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Archived: Belgravia Nursing and Care

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Inspection report

Date of Inspection: 27 January 2014
Date of Publication: 12 February 2014
Inspection Report published 12 February 2014 PDF | 80.21 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 27 January 2014, 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 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.

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 spoke to people who used the service and asked if staff asked for their consent before they carried out care or support. Most said that staff did. One person said “We discussed consent when we had the assessment; they did a very good review.” Another said “Yes they ask my permission and I also signed consent forms when I started with the service.” The provider might like to note that one relative said “The carer is brilliant but they do tend to start cleaning and vacuuming when my family member already has a cleaner. So they do not always do what my family member wants.”

We asked the staff about their understanding of consent, and how they made sure the care being provided was with the consent of the person who received it. One staff member said “I would always ask the person before I do anything for them.” Another staff member said “The care files tell me what I can and can’t do for the person. I also ask them if what I am doing is OK.” This showed us that staff understood they had to gain people’s consent before providing care or support.

We asked staff what would happen if someone changed their mind, or refused support. One staff member said “I would talk to the person and try to help them understand that I’m here to help. If they still refused the support I would make them as comfortable as I could and let them know I would be ready to help when they wanted it. I would also call the manager to let them know and ask for their advice.” Another staff member said “I would call my manager. If it was medication I would try to explain to the person what it was for and how it would help them. I would record in the medication records if they refused. I have to accept the person’s decision. This showed us that staff respected people’s rights to refuse support, and there was a system in place to record these decisions.

We asked staff what would happen if someone lacked the capacity to understand a decision. One staff member said “I have to try to help the person understand the decision in a way they can understand. I have to inform the manager so they can involve the family. I couldn’t make the decision for the person if they didn’t understand.” Another staff member said “I would try to explain why the decision needs to be made. If it was something like going to a dentist I would explain the process to them. I would explain what would happen at the appointment and explain the benefits to them. I would need to inform the manager, as I couldn’t make the decision for the person.” When we spoke to the manager they showed us the procedures they had in place for recording best interest’s decisions, and how external agencies such as advocates could be used. This meant that staff understood their responsibilities if someone lacked capacity, and that they could not make the decision for the person.

We looked at four care files. We saw that people had signed care plans and risk assessments. This showed us that they had consented to the care recorded in them. The provider might like to note that some of the care plans we looked at had not been signed by the person or their relative. The manager explained that the signed copy would be in the person’s home.