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Archived: Orton Manor Nursing Home

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Inspection report

Date of Inspection: 24 June 2013
Date of Publication: 11 July 2013
Inspection Report published 11 July 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 24 June 2013, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff and reviewed information sent to us by commissioners of services.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

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

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Staff told us a lot of people who used the service were able to tell them what they wanted. This included their daily routines such as deciding what they wanted to wear and where they ate their meals. Staff said sometimes people may not be able to verbally express their wishes, but could do so through non-verbal communication.

We saw people who used the service had signed some forms and care plans in their care files, including consent forms for the use of photographs and bed rails.

A visiting family member told us they had discussed their relative’s care, including issues of consent, with staff. The family member said they had been in agreement with the care plans, which gave details of the person’s likes and dislikes. The family member also said the person was able to make choices for themselves.

In the records we looked at we saw evidence that people or their relatives had signed and agreed their care plans. This meant people and their relatives were aware of the information recorded about them and had agreed to the care and support they wanted to be provided.

A person who used the service told us they had been asked if they minded having a care worker of the opposite gender providing them with personal care. The person told us they had said they did not mind. The person also said, “Staff respect my privacy and dignity, they are very sensitive when it comes to that.” Another person told us, “I cannot think of anything they (staff) don’t let me decide for myself. I make the decisions about what care I have.”

We saw that staff consulted people throughout the day. When people were supported with their personal care, the staff explained to them what they were doing and offered reassurance when this was needed. We observed that staff respected people’s choices, about the level of assistance they wanted.

People were supported to promote their independence so far as they were able to do so. We saw that staff encouraged people to eat their own meals and have drinks throughout the day. Where support was required we saw that staff provided this in a dignified way.

We found that people were able to choose where and how they spent their time. One person told us, “I like to spend some time in my room and some time in the lounge. Staff respect that, but they always look in and ask if I am ok. They are all very friendly.”

On the day of our inspection we looked at ‘do not attempt resuscitation records’ (DNAR) for two of the people whose care records we reviewed. We looked at these records to review how people had been supported to make this specific decision. We saw it was indicated in people’s care plans whether the person had a DNAR in place. We saw where the person did not want to be resuscitated there was the required form completed to accompany them to hospital in the event of any emergency so their wishes would be known.