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Two Cedars Residential Care Home Good

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Inspection report

Date of Inspection: 13 December 2013
Date of Publication: 9 January 2014
Inspection Report published 09 January 2014 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 13 December 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.

Reasons for our judgement

During our visit we saw a member of staff administering medication to people living in the home. The member of staff knocked on people's doors before entering their rooms and asked them if they minded us being there. They chatted with people as they prepared the medication. They explained what they were doing with comments such as "I've just come to give you your eye drops". We saw people giving implied consent such as leaning their heads back to receive the eye drops.

During the medication round we saw one person tell the member of staff that they didn't want to have a shower that day as they were too tired. The member of staff explained that they would let the relevant staff know. This meant that people had the opportunity to change their plan of care if they wished.

The manager explained that one person's mental and physical health was gradually deteriorating and they were being monitored by the GP. We were told that a Deprivation of Liberty Safeguard (DoLS) was being considered for this person but was not in place at the time of our visit. The manager explained that the family and staff wanted them to stay at the home for as long as possible as the home and staff were familiar to them.

We looked at the care plans of this person and saw that they had signed their original plan of care but that updates were signed by their next of kin as their mental health had deteriorated. Their records included details of ongoing sight problems. We saw that a planned operation had been cancelled as the person was too distressed at the time to have the operation. This person had a Do Not Resuscitate (DNR) form in place.

We looked at four further care plans and saw that they had been signed by people to agree the plan of care and treatment. Two people had consented to the use of bed rails at night as they were at high risk from falls, and one relative had consented on their mother's behalf as their Next Of Kin (NOK). We saw that one had a DNR form in place.

We spoke with four people about their consent to care and treatment. One person told us everything was explained by staff and one said treatment was never forced on them. One person told us "I'm looked after very well".

We spoke with one relative who told us they were involved and kept informed about their mother's treatment but that they would rather leave it to the health professionals. We spoke with two members of staff who gave satisfactory answers when we asked about people's consent to care and treatment. One member of staff was able to give a detailed explanation of DoLS and the Mental Capacity Act (MCA).