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Easthill Home for Deaf People Good

Our most recent reports on this service are available as British sign language videos. You can watch the video of our December 2015 report here. British sign language videos of our July 2015 report and our November 2014 report are also available.
All reports

Inspection report

Date of Inspection: 9, 17 September 2014
Date of Publication: 1 November 2014
Inspection Report published 01 November 2014 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 9 September 2014 and 17 September 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 and talked with staff.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

We used British Sign Language (BSL) interpreter to help us communicate with people and staff.

Our judgement

Before people received any care or treatment they were supported to give informed consent. However, mental capacity assessments were not carried out according to the relevant code of practice and the reasons for decisions being made on behalf of people were not recorded.

Reasons for our judgement

At our previous inspection, in January 2014 we identified that mental capacity assessments were not carried out according to the relevant code of practice. Staff could not support people properly to give informed consent because their competence in the use of British Sign Language (BSL) was limited. We set a compliance action and the provider wrote to us telling us they would take action to meet the regulation by 30 April 2014. They then wrote to us again, telling us there had been delays and the regulation would be met by “the beginning of June”. At this inspection we found improvements had been made, but the regulation was not being met.

The service had recruited more deaf staff to help people communicate their wishes and their consent better in relation to their care and support. People told us this was a positive step and they were now able to discuss their care needs and preferences better. One person said staff used BSL “to talk to me about help and care” and another person told us staff had helped them understand what their medicines were for.

We spoke with three members of staff who were aware of the need to provide care with the person’s consent and described how they obtained it. They said most people using the service were now able to communicate their consent and were involved in agreeing their care plans. For one person, we saw pictures had been used to help the person express their wishes. Staff had appropriate strategies in place if people refused previously agreed care. For example, they said they would leave and come back later or ask a colleague to try. Care records showed people had declined care, support or medication on some days and their wishes had been communicated and respected. The manager told us this showed people were “developing a sense of self” and felt more able to make and express their decisions.

The manager had received training in the Mental Capacity Act, 2005 (MCA) and understood its principles. Staff training in MCA had not been completed but was planned for the week of our inspection. We viewed a record of a decision that had been taken in the best interests of a person regarding the use of bed rails to keep them safe. The record was comprehensive and showed the decision had been taken in accordance with the MCA and the code of practice.

However, people’s ability to make other decisions, including whether they could manage their own medicines and have access to the keypad code to open the front door had not been assessed. Although some people managed their own medicines and had been given the keypad code, others had not. Best interest decisions had not been recorded to show how these decisions had been made, who had made them or why they had been made. Therefore, the provider was unable to demonstrate that the principles and guidelines of the MCA and its code of practice had been followed.

Deprivation of Liberty Safeguards (DoLS) was not understood well by staff and one person was not permitted to leave the home as staff felt they would not have been safe. We saw the manager was in the process of making an application for DoLS to be authorised for this person. This would ensure they were not controlled or restrained unlawfully.