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Inspection report

Date of Inspection: 18 October 2013
Date of Publication: 3 December 2013
Inspection Report published 03 December 2013 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 18 October 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 staff and reviewed information given to us by the provider.

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

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We observed staff sought people's consent before carrying out any care or support. Although people using the service were unable to communicate verbally; we saw that staff were attentive and gave people time to try and express their needs. Staff responded patiently so that they could interpret what the person was communicating. People also had a communication passport, supplemented by photographs that gave detailed information about how people expressed themselves. The passports helped staff to interpret each person's body language and sounds.

Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. Records confirmed that assessments of people's capacity to make decisions and consent to their care and support had been carried out. As people could not make decisions for themselves, family members or representatives had been involved. We saw that there were systems in place to review these assessments when appropriate and necessary.

We looked at two people's records where this process had been used. We saw that a separate assessment had been completed for each decision. These assessments looked at the person's ability to make the decision, the benefits and risks of the proposed treatment, how quickly a decision was needed and who else needed to be involved in the decision making process. Decisions had only been made on a person’s behalf within a multiagency framework that also involved family members. This showed that the service involved the appropriate parties to make sure people's best interests were served.

The Deprivation of Liberty Safeguards were only used when it was considered to be in the person’s best interest. The manager told us they had not needed to make any applications to restrict anyone's liberty but systems were in place to do so if needed. Staff we spoke with knew who to involve if people could not make decisions for themselves. Staff had undertaken training on understanding the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. The manager told us that there were plans for all staff to complete further training in this area within the next six months through a local authority run course.