You are here

Archived: Donness Nursing Home Inadequate

All reports

Inspection report

Date of Inspection: 19 September 2013
Date of Publication: 15 October 2013
Inspection Report published 15 October 2013 PDF

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

Not met 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 19 September 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

The provider did not have suitable arrangements in place for obtaining and acting in accordance with the consent of people who use the service.

Reasons for our judgement

Our inspection of 15 April 2013 found that the provider did not have consistent arrangements in place to assess people's capacity to give consent, or to obtain and record their consent. The provider wrote to us and told us how the home's arrangements for obtaining consent would be improved.

People told us that they were not obliged to do anything they did not wish to do but that they were happy to take staff advice. They also felt their views were listened to.

We confirmed through looking at records and talking to staff that staff had received training in the Mental Capacity Act 2005 and deprivation of liberty safeguards. We found that the home always took people's opinion into account and had given their right to consent to treatment much thought.

We looked at four people's care records and saw the newly devised documentation was in place. People signed consent to give consent to aspects of their care, such as medication administration and tests and treatment they might need. However, records showed that the home did not always follow up the information they received by putting the person at the centre of their care. For example, one person's capacity assessment stated that they had the capacity to consent to their care plan. However, we found that staff had only consulted the person's family and not the person themselves about their care arrangements. Although, having spoken to the person we believe they would be likely to delegate that task to their family, there was no record of this.

We also found that the home had no records that people recently admitted to the home had consented to that admission. The registered manager told us how she always visited people who might move into the home and asked them if they wanted to be admitted but their response/consent was not documented.

We found that, should it be decided that a person did not have capacity to make decisions about their welfare there was no documentation as to how that decision had been arrived at. The home may have followed the five statutory principles - the values that underpin the legal requirements of the Mental Capacity Act 2005 – but there was no documentation to show that they had. However, senior staff were able to describe the importance of using practical steps to help a person understand any decisions that were needed, such as considering the best time of the day for the discussion when the person was likely to feel well enough to be involved.

We found that there was some conflicting documentation. Records produced by the home reflected what we were told the person wanted, such as resuscitation in the event of collapse, but some records signed by medical practitioners were different and/or incomplete. This had the potential to put the person using the service at risk of care which had not been consented to. The registered manager explained how this was a recognised problem which the home was trying to address with GPs.