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Archived: Grace House Residential Home

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Inspection report

Date of Inspection: 10 July 2013
Date of Publication: 9 August 2013
Inspection Report published 09 August 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 10 July 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 people who use the service, 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.

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 last inspected this service on the 7 March 2013 and found the provider was not meeting the essential standards of quality and safety consent to care and treatment. For example we could find no evidence that showed the provider had carried out Mental Capacity Assessments of people's ability to

consent before making important decisions about their care.

We looked at eight people's care records and noted that the providers had undertaken mental capacity assessments regarding these people. We spoke with both providers regarding these assessments. They informed us they were in the process of undertaking assessments on all of the people living in the home. We saw the records regarding these assessments and they confirmed what we had been told. We noted in some of the records evidence of multi-disciplinary review meetings where people, their families and where appropriate social and health care professionals had been involved. The records demonstrated to us that people's care had been discussed with them and their families and they had consented and agreed advanced directives and end of life care plans.

We noted people’s files had signed consent forms regarding all aspects of people’s care. For example, refusal to be checked during the night, and the sharing of their medical and social records with other health and social care professionals. We saw evidence of email correspondence between the home and people’s relatives where appropriate regarding people’s care. These records demonstrated that people and their relatives had been kept involved in discussions around their care. One of the people we spoke with during our visit said "I am always involved in any decisions regarding my care, staff always ask for my permission before doing things and I hear them asking other people as well."

We spoke with two people who expressed satisfaction with the way staff managed their care. They told us staff always asked their permission before they provided any care. One person said "All of the staff are polite and explain things to me before doing anything". Another person said "Staff always ask my permission before they come in to my bedroom." This meant people and their families were asked for consent prior to their care being delivered.

We spoke with staff about their responsibilities for ensuring they had consent from people before providing their care. Staff confirmed the importance of ensuring that where possible people and their families understood treatment and care. They talked about gaining consent, and described how they would discuss options and agree a plan of care with people and their family member where appropriate. One staff member said "I would never carry out any care on a person unless I explained what I was going to do".

Throughout the visit we observed staff talk to people and explain what they were about to do. They provided time and opportunities for people to ask questions. Staff used a range of communication skills, including touch and facial expressions to support the verbal information given. We observed on one or two occasions people refusing to give their consent to care being provided. Staff were seen to respect the person's decision. They returned a little later however and the person agreed to the care. This meant people where they were able, gave consent to the care and support they received.