You are here

Saltmarsh House Residential Care Home Requires improvement

All reports

Inspection report

Date of Inspection: 15 November 2013
Date of Publication: 18 December 2013
Inspection Report published 18 December 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 15 November 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 and talked with staff.

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

Throughout the inspection we observed staff talking respectfully to people and gaining their consent to basic care and support. For example, people were asked what activities they wanted to participate in throughout the day and were offered choices of meals and drinks. Staff were seen to ask people if there was anything they wanted, and we saw people's decisions were respected. Staff acknowledged people's ability to make decisions about ordinary day to day activities and to give consent to ongoing care and support.

We spoke with two members of staff who outlined how they gained people's consent when supporting them with day to day activities. Both members of staff were clear that they involved people as much as possible and offered choice. The staff told us that all people at the service were able to communicate verbally and therefore they asked them directly in order to obtain consent. One member of staff said "I ask them first. I follow the care plans and involve the families in decision making if they lack capacity. It is about talking to them and checking that they are happy".

Before people received any care, treatment or support they were asked for their consent and the provider acted in accordance with their wishes. People we spoke with told us staff discussed their care and support with them and looked after them well. One person told us "the staff are lovely here, they sit and talk with me and are happy to spend time with me. They never make me do anything I don't want to do - they are so kind" and another said "I am very happy here - I choose how I spend my day and what I do. The staff are fantastic".

Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. Staff and the manager explained that due to the nature of the service provided, people had capacity to be able to consent freely to care and support. We discussed consent and capacity with the manager, and they were aware of their legal requirements where people did not have the capacity to consent. They understood about statutory processes under relevant legislation, such as the Mental Capacity Act 2005. They knew about the Deprivation of Liberty Safeguards (DoLS), and knew when it would be necessary to instruct an Independent Mental Capacity Advocate (IMCA). The manager had sufficient knowledge of their legal requirements to be able to ensure people who did not have capacity to consent would be appropriately safeguarded.

The service had formal processes to gain and record people's consent to care and support in different situations and circumstances. We reviewed three care plans and each person's records contained 'Assessment of daily living activities' pages. These pages outlined the preferences and choices for how each person liked their day to go including what activities they liked to participate in. These pages also assessed the level of capacity for each person. Within the care plans there were consent forms for the administration of medication and consent to the delivery of personal care which had been signed by people using the service. People at the service were treated as individuals and benefited from the service's in-built approach to gaining their consent to any care and support.