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Inspection report

Date of Inspection: 9 May 2013
Date of Publication: 14 June 2013
Inspection Report published 14 June 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 9 May 2013, checked how people were cared for at each stage of their treatment and care and talked with people who use the service. We talked with carers and / or family members, talked with staff and reviewed information given to us by the provider.

Our judgement

Before people received any care they were asked for their consent and staff acted in accordance with their wishes.

Reasons for our judgement

During the inspection we viewed a selection of people’s care plans. These demonstrated that people’s care had been planned and arranged in line with their personal wishes and preferences. Care plans also contained evidence that regular reviews were carried out during which, people who used the service and where appropriate, their representatives were asked for their views and opinions and encouraged to make decisions about their care.

All the care plans we viewed contained written consent from the service user, in relation to various aspects of care such as personal care and assistance with medication. Daily records, which were completed by carers, demonstrated that people were enabled to make every day decisions and that their choices were respected.

The Mental Capacity Act, 2005 sets out legal requirements and national good practice guidance, which services must adhere to when supporting someone who lacks capacity to consent to care or treatment. We saw that a number of the agency’s policies and procedures referred to the guidance, for example policies on people’s rights to refuse treatment and end of life care. However, the provider may find it useful to develop a stand-alone policy and guidance in relation to the Mental Capacity Act, 2005 to further ensure that all staff have a good understanding of the area.

We looked at the care plan of one service user who had some complex needs. Concerns had been identified due to the person’s frequent refusal of certain aspect of care. We were able to confirm that the agency had liaised closely with the service user and his representatives, as well as other professionals involved in his care. Very clear guidance had been included in his care plan for staff to follow in the event of refusal, as well as robust safeguards to ensure the person’s safety and wellbeing in these circumstances, including the obtaining of medical advice.

We also noted that the manager of the agency had met with the service user and other relevant professionals, to ensure that he was fully aware of the potential risks involved when refusing the particular aspects of care. This helped to ensure that the service user was being supported to make informed decisions about his care.