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Archived: 74 Sir Evelyn Road

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Inspection report

Date of Inspection: 20 August 2013
Date of Publication: 7 September 2013
Inspection Report published 07 September 2013 PDF | 78.14 KB

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 August 2013, observed how people were being cared for 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 and where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

Reasons for our judgement

Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

The five people who lived at 74 Sir Evelyn Road had complex needs and limited ability to communicate with us. We observed staff interacting with people who lived in the home throughout the day. We saw that they had friendly attitudes and were kind and helpful when supporting the people who used the service. We noticed that staff asked people what they wanted to do and where they wanted to go. This promoted their independence and community involvement. A member of staff told us, for example, “I offered X the option of going bowling, going to the cinema and lunch out. X chose to go bowling and I arranged for him to be supported out by staff. This fulfilled his wish for the day”. Another staff member said, “We ask people for their consent before proceeding on any activity. If they do not want to do something, they let us know. If people cannot communicate depending on their mental capacity, we request consent from someone else on their behalf”. This showed that the staff enabled the people to make informed choices.

We observed that staff knocked on the bedroom doors and requested permission from people before entering their bedrooms. For example, one person refused to allow us into their room and this was respected as their choice. We also noted that staff asked permission from people who used the service before supporting them. During lunchtime we observed that staff sought people’s permission before supporting them to make lunch. This demonstrated that staff understood the need to enable people to make decisions.

The manager confirmed that the home made decisions for people who used the service by liaising with social workers, health professionals, relatives and advocates. The manager said: “For those people who are unable to have a direct contribution to decision making, decisions are made on their behalf through team meetings, liaising with funding authorities, medical professionals and other significant people in the person’s life. All such decisions are recorded in the care plans and daily records”

We saw that seven staff were trained in understanding and applying the Mental Capacity Act 2005, and staff recognised that best interest meetings may be needed to be arranged for people who lacked capacity and were unable to make decisions for themselves.

The manager confirmed that the remainder of the staff team had been enrolled to embark on the training course in 2013. We saw that a capacity assessment and best interest meeting had been arranged for one person who might have made a decision that could put them at risk. For example, we saw that a capacity assessment and best interest meeting had been arranged for one person who would like to travel overseas, but staff felt that it might not be in the person’s best interest. This showed that the provider was aware of decision making processes and acted in accordance with what was in the best interest of the person.

The home had a policy and procedure for meeting the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DOLs).

The provider may find it useful to note that although risk assessments and care plan goals were dated and signed by the staff or the manager. We saw that there were gaps where the person or their representatives had not signed either the risk assessment, care plan, service user guide and guidelines to indicate their involvement and consent despite the fact that the form requested a ‘person supported’ signature.