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Archived: Swiss Cottage Care Home

The provider of this service changed - see old profile

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All reports

Inspection report

Date of Inspection: 2, 6 May 2014
Date of Publication: 5 June 2014
Inspection Report published 05 June 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 2 May 2014 and 6 May 2014, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff and talked with commissioners of services.

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

At our previous inspection on 22 November 2013 we required the home to make improvements in regards to consent to care and treatment. This was because suitable arrangements were not in place for obtaining and acting in accordance with the consent of people in relation to their care and treatment. We found where people did not have the capacity to consent; the provider had not always acted in accordance with legal requirements.

The provider sent us an action plan which stated that they would make improvements and be compliant by January 2014.

We found that staff provided people with choices such as what they would like to eat. We observed the breakfast activity on one particular unit and found that staff showed people the different choices which were on offer. This enabled them to choose what they wished to eat. We heard staff asking people if they wished to participate in activities or have a stroll in the garden. This demonstrated that people were consulted about their care.

We looked at six care plan files and found that in each file there was a consent form which had been signed by either the person receiving care or a relative. The forms we looked at were appropriately completed. It was evident that people or a family member gave their permission for staff to assist them with their care needs.

We spoke with staff who confirmed that they had been provided with training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguarding (DoLS). The training matrix made available to us during our inspection confirmed this. A staff member was able to describe the home’s process in relation to when people had returned from hospital with a Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) sheet in place. The staff member said, “We always get the GP to review the sheet if the decision made is not indefinite. If an indefinite decision was made and the person was not involved with the decision at the time it was made we would get the GP to explain to them and their family.” We spoke with the home’s GP during our inspection and they were able to substantiate the statement made by the staff member. This meant that staff were following the appropriate procedure where people did not have the capacity to consent.

We saw evidence in the care plans we examined that where people lacked capacity to make decisions, best interest meetings were held; which involved health and social care professionals, family members and staff. We spoke with a relative of a person who told us that staff always consulted them in decisions made about their family member’s care. The person said, “I signed consent for my [name] to have bedrails and the flu jab.” This demonstrated that the home involved family members in people’s care and treatment.