Somerset 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 had care plans and personalised support plans which reflected both their physical and mental health needs. People were involved in the assessment of their needs, and support was provided to maximise their involvement.

Assessments were completed prior to admission to ensure the service was suitable and staff had the information needed to provide safe and effective care and support. A staff member told us, “Staff gather information from relatives and other professionals, so they are aware of people’s individual needs. Staff have daily handovers and staff meetings to ensure all staff are kept up to date with any changes.”

People’s consent was sought, and they were encouraged to make decisions for themselves, which we observed during this inspection.

People’s support plans were focused around promoting quality of life, promoting independence, achieving goals and ensuring they remained in good health. Assessment tools were in place where necessary and completed accurately. People’s nutrition and hydration needs were met. A staff member told us, “We have daily handovers and regular team meetings where we discuss the needs of all people. If we identify any changes in people’s needs, we report these and make sure these changes are discussed with the staff team.”

The provider was proactive in seeking ways to improve people’s experiences. Leaders supported the health and wellbeing of staff, which was confirmed by staff we spoke with.

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-based good practice and standards.

The provider ensured care was centred on what was important to and mattered to each person. People were actively involved in decisions about their care and support, and their views, preferences, and personal goals were clearly reflected within their care plans.

Care plans were person centred, detailed, and regularly reviewed and included information about people’s health conditions, identified risks, communication needs, cultural and religious preferences, and personal routines. Reviews were completed with people and, where appropriate, their relatives or representatives, to ensure care remained responsive to changing needs and circumstances.

Care was delivered in line with current legislation, national guidance, and evidence based good practice. Staff followed recognised clinical and professional frameworks relevant to people’s needs, including mobility support, nutrition and hydration, medicines management, pressure area care, and infection prevention and control. Where specialist advice was required, staff worked proactively with healthcare professionals such as GPs, community nurses, dietitians, and therapists to ensure people received timely and appropriate treatment.

Staff demonstrated a good understanding of best practice standards and how to apply them in daily care; they received training and competency assessments to support safe, effective practice and were kept updated when guidance changed. This ensured care delivery was consistent, safe, and based on the most up to date evidence.

People told us they felt listened to and respected, and staff understood their needs well. People said care was delivered in a way that promoted dignity, independence, and positive outcomes. Records and observations confirmed care and treatment were delivered as planned and in accordance with agreed care strategies.

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 provider worked effectively across staff teams and with external services to ensure people received coordinated, seamless care. Staff communicated well with each other and with professionals from health and social care services to support positive outcomes for people.

Systems were in place to ensure information was shared appropriately and consistently between teams when people accessed different services or experienced transitions, such as moving between care settings or receiving input from specialist services. This meant people and their relatives did not need to repeat information unnecessarily and could be confident that staff understood their needs.

Assessments of people’s needs were completed comprehensively and shared with relevant services in a timely manner, with appropriate consent. This supported continuity of care and reduced the risk of gaps or duplication in support. Care records reflected shared decisions and multidisciplinary input, ensuring care plans remained accurate and responsive.
Staff worked collaboratively, holding regular handovers, meetings, and informal discussions to review people’s progress and ensure continuity. These arrangements supported effective communication about people’s changing needs, risks, and outcomes. Where required, staff worked alongside external professionals such as GP’s and social workers to ensure care and treatment were aligned.

People benefitted from a joined up approach, and there was clear evidence staff understood people’s individual histories, preferences, and needs; this approach helped people feel known, respected, and supported.

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.

The provider ensured people’s physical health was monitored regularly. Staff, leaders and professionals worked closely with people to ensure their psychological wellbeing was reviewed consistently. The provider was proactive in engaging with healthcare services and professionals.

The provider empowered people to maintain good health and wellbeing. Staff and leaders told us how people were encouraged to make positive choices regarding their health and wellbeing. A person told us, “They [staff] take me to the doctors and hospital appointments. They take me for checks at the opticians, and I go to the dentist every 6 months.”

The provider ensured people’s wellbeing was considered by ensuring they had access to meaningful activities and wider community engagement. A person told us, “The staff encourage me to do things for myself. I go to college and I will make my own way, or the staff can also take me. I go out on my own, and if I have an appointment they [staff] will arrange for someone to take me.” Staff documented successful outcomes and celebrated these with people.

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.

The provider had effective systems in place to routinely monitor people’s care and treatment, using this information to continuously improve outcomes. People’s progress was regularly reviewed to ensure care remained effective, responsive, and aligned with both clinical best practice and people’s own expectations.

Staff recorded outcomes within care plans and daily notes, enabling them to track changes in people’s wellbeing, independence, and health status. This included monitoring physical health, emotional wellbeing, risks, and progress towards personal goals. Where improvements or concerns were identified, care plans were updated promptly to reflect the most appropriate support strategies.

Regular reviews were carried out with people and, where appropriate, their relatives. These reviews focused on whether care was achieving the outcomes which mattered most to people, such as maintaining independence, managing symptoms, improving quality of life, and feeling safe and supported. Feedback from people was actively sought and used to inform improvements in care delivery.

The provider also monitored outcomes through audits, quality checks, and outcome measures linked to key areas of care, including medicines management, nutrition and hydration, mobility, and risk management. Findings from these monitoring activities were shared with staff and used to drive learning, improve practice, and reduce variation in care delivery.

Staff worked collaboratively with healthcare professionals to review and adjust care and treatment. This ensured people received timely interventions and benefited from specialist expertise when required. The provider demonstrated a clear focus on achieving positive, consistent outcomes for people.

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

The provider ensured people were informed of their rights around consent; these rights were consistently respected when planning and delivering person centred care and treatment. A person told us, “They [staff] ask for consent to come into my room.” A second person said, “Staff ask for my consent when helping me shower.”

People were supported to understand the care and treatment offered to them, including the reasons for it, potential risks, and alternative options where appropriate. We saw staff took time to explain information in a way people could understand, using clear language and adjusting their communication to meet individual needs. This ensured people were able to make informed decisions about their care.

Consent was sought appropriately before support was provided and was clearly documented within care records. Staff demonstrated a good understanding of consent being an ongoing process, not a one off event, and regularly checked people remained happy with the care being delivered.

People told us they felt respected and involved in decisions about their care; they said staff sought their permission, listened to their views, and supported them to remain as independent as possible. Observations and records confirmed staff consistently respected people’s autonomy and choices.

The provider demonstrated a strong commitment to respecting consent and promoting people’s rights, ensuring care and treatment were delivered lawfully, ethically, and in a person centred way. A relative told us, “They [staff] did let [person] know [they have] a right to consent.”

People’s consent was sought, and they were encouraged to make decisions for themselves, which we observed during this inspection.