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Archived: Lighthouse Homecare Inadequate

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Inspection report

Date of Inspection: 29 November 2013
Date of Publication: 8 January 2014
Inspection Report published 08 January 2014 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 29 November 2013, observed how people were being cared for and talked with people who use the service. We talked with staff.

We also spoke with an external social care professional.

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

We spoke with three people who used the service. They all told us that they felt fully involved in their care and support. They participated in their care plan reviews and said that they made decisions for themselves. They told us that staff always asked them what support they needed. We also spoke with an external social care professional who said that people, and their representatives where appropriate, were always involved in any reviews of care and support.

Staff we spoke with described how they worked together with people who used the service and negotiated the agreements and care plans. Staff demonstrated knowledge of the consent process and were aware that no-one can give consent for another adult. We saw that staff were trained in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). We were told that where agreement was not possible, for example for someone not to drink alcohol, then the involvement of local alcohol support groups was sought. Staff said that the consequences of breaching agreements on people’s health and well-being were discussed with each person individually. This meant that care and support were provided in accordance with people’s knowledge and agreement.

We looked at four people’s care plans. We saw examples of negotiated agreements in place. We were told that the signed copy was held by the person at their own home. These reflected the risk assessments. We also saw examples where people had signed consent for their information to be shared. We observed discussions during the day where support was offered and accepted. One example was with medicines management for a person going on home leave.

The first ‘Lighthouse News’ was published in November 2013. The newsletter was for people, their friends and relatives as well as for staff and other professionals. The first topic was about consent with the title ‘Silence does not = consent’. The article explained the importance of understanding and agreeing to anything that may be written or produced about them in the newsletter that could identify them. It described the process and said that consent would never be assumed. The article also reminded people that consent ‘is in all areas of your life’.