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Inspection report

Date of Inspection: 20 November 2013
Date of Publication: 17 December 2013
Inspection Report published 17 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 20 November 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 carers and / or family members and talked with staff.

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

The provider had systems in place to gain and review consent from people who used the service.

Reasons for our judgement

We observed the care and support given to people who lived at the home. We saw that staff spoke kindly to people, and gave them time to respond. We saw that when staff had asked a person a question or offered to help them they had been patient and waited for people to give their answer. Staff told us they would know if people were unhappy or wanted something. They told us people would indicate in their own way what they wanted and that staff would respond to this.

We observed how people were supported with their lunch time meal. We saw that staff gave people a choice of meal and took the time to explain to people if they were unclear what the meal was. The provider may wish to note that people may find it easier to make a choice if they were shown the meal options available to them.

We found that people had been asked for their consent before they were given any care or treatment and staff had acted in accordance with their wishes. Staff told us that they asked people and supported them to make decisions in their everyday lives. Staff told us that many people they supported with dementia could not always make everyday decisions for themselves: “But I still give them the choice and explain what I would like to do for them”. “When I give personal care I ask first before I give it”. This meant that staff recognised the importance of ensuring people agreed to any provision of care before they carried it out.

We saw that care records had been kept under review and people had been involved where they had been able. We saw that people’s wishes had been recorded. We saw records that showed how support had been obtained when people had been unable to consent to their care or where decisions needed to be made on their behalf. For example, support from relatives, advocates or medical professionals had been sought in these instances. The registered manager told us that best interest meetings were held to support people who were unable to make significant decisions for themselves. We saw evidence of best interest meetings that had been held for this purpose. This meant that people were kept fully informed about the care available to them and were supported to make informed decisions about their care and treatment.