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Crawshaw Hall Medical Centre and Nursing Home Good

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Inspection report

Date of Inspection: 28 May 2014
Date of Publication: 24 June 2014
Inspection Report published 24 June 2014 PDF

Before people are given any examination, care, treatment or support, they should be asked if they agree to it (outcome 2)

Not met 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 28 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 and talked with staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

People who used the service were not protected because suitable arrangements were not in place for obtaining and acting in accordance with consent

Reasons for our judgement

We asked staff to tell us about the importance of ensuring people who used the service had given their consent to any care or activity. We were told, “I would ask them. If they say no I would inform the nurse in charge, go back and try again” and, “I would always ask them (people who used the service) what they wanted to do it is their choice at the end of the day”.

We spoke with five people living in the home. We were told, “They (Staff) always ask permission and ask what you feel about it” and, “Staff knock before they enter my room”. We observed staff speaking respectfully to people living in the home and knocking on people’s doors before entering their bedroom.

We asked staff to tell us about their understanding of the Mental Capacity Act (MCA) (2005) and Deprivation of Liberty Safeguards (DoLS). Four of the six staff members we spoke were unable to demonstrate us with a clear understanding of the MCA (2005) and DoLS or explain the actions they would take if they were concerned about a person living in the home. This is important to ensure staff are aware of what to do if a person lacked capacity to make a decision for themselves.

The operations director provided us with two training files for both units in the home. We looked at one of the training files for the staff. We saw that only four of the 18 staff had received training in MCA and DoLS. The second training file identified 15 staff members had received training for MCA and DoLS in the last year. Two of the staff we spoke with told us they had not undertaken training in Mental Capacity or Deprivation of Liberties.

We were told there were two people currently living in the home who had documentation relating to DoLS. We looked at these care files. We saw up to date documentation relating to DoLS was in place and had been signed and dated appropriately in one file. However documentation relating to a DoLS in the second file we looked at was out of date. There was no record of action for review seen. This meant there was the potential this person was being deprived of their liberty unnecessarily.