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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (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 lacked robust information. For example, 1 person’s care plan did not contain details about what is important to them or their capacity to consent to their care and support.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. We could not be assured staff delivered evidenced based care and support, due to a lack of detail in people's care records. For example, 1 person was advised to have bed rest to alleviate oedema symptoms, and this information was not in their care plan. Another person had been advised by professionals to have thickened fluids to reduce their risks of choking, their care plan did not contain enough information relating to which level of thickener was required and mobile apps which staff used as guidance, contained the wrong information.

The provider did not always work well across teams and services to support people. People were visited by a GP and district nurses regularly, and records evidenced involvement with a range of professionals, including advocates, social workers, community learning disability and SALT teams. However, we could not be assured staff always acted upon their advice, due to a lack of detail in people’s care plans and daily records. We found 1 person’s record contained conflicting information about SALT’s advice to cut up their food, to reduce their risk of choking.

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. Whilst records evidenced some external healthcare input, care records lacked detail about how staff safely supported people, in line with their assessed needs. We found some delays in accessing medical care and some care not to have been carried out, such as repositioning. We also found concerns relating to IPC and managing medicines.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. Care records lacked detail about people's future goals and aspirations. It could not be evidenced what was in place to obtain people's goals and wishes, and how they would achieve them. However, people told us they enjoyed a range of activities, such as attending day centres, playing golf, cinema trips, and going shopping in town. A person said, “We go to ladies’ group on Tuesday and [name] going to the disco this week, at a community centre. We go out together, we go to town. I am happy, no moans, it is nice and quiet.” Relatives told us they were involved in reviews and care planning. A relative said, “I am always advised if there are changes to the care plan and I am asked for my opinion on the changes. We all get together, me, my loved one, the manager and the keyworker, and review the previous year and any changes to the care plan to make sure that the changes are of a benefit.”

Staff were trained in relation to the Mental Capacity Act (MCA) and understood their roles to gain consent from people. People had their capacity assessed and where required deprivation of liberty safeguards (DoLS) authorisations were applied for. However, care plans lacked detail about people's capacity, for example 1 person’s care plan stated they had no needs in relation to capacity, this person lacked capacity and had a DoLS authorisation in place. Where people required a best interest decision, such as for video monitoring, this was in place.