Consent Policy

Aim

Cavendish Professionals aims to ensure that all clients are asked for their consent whenever care or treatment services are proposed or changed and that there are effective procedures in place to ensure that they can give or withhold such consent.

Background

Cavendish Professionals understands the term ‘consent’ in the context of health or social care to refer to the moral and ethical duty on a service provider to obtain prior agreement from a person before any care or treatment or procedure is performed upon them or before a service is provided. The organisation understands this to be a fundamental human right. Furthermore, it understands ‘informed consent’ to refer to the need to ensure that the person giving their consent has a clear appreciation of and understanding of the facts, and the implications and consequences of their actions.

Given that ‘informed consent’ is therefore desirable before any care or treatment decisions are made, it follows that clients need to be fully informed about the care or treatment that they are being asked to consent to. Where this is not possible, because they may lack the mental capacity to make a decision for themselves, then the organisation understands the need to comply fully with the Mental Capacity Act 2005 that states that where a client might not have the mental capacity to give informed consent about any care and treatment proposed they should be properly assessed in line with the requirements of the Act. If from the assessment it is clear that the person cannot give their informed consent on account of their mental capacity, a decision must be taken in their ‘best interests’ following Mental Capacity Act procedures.

To ensure that a decision is in a person’s best interests, the organisation will always encourage and enable the person to have the services of an independent advocate if needed. If the care and treatment proposed implies a deprivation of that person’s liberty in any way, the organisation will always invoke established deprivation of liberty safeguarding procedures.

The desired outcome is that all clients are asked for their consent whenever care or treatment services are proposed or changed and that there are effective procedures in place to ensure that they can give or withhold such consent.

Policy

Cavendish Professionals believes that every client has the moral and ethical right to be asked whether or not they consent to care or treatment options which affect them.

Therefore, in Cavendish Professionals:

Clients (or their representatives) should always be asked for their explicit, informed consent whenever care or treatment services are being proposed to meet their needs, which include personal, health (including medication), social, psychological and spiritual needs. Written consent should be requested and documented on PASS except in the case of minor, day-to-day decisions which may be subject to verbal consent.
Clients should be given adequate information about the proposed care or treatment. This should be supplied in a format and a way that the person can understand and should be sought by a person who has sufficient knowledge about them – and about the care, treatment and support options they are considering – in order that the client can make an informed decision.
The information provided to the client about the care or treatment should include information about the risks, benefits and alternative options as well as information about how they can withdraw consent if they so wish.
Clients and their representatives should be asked to read and sign all basic agreements about the service they receive and should be consulted on any proposed changes to these.
Clients (or their representatives) should always be asked to sign their plan of care as an indication that they are in agreement with the services being proposed to meet their needs, which include personal, health (including medication), social, psychological and spiritual needs.
Any proposed changes to a plan of care should always be discussed with the client and, where appropriate, with their representatives. Consent should be obtained and this should be recorded. Clients’ agreements should always be obtained following a review.
Where verbal consent is being sought for what are usually day-to-day care and treatment proposals or changes, the reasons for the need to seek consent, the fact that it has been obtained, and how, should all be recorded in the person’s care plan.
Clients’ consent should always be sought in relation to any proposed participation in social and community activities, either directly from the resident or as a ‘best interests’ decision taken in discussion with their relatives and representatives.
The organisation expects other healthcare professionals or organisations to be responsible for seeking consent for any care and treatment that they provide and the organisation will help to implement such care or treatment only on the basis that the client has given their consent to the proposed treatment or a ‘best interests’ decision has been taken and recorded.
Clients should always be given enough time to think about their consent decisions where requested, except in an emergency when this may not always be possible. In a life threatening emergency situation, when receiving consent is not possible, decisions should be made which are in the best interests of the client and with reference to any advance decisions which they may have made.
The confidentiality of clients’ consent decisions and deliberations should be respected at all times.
Where a client is suspected of lacking the capacity to make an informed decision relating to a consent issue then a ‘best interests’ decision may have to be made for them. In such cases the full provisions of the Mental Capacity Act 2005 should be followed. The fact that the client has not been able to give their valid consent should be fully recorded using an appropriate form and, where necessary, deprivation of liberty safeguarding procedures should be implemented.
Where it is considered that the care and treatment provided might restrict a person’s ability to exercise choice or their freedom of movement, such as when bed rails are proposed, their written consent is always obtained or a ‘best interests’ decision fully recorded.
Where a client is found to lack the capacity to give their consent over one particular care or treatment option it should never be assumed that this applies to all decisions and further appropriate attempts should be made to inform them about treatment options and to obtain informed consent. A client must be assumed to have capacity unless the contrary is established and should not be treated as unable to make a decision unless all practical steps have been taken without success to help them take the decision.
Any refusal to give consent, or difficulty in obtaining it because of suspected mental incapacity, should be recorded in the clients’ care plan together with an account of the actions taken to address the consequences of the decision or difficulty.
Any valid decision by a client to refuse or withdraw consent should always be fully respected.
Cavendish Professionals will support, enable or facilitate advocacy for any client who might require it by being undecided about giving consent or by lacking the capacity to give their informed consent.
Valid advance decisions about wishing to refuse care and treatment in the event of a loss of mental capacity will be disclosed and acted upon under the appropriate circumstances in order for a decision to be made in line with the person’s wishes.
Consent should always be sought if any proposal or request is made to take part in any research project and ‘best interests’ meetings should be held in the cases of anyone who cannot give their informed consent about taking part.
Consent should always be sought in advance of any Care Quality Commission inspection where clients’ notes or records are to be viewed and ‘best interests’ meetings should be held in the cases of anyone who cannot give their informed consent about taking part.
Only staff who have accessed training in the Mental Capacity Act 2005 and have shown that they are competent should take part in ‘best interests’ decision-making in relation to clients who cannot give their informed consent.

Management duties

Managers and supervisors in the organisation have a duty to:

regularly audit the use of this policy and the effectiveness of procedures to obtain consent
monitor complaints and compliments relating to consent issues, taking action as required and fully investigating any complaints
ensure that clients, and their relatives and representatives, have adequate processes in place to be able to register queries or complaints about consent issues and to have their thoughts listened to and acted upon.
ensure that staff record client information and care notes such as pictures with the consent of the client

Staff duties

Staff in Cavendish Professionals have a duty to:

always act in full compliance with the Mental Capacity Act 2005 and with the associated Deprivation of Liberty Safeguards
understand the importance of obtaining consent and acquaint themselves with the procedures for obtaining consent operated in Cavendish Professionals
comply fully with organisational policies on confidentiality and data protection
attend appropriate training
always ensure they record information in an appropriate manner and if a photograph is needed, consent is asked for and recorded accordingly

Training

In Cavendish Professionals:

induction will include guidance about obtaining consent
all staff will be trained in the requirements of the Mental Capacity Act and with the associated Deprivation of Liberty Safeguards.

Date: January 2024

Version: 8 (Review)

Source: Expert Care Manager