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We are carrying out a review of quality at Chesterfield Royal Hospital. We will publish a report when our review is complete. Find out more about our inspection reports.
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Inspection report

Date of Inspection: 17 May 2011
Date of Publication: 12 July 2011
Inspection Report published 12 July 2011 PDF | 155.41 KB

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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 reviewed all the information we hold about this provider, carried out a visit on 17/05/2011, checked the provider's records, observed how people were being cared for, looked at records of people who use services, talked to staff and talked to people who use services.

Our judgement

There are effective systems in place to ensure that people give valid consent to the care and treatment they receive.

User experience

The people we spoke with who had been admitted for planned surgery or other planned procedures all said they had attended a pre-admission outpatient clinic. They said that they had been given sufficient information in this clinic about the procedure and any risks involved and had signed a consent form.

Most people we spoke with who had been admitted as an emergency said that staff had given them all the information they needed to make an informed choice and to give consent when required. As noted in Outcome 1, one person had been in hospital three days and said that no one had explained about their care and treatment, and they had not been involved in decisions.

We saw written information in some care records that demonstrated people had consented to care and treatment, although this was not seen in all of the records we looked at. We saw completed consent forms in the records of children admitted for surgery and saw that these had been signed by a parent.

In the surveys and other information we looked at people said they had sufficient information to give valid consent to the care and treatment they received.

Other evidence

The staff we spoke with were clear about how and when people should give consent to the care and treatment received. They told us that they usually have time to answer questions if people have any when they get onto the wards, but this can depend on staff workload and what time the person comes in for surgery. Staff said they find that people are usually well prepared by the time they come onto the wards, for example, they will have seen specialist staff such as a stoma nurse. Staff told us that consent forms were used for invasive procedures, such as surgery. Staff said that verbal consent was used for non-invasive procedures and that a note was made if the person refused consent.

Staff told us that they use a pre-operative checklist for each person requiring surgery or invasive procedures, and it was part of the checklist to ask if the person still wanted to go ahead with the surgery or procedure. Staff said people were mostly looking for some kind of reassurance at that stage.

The staff we spoke with had an understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff told us that deprivation of liberty issues were dealt with by the hospital’s patient safety team. Some staff said they had not received recent, specific training about this.

We asked the provider for further information about staff training about the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. They told us that new starters received this training as part of their induction and existing staff as part of a rolling programme of training. The provider told us that 73% of staff were up to date with mandatory training, which included the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.