The West Gate

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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 assessed the quality statement Consent to care and treatment. We found staff were working within the principles of the Mental Capacity Act 2005 and supporting people to make day to day decisions. However, when Deprivation of Liberty (DoLs) had been authorised, action had not been taken quickly to make sure conditions on the authorisations were met.

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.

People told us they were encouraged to make decisions by staff and their decisions were respected. People who were able to go out without staff support told us they were able to do this when they requested. People told us staff respected decisions they made. For example, they told us, “If staff put something out and I say I don’t want to wear that, they put it away again”. Relatives described to us how they had been involved in making decisions about their loved one’s care. For example, staff discussed and agreed with relatives applying for Deprivation of Liberty Safeguards authorisations for people and the administration of vaccinations. They described how staff acted on people’s choices including, “My relative can choose the activities they would like to take part in. There are some days they like to join in and others where they don’t and like to stay in their room”. One relative told us, “Staff are respectful of my relative’s choices”.

Staff were able to demonstrate an understanding on what it meant for someone to have capacity and what they needed to do if they did not. We were told, "Everyone has the right to make a decision if they can. Even if we think its unwise, it’s still their decision. It just really important that they understand the decision. We support people to make their own decision and if they can’t, we support them in their best interests," and "We ask consent, it’s just the right thing to do and a tip I always tell new staff is introduce yourself. Always say hi and is it ok to support you with 'xyz'. If people do not want assistance there and then we will go back later or maybe another member of staff can try as not everyone gets on with everyone."

There were processes in place to assess people's capacity to make decisions and if people required a Deprivation of Liberty Safeguards (DoLs) to be applied for. There was an effective system to initially apply for DoLs and reapply when needed. However, when authorised DoLs contained conditions these had not always been acted upon quickly by staff, to make sure they were met.