Seymour 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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.The service was in breach of legal regulations in relation to person-centred care; consent to care and keeping clear records for supporting people with making decisions.

This service scored 58 (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 always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.People’s care records included information about how to support them including specific situations where they may need additional support. Our observations during the site visit did not confirm the staff followed the plans of care to support people.For example, we observed how staff communicated with people, especially during periods of distress. Staff were heard telling people, “You need to behave well”, “You’re not being good” and “Go to your bedroom now, don’t talk to me”. Staff did not ensure they followed the plans of care to provide person-centred care or even spoke to people with kindness or dignity.

We also observed staff told people they would inform relatives if they did not comply with staff instructions. This also did not evidence staff understood how to communicate with people according to their individual needs as noted in their plans of care. The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.People’s nutrition and hydration needs were not always met in line with current guidance and best practice. We found two people were on fluid monitoring and required a daily fluid intake of 1500ml. Although staff recorded intake when drinks were offered to people, the service did not evidence how or if the fluid targets were met. This did not ensure people’s hydration needs were met in line with best practice. We also found one person was supported to choose some food items which were to be avoided for their specific diet due to their increased risk of choking.We observed people were supported with their food shopping. However, some people were not always able to access their own food in the shared kitchen. For example, one person expressed to staff they wanted to eat their own fruit, rather than the dessert which was being made as part of the activity. We observed 1 staff trying to take the fruit away from the person, however another staff eventually supported the person to have it. This did not demonstrate staff ensured people were in control of planning their choices and activities in line with their own preferences.

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.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.We noted the service used CCTV cameras within the home. Although these were not placed within people’s bedrooms or bathrooms, they were in use across communal areas such as the garden, dining area, and hallways. We reviewed people’s mental capacity assessments and best interest meeting notes regarding their consent for use of CCTV. The provider did not maximise people’s participations in these meetings. For example, one person’s care plan stated, “you might need to repeat the question a few times”, and noted Makaton or objects of reference were to be used whilst speaking. However, the provider did not evidence any of these tools and techniques were applied. Furthermore, the provider did not evidence they completed capacity assessments assuming people’s capacity. For example, when determining if the person understood the information presented, the assessment noted “nonverbal and not able to comprehend complex things”. The provider did not evidence all means of support were provided and use of CCTV was the least restrictive approach to ensuring people’s safety in the service.All 4 assessments were completed within the space of 15 minutes which did not reassure us people were appropriately involved and consulted about these decisions and actually seeking their consent regarding such aspects of care.The provider did not ensure the capacity assessments demonstrated that people were appropriately involved in the process and provided with information the way they understood to make specific decisions. Some of the information was the same and copied in different assessments. This did not ensure the assessments were meaningful and accurate. For example, one person had an assessment for decision to continue receiving care and treatment. However, it lacked detail about whether the person was actually involved. The record noted the service discussed this with the family in February 2024, but the assessment was completed in April 2025. Best interest decision was noted the same as for another person and their assessment for continuing with care and treatment at the service. When people were able tomake their choice or decision, the outcome of assessment was still noted as the person lacking capacity. This did not demonstrate the provider ensured the staff completing capacity assessments had good knowledge and understanding of the process and MCA legal framework.

Staff were able to describe how they would support people with decisions and consent. However, we observed the staff did not always support people with making decisions appropriately. For example, we observed one person expressed they did not want to participate in an activity. Staff responded to them with “I’m not going to ring [relative], I'm telling you”. On a second occasion we observed when a person requested support to contact their relative, staff responded “not now, we’ll call tomorrow”. Staff did not ensure people were provided with a person-centred approach and supported with their choices and needs.