The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Empowering informed decision-making rights
The service told people about their rights around consent and respected these when delivering person-centred care and treatment. People were empowered to make their own decisions about their care and support.
Staff knew about people’s capacity to make decisions through verbal and non-verbal means, and this was well documented. Staff demonstrated best practice around assessing mental capacity, supporting decision-making and best interest decision-making. Staff clearly recorded assessments and any best interest decisions for people the service assessed as lacking mental capacity for certain decisions.
Read more about this service here.
Care provider: Stallcombe House
Date published: August 2025
Upholding consent and decision-making
The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. For instance, all the care plans we reviewed included clear information about consent and decision-making. People had been actively consulted on matters such as the use of their images on social media and whether they wished to receive personal care from staff. The provider followed the principles of the Mental Capacity Act to assess individuals’ capacity to make specific decisions and choices.
Read more about this service here.
Care provider: Libertatem Healthcare Group Ltd Head Office
Date published: July 2025
Respecting consent and individual preferences
The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People told us staff asked for consent before assisting them with personal care tasks, and people felt their views and wishes were considered when care was planned. Staff confirmed they had received mental capacity training and were aware of what consent was and what to do if this could not be readily obtained from people. Where people were unable to give consent to cares, capacity assessments and best interest decisions were in place which were detailed, person centred and decision specific. Care plans and pre assessments detailed consent from people and/or their appointed representatives and was inclusive of people’s views and preferences.
Read more about this service here.
Care provider: Birch Park Care Home
Date published: June 2025
Respecting dignity and informed choice
The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff knew what the MCA was in relation to, and how to apply it in practice. Family members’ comments included, “[Staff] respect [my relative’s] dignity all the time and explain how and what they are doing to make it easier for him to understand what is happening.” Staff said, “We take clients wishes and choices into consideration at all times and we don't assume they don’t have the capacity until it's proven that they don’t.” Processes were in place and followed to assess people’s capacity for making decisions where this was necessary.
Read more about this service here.
Care provider: Comfort Care At Home
Date published: April 2025
Reassessing capacity, removing restrictions
Staff had an excellent understanding of their responsibilities around the Mental Capacity Act and the need for best interest decisions to be made for people who lacked the mental capacity to make these decisions for themselves.
Staff gave an example where they had transitioned one person from a long stay hospital placement. After a settling in period staff recognised this person's ability to make decisions and that some of the care first identified was unnecessarily restrictive. This person's capacity to consent was being reassessed with many of the initial restrictions in place, removed.
Read more about this service here.
Care provider: Orbis Support Offices
Date published: March 2023
The importance of consent in everything we do
In this two-minute audio clip from the Care Exchange podcast, Ronnie Lillywhite explains the importance of gaining people’s consent for every interaction.
You can listen to the full podcast here and access our latest episodes of The Care Exchange here.
Care provider: Anonymous
Date published: February 2021
Consenting to the flu jab
Staff used creative ways to support people to have the knowledge and understanding to make their own decisions and choices. For example, staff sourced information from government health organisations and developed a communication booklet to explain flu jabs. Staff went through this with the person, using the booklet, pictures and signs. The person decided to have the flu jab.
Read more about this service here.
Care provider: SENSE - 89 Hastings Avenue
Date published: April 2019
Effectively communicating about Mental Capacity Act (MCA) and consent
Due to a thorough understanding of the MCA and focussing on people's rights, the provider and staff had noticed that some relatives struggled with understanding the MCA ethos and could sometimes become anxious. For example, a visitor had commented on one person not having shaved or not acting in the way they expected. The provider then delivered a bespoke training session for relatives, helping them to understand how the home enabled people to make their own choices as much as possible. The provider also kept the MCA on staff meeting agendas and randomly asked staff questions when they visited to promote the ethos of people's choice.
People who were able to confirmed and recorded evidence that consent was sought through verbal, nonverbal and written means. For example, if people were unable to verbally communicate, staff were observant of their body language and pictures. People had been asked about the frequency they wished to be checked at night. Staff ensured people were able to make an informed choice and understood what was being planned. Care plans gave clear guidance for staff to ensure explanations were provided to people about their care and treatment, and their views respected.
Read more about this service here.
Care provider: Wisteria House Dementia Care Ltd
Date published: January 2019
Seeking consent while making adjustments to minimise risk
The service met to discuss best interest issues and decide what to do. For example, following a recent incident where the person they were caring for undid their seatbelt whilst the vehicle was moving, the service discussed what practical solutions could be considered to mitigate future risk. After consultation with the person and everyone else involved in their care, a best interest decision was made that a ‘harness’ type of seatbelt would be used, to help to keep the person safe during journeys and to continue with their daily lives. Records were maintained of every occasion the harness was used and regular review meetings held. The person still used the harness but on their own terms and only on occasions when they recognised they felt anxious.
Care provider: Anonymous
Date published: April 2018
Communicating the DoLS process to staff, people and family members
The provider had produced a small booklet titled called ‘communicating kindness - how we make decisions on a resident’s behalf’. It contained information about what ‘lack of capacity’ meant, and explained the process in respect of DoLS. It also gave an overview of who should be involved in the process. A family member interviewed by the CQC highlighted how this booklet had answered many of their questions and reassured them of the quality of care being provided.
Care provider: Anonymous
Date published: April 2018
Reviewing training processes to reflect best practice
Staff had received training on the Mental Capacity Act (MCA) but this was customised to reflect on examples from within the service.
Care provider: Anonymous
Date published: April 2018
Using aids to help offer choice to people
The service uses pictures, charts or ‘objects of reference’ to help people understand what’s happening and offer choice and control. For example, if someone can’t make the decision about receiving personal care, they may still be able to choose between a bath, wash down or shower, or choose who does it and when.
Care provider: Anonymous
Date published: April 2018
Reviewing staff knowledge around capacity
As part of monthly self-audits, one manager had asked staff to explain the MCA. Initially this proved difficult and they couldn’t answer clearly, even if their training had been recently refreshed. However, the fact that staff began to realise this was part of our internal auditing resulted in them wanting to retain this knowledge and demonstrate their understanding. Momentum soon built, with staff wanting to deepen their understanding around the MCA and put their latest learning into practical use.
Care provider: Anonymous
Date published: April 2018