10 March 2017
During an inspection looking at part of the service
This focused follow up inspection took place on 10 March 2017 and was unannounced. It was undertaken to check the service was effective and meeting the regulations in relation to consent and the Deprivation of Liberty Safeguards.
At our last inspection in July 2016, we found the regulations were breached in relation to the need for consent. People’s care records did not contain evidence of their consent to their care, and some relatives had consented to aspects of people’s care without the legal authority to do so. Where there was reason to believe people may have lacked the capacity to make decisions about their care, the requirements of the Mental Capacity Act 2005 had not been followed. Mental capacity assessments had not been undertaken and, if appropriate, best interests decisions made in relation to this care. Some people lived with dementia and would not have been safe to leave the home without support from a member of staff, yet there had been no consideration of whether they were deprived of their liberty. No applications had been made to authorise this under the Deprivation of Liberty Safeguards.
The registered manager sent us an action plan dated 24 September 2016 that set out the actions the service would take in order to meet the regulations. This stated they would meet the regulations by 24 November 2016.
At this inspection in March 2017, we found improvements had been made. Actions were still in progress to meet the regulations in relation to consent and the Deprivation of Liberty Safeguards. The registered manager and deputy manager were in the process of meeting people and, where appropriate, their relatives to review their care and record their consent, or mental capacity assessments and best interests decisions. People told us care was only provided with their agreement.
The service had a registered manager, which is a condition of its registration with CQC. The registered manager had worked at the service for many years. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff were supported to perform their roles effectively and safely, through training and regular supervision.
People were supported with their need for nutrition and hydration. They had a choice of meals and snacks and drinks were provided during the day. Staff were aware of people’s special dietary needs and these were catered for.
People’s health was monitored. Where they experienced any signs or symptoms of concern, these were referred to healthcare professionals such as doctors and district nurses.