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Inspection report

Date of Inspection: 2 October 2013
Date of Publication: 29 October 2013
Inspection Report published 29 October 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 2 October 2013, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members and 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

We looked at the care plans of four people who used the service.

We spoke with people whom were able to make their own decisions and asked them whether they were involved in decisions relating to their care. One person who used the service told us, "Staff mostly ask me what I want to do and give me choices of things,” Another person told us, “Sometimes staff will ask me what I want to do, but occasionally they don’t. The care is very good here, anything you want they will always try to help you.”

We asked relatives of people who lacked the ability to make their own decisions whether they, as their representative, were involved in decisions relating to their family member’s care. We also asked them if they thought their family member was safe and well cared for. A relative we spoke with told us, "I am kept fully involved. Anytime they are ill or a decision needs to be made I am consulted. When I leave here after my visit I am happy that they are safe, one hundred per cent.” Another relative told us, “I have been fully involved, I cannot fault the home. They have dealt with our family member’s issues with sensitivity.”

We spoke with staff and asked them how they ensured that they were aware of who could make their own decisions and who could not and how they used that knowledge to provide effective care for people. "I have completed dementia awareness training, it has helped me gain a greater understanding about the condition. I know it is important to give people choices and ensure that I read care plans to keep up to date.” Another staff member told us, “I am doing dementia awareness training as part of my NVQ Level 3 in Adult Social Care. I am aware that I can’t just presume people aren’t able to make a decision, people have a right to make a choice.”

We observed staff throughout the day assisting people with day to day tasks, getting involved with activities and stopping to talk to people to ask them how they were. Their approach was caring and attentive and the people they were interacting with appeared happy.

We saw an exercise activity take place in the afternoon where the majority of people joined in. However, others were given the choice to do something else like relax in the lounge and watch television. This meant people were given options and not forced to do anything that they did not want to do.

Before people received any care, people who used the service or their relatives, if required, were asked for their consent and the provider acted in accordance with their wishes. The registered manager told us that they personally liked to speak with people who used the service and their relatives to discuss any problems or concerns that they may have relating to any aspect of their care. The registered manager told us they were confident that decisions were not being made for people without their consent. All of the people we spoke with and their relatives agreed that they were fully involved and consulted. However the provider may wish to note that details of these discussions were not always recorded in the care plans we looked at.

Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. In all of the care plans we looked at the provider had suitable arrangements in place to assess the ability of people to give their consent in relation to the care provided for them. The provider ensured that an assessment of a person's capacity was undertaken as required by the Mental Capacity Act 2005. The Mental Capacity Act 2005 (MCA) is legislation used to protect people who might not be able to make informed decisions on their own about the care they receive.

We saw that the provider had a policy that ensured that people’s right were respected at all times. We also saw evidence that people’s religious or cultural beliefs were respected. In one care plan we looked at a person was a practicing Methodist. The manager told us that a Methodist minister regularly attended