which mainly consisted of making sure they could manage to care for themselves. They said staff never forced anything onto them, including medicines.

All the staff members we spoke with said that they would always ask people’s permission before offering any form of care to them, and would always explain to them what they were doing and why. One staff member said that many of the people who used the service simply needed encouragement, for example to take a bath, to eat breakfast and to take their medicine. They said that they would say things such as: “It’s your bath day today – would you like to take a bath?”

All the staff members we spoke with said that if a person refused care they would never force it upon them. Instead they would offer them more encouragement and explanation about why the care was important. If the person continued to refuse they would refer this to the manager. They said that if a person refused to take their medicine they would respect this choice but if it continued they would liaise with the person’s GP and relatives as well as the manager. One staff member said: “It’s their choice if they refuse to take their medicine.” Another said: “It’s their choice at the end of the day.”

From our conversations with people who use the service and with staff we were satisfied that people were being asked for their consent before any care or treatment was offered to them, and their right to refuse care and treatment was being respected. This meant that people’s dignity, freedom of choice and human rights were being respected.

We looked at what would happen if an important decision had to be made regarding a person’s care and wellbeing but where might be some doubt as to whether they could give their consent.

The people we spoke with said they had made a conscious decision to come into the home and were able to make informed decisions about their day to day care. One of the staff members we spoke with said that 95% of the people who use the service were able to make informed decisions about all aspects of their every day living. They said that if a serious decision had to be regarding the person’s care, for example to move them to another care home because their condition had deteriorated, then the manager would take over and liaise with the person’s GP and relatives.

The manager said that if a serious decision had to be made regarding a person who uses the service, for example if they had to be moved to another establishment, then a best interest meeting would be called involving the person’s GP, their relatives, the person themselves and the manager. We asked if there were any notes to these meetings and the manager said these were not easily accessible because they had been archived after the person had left the home.

From our conversations with people who used the service, staff and the manager we were satisfied that the provider had processes in place to deal with situations where decisions had to be made about a person’s care and wellbeing but where there was doubt about their capacity to give consent to such decisions. This meant that the provider could ensure that they were acting in the best interest of the person.