Carlton 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.

The service had effective processes in place to ensure people’s needs were assessed in a timely and holistic way. Assessments were completed using a multidisciplinary approach, enabling staff to develop a well‑rounded understanding of each person’s physical, mental, emotional and social needs. People were involved in monthly reviews of their care plans to ensure they remained up to date and reflective of their wishes and preferences.

Changes in people’s needs were communicated effectively to staff who knew them well, ensuring that the support provided remained responsive, consistent and aligned with each person’s individual requirements.

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 registered manager demonstrated a clear understanding of, and effectively implemented, the right support, right care, right culture guidance. Staff were well trained and reported receiving strong support and development to enable them to meet people’s needs effectively. Staff were knowledgeable about national guidance and recommended approaches and focused on delivering individualised, person‑centred care.

There was a comprehensive and ongoing programme of training, which was regularly reviewed and updated in response to people’s changing needs. This included Oliver McGowan training, the government‑recommended training for learning disability and autism, as well as Positive Behaviour Support (PBS). Training was specifically adapted to reflect the needs of the people the service supported, ensuring care was tailored, consistent and delivered by a staff team with the appropriate skills and knowledge.

People were at the centre of decisions about their care and support, including their daily routines and activities. Staff consistently promoted people’s independence, choice and control, supporting them to make decisions about their own lives. People were encouraged to access the community as part of their everyday routines, with a clear focus on promoting a good quality of life for everyone.

The provider understood and followed the principles of STOMP (Stopping Over‑Medication of People with a Learning Disability, Autism or Both). People were supported to be actively involved in regular medication reviews with relevant healthcare professionals, helping to ensure medicines were used appropriately and in line with best practice.

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.

Collaborative working meant people’s long‑term goals, preferences and aspirations were consistently placed at the centre of all decision‑making. Staff, teams, and external professionals worked well together with clear communication and shared goals.

One person had been supported to access an education placement that aligned with their long‑term goals for personal development and independence.

The provider supported people to manage their health and wellbeing in ways that promoted independence, informed choice and improved long‑term outcomes. Staff understood people’s individual health needs and worked with them to develop healthier routines that were realistic, meaningful and aligned with their preferences.

We saw evidence of people engaging in mindfulness and pamper sessions. Staff told us people relaxed during these sessions, enabling them to be open about their feelings, emotions and any concerns they had. This meant issues could be identified early and addressed promptly before they escalated.

People were involved in safe and healthy relationship workshops, which helped them to develop a better understanding of relationships and supported them to make informed decisions.

A wellness hut was being developed in the summerhouse. This would provide a safe, calm and relaxing space away from the main home, further supporting mindfulness activities and promoting people’s overall wellbeing.

A healthy food menu was created for the week, which was agreed and written by the people who lived at the home.

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.

Review meetings were completed to ensure all information was accurate and up to date. People’s long-term goals and achievements were discussed, alongside agreed plans to support progress in ways that suited everyone. For example, one person expressed a wish to go swimming. Staff worked with the person to develop a personalised plan to support this goal, which included identifying the most suitable swimming facility and using a carefully planned, step-by-step approach to prepare for each visit. This ensured the person felt confident, supported and able to access the activity successfully.

Reviews brought together information from daily records, professional input and people’s own views to ensure support plans remained accurate, responsive and person centred. Where changes were identified, staff updated plans promptly and shared new strategies with the wider team to maintain consistency. The management team demonstrated a strong approach to monitoring and improving outcomes. Regular reviews, consistent key worker involvement and a focus on achievable goals ensured people received support that was effective, personalised and aligned with their ongoing development.

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

Staff understood people’s communication plans well and used their preferred methods consistently when seeking consent. Staff demonstrated a clear awareness of how each person expressed agreement, refusal or uncertainty, and they adapted their approach to ensure people were fully involved in decisions about their care.

Communication plans were detailed and person‑centred, outlining the gestures, signs, symbols or verbal cues each individual used. Staff were familiar with these plans and applied them reliably in day‑to‑day practice. Observations throughout the assessment showed staff checking in with people before offering support, explaining what they were doing and waiting for clear indications of consent before proceeding. This included using visual prompts, simple language, or giving people additional time to process information when needed.

The home had easy read documentation available for all interactions with people such as best interest decision and review meetings which ensured people were able to fully be involved in decision making about their care.