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Inspection report

Date of Inspection: 27 April 2011
Date of Publication: 28 June 2011
Inspection Report published 28 June 2011 PDF

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People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run (outcome 1)

Meeting this standard

We checked that people who use this service

  • Understand the care, treatment and support choices available to them.
  • Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support.
  • Have their privacy, dignity and independence respected.
  • Have their views and experiences taken into account in the way the service is provided and delivered.

How this check was done

Our judgement

Although people had experienced basic opportunities to understand the care, treatment and support choices available to them and had made decisions about their care on a daily and practical basis, they had not had good opportunities to understand the choices in respect of having their views and experiences taken into account in the way the service was provided. People had experienced a level of privacy, dignity and independence that could have been better.

User experience

During the site visit to the home we interviewed three people that lived there and spoke to two others. People said they had felt well respected and had been treated well by the staff. They said they had made decisions about their daily lives, rising, dressing, where to sit and so on but really there had been very little going on to make decisions about.

One person said she had often been very frustrated about not being in charge of her life because of being in care. Another said she had wished her circumstances had been different and that she had been able to continue to live at home. She said she thought everyone else agreed with this too.

Other evidence

In April the provider submitted a PCA document to the CQC which described how the home was compliant with the outcome and all of the elements that formed the outcome. The PCA was in the provider's own format and it stated that the home had not been completely compliant with the outcome as there had been minor concerns identified with staff training in the Mental Capacity Act (MCA) and Deprivation of Liberty (DoL) legislation.

We spoke to the unregistered manager and the acting manager and to the staff to determine whether or not staff had been competent or had understood the requirements of MCA and DoL legislation. We found that staff had not been trained in and did not understand the implications of MCA and DoL orders.

We found in discussion with staff that they had been aware of peoples' rights and told us they had cared for them in a way that respected their rights and individuality on a daily basis and according to circumstances, but we found that in practice staff made no connection to this from legislation information. Nor did staff action fully reflect what they said when it came to their practice.

An example observed during our visit to the home was when the staff gave out a hot drink mid-morning. People were asked if they wanted tea or coffee and their choice was respected, but they were also asked if they wanted some cake. Those that said yes were handed an individual piece on a paper napkin. They were not offered a plate of cake from which they could take a piece and were only told what sort of cake it was, ginger, as they were given it. This action did not respect that people in the home were adults and had the ability to choose from a plate and to choose whether or not they wanted ginger cake in the first place.

Another example observed was when one person had been introduced to us and was trying to explain her comments about something she did not like in the home. She had been interrupted and spoken over by the provider who had wanted to explain for her.