The Red House Welfare & Housing Society

On this page

• 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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation person centred care.

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

People’s needs had been assessed and recorded in their care plan. However, these were not always accurate or up to date. For example, a person’s care plan stated they had good skin integrity, but another part of the care plan recorded they had a pressure ulcer.

People were not involved with their care planning. A person said, “Care plan, they may have told me when I first came here.” Another person said they had been, “Told about their care plan.”

People’s care plans did not demonstrate they were reviewed regularly to include their health needs. A lack of reviews regarding individuals' overall wellbeing and communication needs prevented the delivery of person-centred care and the best possible outcomes.

The provider did not plan always and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

Care plans contained recognised tools for assessing people’s needs and monitoring outcomes, such as Waterlow (a tool for assessing pressure ulcer risk) and MUST (Malnutrition Universal Screening Tool) charts. However, where the use of these tools had required actions to mitigate the risk, such as weekly weights, these were not always completed and therefore compromised safe delivery of care.

Where people required their food or fluid intake to be monitored this was not carried out effectively. Care staff were unclear whether they should record people’s fluid intake on a chart in the staff room or on the electronic system. This meant that recording was inconsistent. Care plans did not record how much fluid a person should be consuming. Where people’s fluid intake was recorded there was no system to monitor if this was sufficient and identify if staff needed to take action. We found instances of very low fluid intake recorded with no action taken. This put people at increased risk of avoidable harm, due to dehydration, and other linked poor health outcomes.

We observed the lunch time meal in the service dining room and saw that people chatted and enjoyed their food. People spoken with were complimentary about the food. A person said, “The cook is excellent, the pork today was lovely, food is good here”. Another person told us how their dietary needs were met with gluten free products.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Staff worked with a range of healthcare professionals to support people's health and wellbeing. Records demonstrated involvement from GPs, district nurses, health professionals and other specialist services when required. However, senior staff spoken with were unclear how feedback from professionals was recorded and accessed. This may mean instructions left by a healthcare professional were not communicated to staff to enable them to be actioned.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

The service did not always make referrals to health care professionals promptly. For example, a person’s care records recorded a pressure ulcer on 20 May 2025. However, the first district nurse entry was not until 3 June 2026, 2 weeks after the initial entry. Delay in requesting district nurse input could have resulted in deterioration of the condition.

People’s experience was inconsistent in this area as some people told us support was provided and they were empowered to maintain their independence. One person said, “I can come and go, just sign the book went to the History Society this morning, I go to the Women’s Institute (WI), I am reasonably independent.”

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Care records did not demonstrate routine monitoring of people's health and wellbeing. For example, where a person required their weight to be checked regularly this had not been recorded as being done. This lack of being able to demonstrate routine health monitoring meant significant changes in physical wellbeing could go unnoticed. Without regular weight checks, staff cannot identify malnutrition or trigger vital referrals to external specialists, exposing individuals to the risk of avoidable harm. In another example a person’s care plan contained insufficient detail to provide adequate guidance for staff on how their bowels should be managed, monitored or actions to take should they become constipated. This lack of detail resulted in the person experiencing extreme discomfort and requiring external medical intervention.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

Mental Capacity Assessments (MCAs) are required where there is cause to believe a person may be unable to consent to all aspects of their own care and treatment. One person’s care plan contained a dementia care plan but there was no supporting mental capacity assessment (MCA) to determine what they were able to consent to and what decisions they may need support with. The dementia care plan simply stated, ‘Memory is not what it used to be.’ Another person’s care plan stated they needed staff to give them ‘a little guidance’ when making decisions. There was no information as to what guidance they may need or what the decisions were. Lack of relevant mental capacity assessments meant the service had not fully assessed if the person was able to make decisions regarding their care and support and put them at risk of inappropriate restrictions and receiving care that did not align with their choices, preferences, or best interests.