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Inspection report

Date of Inspection: 27 June 2014
Date of Publication: 10 July 2014
Inspection Report published 10 July 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 27 June 2014, 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 staff, reviewed information sent to us by commissioners of services and reviewed information sent to us by other authorities. We talked with commissioners of services and talked with other authorities.

Our judgement

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

Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

Reasons for our judgement

We measured this outcome by talking to people who lived in the home. We also spoke to the provider and her staff team. We observed people being cared for and supported and we read all six individual files.

People told us that the staff in the home always asked them their opinion and gave them plenty of options and choices. They told us that consent was always gained before any intervention. For example one person told us:

"I am asked on a daily basis about what I want to do and if I want to go out. Nothing is done without me consenting. I get asked about all the small things but I've also had a chat with the provider about my end of life wishes."

We read all six care files and we saw that care plans had been written, where possible, with the person involved. One of the plans had hand written amendments done by the person whose plan it was. We noted that some people needed help with consenting to care and treatment.

We looked in one particular file and we saw that the provider had made sure that this person's relative had the right to assist with making informed consent. We saw that the provider had checked that this relative had lasting power of attorney. This meant that they could make decisions on behalf of the person in relation to their care and welfare. We saw that this was actually done with the relative, the provider and the person themselves. We saw plenty of written evidence to show that people were consulted even when they had some impairment due to dementia.

We observed the staff team consulting and negotiating with people. Any intervention was done with politeness and sensitivity. People were encouraged and supported appropriately. For example we saw one person being reassured and persuaded to have a visit from the doctor. This person was able to say that they would accept treatment but was very clear that they only visited hospital it was absolutely necessary. This was written into the person's care plan.

We judged that all these examples showed that people were only given care and support when they consented. It also showed that where people had problems consenting the staff team worked with them appropriately.

We asked the provider if anyone was under any restrictions of the law. She said that no one was in the home under any of these kind of restrictions. We discussed legal restrictions and we judged that the provider understood her responsibilities under the Mental Health Act and the Mental Capacity Act.

We looked at the dependency levels of people in the home and we looked at access to and from the building. Some people in the home were living with some form of dementia. We noted that through careful care planning and attention to providing support and outings these people were not deprived of their liberty. The provider had looked at the legal aspect of deprivation of liberty and had made a judgement along with other people involved in the care that no one in the home was deprived of their liberty.