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Inspection report

Date of Inspection: 4 July 2013
Date of Publication: 30 July 2013
Inspection Report published 30 July 2013 PDF | 82.19 KB

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 4 July 2013, observed how people were being cared for and talked with carers and / or family members. We 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. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

Reasons for our judgement

During our inspection, we found that staff ensured that people and their families were involved in decisions about their care where possible and that staff gained consent before carrying out care and treatment. For example, we observed that staff asked people where they would like to sit, whether they would like a hand massage and checked with them before administering medicines. Relatives we spoke with told us that staff informed them about appointments, such as GP and hospital visits, so that they could attend and support their relative with decisions about their care and treatment.

Most of the people who used the service were unable to communicate verbally or had very limited ability to do so. However, we saw that staff understood what people wanted by individual behaviour and gestures that people displayed. We saw that these methods of communication were reflected in people's care plans. This ensured that people who used the service were enabled to participate in making decisions about their care and treatment.

Records we viewed showed that people's capacity had been assessed to ensure best interest decisions were made to ensure people received appropriate care and treatment. We saw that the capacity assessments had been recently reviewed as part of the person's care plan review to ensure they reflected people's current capacity and needs. Staff we spoke with were aware of the Mental Capacity Act (2005) and of their role in ensuring that people's human rights were respected.

We noted that where advanced care plans were in place, these had been discussed and agreed with people's relatives so that decisions about people's care were made in people's best interests. We saw that consent forms were in place so that people, or their relatives where appropriate, were asked for consent to use photos and video of the person who used the service, such as on the provider's website or to capture memories for people. This showed that there were systems in place to ensure that people’s wishes were respected, and their consent gained or best interests considered, when carrying out their care and treatment.