Wilton House

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 remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed before they started to use the service and were kept under review. Support plans were person-centred, and considered people’s abilities, communication, goals, diverse needs and any specific care or health needs. This helped to ensure staff had clear guidance to follow to maximise and promote people’s quality of life.

People’s support plans set out their current needs, promoted strategies to enhance independence and promote activities of daily living. People’s protected characteristics and diverse needs under the Equality Act, were reflected in their support plan such as preferences and culture. Positive risk taking was encouraged, supported and monitored by staff.

People were aware of their support plan and had regular meetings with their keyworker to review this. Support plans were produced in formats people could understand for instance, using easy read and pictorial.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence.

Staff encouraged people to be involved in menu planning, shopping and preparing meals. During the inspection visit we observed a person getting a snack and making themself a hot drink. One person had finished making cupcakes and later, were supported to prepare a meal at lunchtime using the microwave.

People told us the weekly house meetings were used to plan the menu and activities for the week. One person said, “I love a roast dinner, and I like fish and chips too.” Menus reflected a variety of people’s food preferences along with the name of the person assisting staff to prepare the meal of choice. This was displayed in the kitchen as a reminder for all.

People’s records showed evidence-based risk screening tools were used and best practice guidance was followed. For example, the care practices considered the principles of ‘right support, right care, right culture, guidance CQC follows to assess the support of people with a learning disability and autistic people. Leaders and staff followed the principles of STOMP, referred under ‘Medicines Optimisation’ under the key question Safe, and Mental Capacity Assessments were complete in line with legislation.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The registered manager and staff worked effectively as a team to ensure people received continuity of support. Staff told us being a small care home meant communication was good. Handovers between staff, reflective practices and debriefs following incidents or concerns meant information was shared promptly.

Staff worked closely with healthcare professionals such as the learning disability and the mental health teams to maintain and improve people’s wellbeing.Care records viewed confirmed this. A relative said, “For me, the way the manager and staff have supported us as a family and [Person name]; liaised with the hospital and other professionals to support [Person name’s] move has been brilliant.”

Each person had a detailed hospital passport used to support people with a learning disability and autistic people which included information about their care and health needs, risks, communication needs and preferences. This document enables hospital staff to provide proactive and appropriate support to people when they require medical treatment.

Feedback received from the local authority with responsibility to monitor the quality of care for people they have responsibility for, was positive.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People told us staff supported them to live their best lives and respected their rights and choices. One person told us they were trying to lose weight by eating healthier. Staff told us they supported people to make healthy food choices, while respecting their food preferences.

People’s support plans contained relevant information which enabled staff to understand people’s healthcare needs and how they wished to be supported with specific goals to promote their independence. Staff encouraged activities outside the home, and we observed staff going for walks with people in the local area and using the local gym. Individual activity plans provided structure and support for some people, which promoted their wellbeing. For example, with planned support a person achieved their goal to attend routine health appointment independently.

Staff worked with health professionals to ensure that people’s health was consistently monitored, and to respond to any immediate need. People were supported to attend regular health checks. People’s records showed there was good communication with the GP, community nurse and specialists services. This ensured there was focus on identifying risks to people’s health and wellbeing early.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People told us staff encouraged them to eat a balanced diet and to exercise regularly to stay fit and healthy. People’s wellbeing and health was monitored through regular care reviews by staff and with relevant health and social care professionals.

Staff understood people’s health needs and recognised changes or deterioration and recorded information consistently. This helped the professionals understand when health intervention was needed. For example, staff were knowledgeable about what caused a person’s anxiety and how to respond to reduce this.

The registered manager and staff understood the benefits for improving people’s outcomes by involving people in their care and to develop strategies to support their wellbeing. For instance, when incidents occurred, people and where appropriate their relative was consulted to help improve the support and approach of staff.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were aware of their rights around consent and told us staff sought their consent and respected their wishes. Staff empowered people to make their own decisions about their care and support through verbal or non-verbal means, and this was well documented. Staff were able to explain how they ensured people’s consent was sought. A member of staff told us,“I support people to make their own decisions as much as possible. I give them information in a way they understand and then let them choose for themselves. I understand that people have the right to make unwise decisions if they have capacity. My role is to explain any risks clearly but still respect their choice.”

The registered manager and staff worked within the principles of the Mental Capacity Act 2005 (MCA). We saw people were supported in the least restrictive ways possible. Where people lacked capacity, this was documented clearly. Where needed, relatives, with the appropriate legal authority, had been involved in making best interest decisions for their family member. Records showed Deprivation of Liberty Safeguards (DoLS) were requested and any conditions had been adhered to.