Hyne Town House

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People who were able to share their views with us told us staff always gave them choices and asked them what they wanted to do. Relatives told us staff always asked for people’s consent and they were involved with mental capacity assessments when they were needed. However, we found people were not always supported to have maximum choice and control of their lives. Mental capacity assessments and best interest decisions showed a lack of knowledge and understanding of the principles of The Mental Capacity Act 2005. This was a continued breach of regulation 11. People and their relatives told us the service was quick to respond to any health needs people had and sought timely medical advice. Staff told us they had developed good relationships with health professionals involved with the service and where advice was given, this was written into people’s care plans.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

People and their relatives told us the service was quick to respond to any health needs people had. Relatives told us staff contacted them if there were any concerns, sought timely medical advice for people and kept them informed of any appointments. For example, one relative told us that staff arranged a podiatry appointment for their relative and took them out to lunch after. Another relative told us, “Someone from the G.P practice visits every week, and they ring me if anything is wrong.”

Staff said they had good relationships with health professionals involved with the service. The registered manager told us they had monthly meetings and weekly conversations with people’s GP and staff were quick to arranged reviews for people and report any concerns where needed.

People’s records contained information from different health professionals involved in their care. Where advice was given, this was written into their care plans, and we saw this advice being followed by staff. This included monitoring people’s diets or ensuring they moved around the service safely.

People who were able to share their views with us, told us staff always gave them choices and asked them what they wanted to do. Relatives told us staff always asked for people’s consent and some told us they were involved with mental capacity assessments when they were needed. One relative said, “They ask his consent and give him as much choice as they can.”

The registered manager told us staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). They described the importance of obtaining people's consent and followed the principles of the mental capacity act. However, we found this knowledge and understanding was not applied consistently. For example, some people's care records did not always show their consent and/or views had been sought in relation to decisions being made on their behalf or that people were always being supported and empowered to have maximum choice and control over their lives.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. The provider had developed systems and processes to help ensure people were supported to understand their rights. Records showed, and staff confirmed they had received training in safeguarding adults, the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). However, we found people were not always supported to have maximum choice and control of their lives. Mental capacity assessments and best interest decisions showed a lack of knowledge and understanding of the principles of the MCA. For example, some people’s MCA’s contained conflicting information relating to multiple decisions within one assessment process, which was not decision specific; did not contain the views of the people consulted regarding the decision and lacked detail with regards to the decision to be taken. The registered manager told us 4 people received their medicines covertly. We reviewed people’s records and found their respective capacities to consent to these arrangements had not been assessed and care records did not evidence a decision had been made in line with the principles of the MCA. Where the service had submitted DoLS applications to the local authority, people's capacity to consent had not been assessed prior to these applications being made and the service was unable to provide evidence that they had followed a best interests process. The failure to accurately assess and record people's capacity and best interest decisions risked compromising people's rights. This was a continued breach of regulations.