Honeybourne 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

We identified 1 breach of legal regulations. People were not always supported to have maximum choice and control of their lives and staff did not fully understand their roles and responsibilities under the Mental Capacity Act 2005 (MCA) including Deprivation of Liberty Safeguards (DoLS). However, the provider had systems and processes in place to help ensure people were supported to understand their rights and staff had received training in MCA and DoLS. We have asked the provider for an action plan in response to the concerns found at this assessment.

This service scored 71 (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.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

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 manager and staff told us they had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), and whilst they were able to describe the importance of obtaining people's consent. We found 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 being supported and empowered to have maximum choice and control over their lives.

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, one person’s MCA assessment listed a series of questions which were asked on multiple occasions and used as the basis to demonstrate the person lacked capacity. Staff recorded the person did not provide a verbal response. The person’s care records stated the person was non-verbal, the manager and staff also confirmed this. Where the service held or supported people to manage their finances. Mental capacity assessments were poorly completed; were not decision specific and did not always show that people did not have capacity to manage their day-to-day monies or that the decision to hold people’s monies had been made in the person's best interests and not pre-determined by the service as being safe. MCA assessments were not decision specific. For example, one person’s capacity assessment listed 15 areas of the person’s life which were to be assessed within one assessment. One person was due to have a complex medical procedure. Staff confirmed that the person’s capacity had not been assessed and there were no records to show, staff had followed a best interests process. The failure to properly assess and record people's capacity and best interest decisions risked compromising people's rights. This was a breach of regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.