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 requires improvement. At this assessment the rating has remained 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 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. Information relating to people’s health and care needs had improved and care plans had been reviewed, with a variety of professionals involved in providing guidance. We found that care plans, despite being reviewed, still required changes to ensure they were fully up to date and reflective of people’s needs. For example, 1 person’s frequency of pressure relief was not updated in line with the latest information provided by the district nurse. Care plans required further strengthening to ensure specific information was easily accessible and staff had full awareness of the guidance to deliver care consistently.

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.

Improvements were made in how people’s eating and drinking needs were supported, with staff awareness significantly increased. Staff were able to provide specific information about people’s needs when asked, and records relating to food and fluid matched the required consistency. Care plans had been reviewed and now included clear details on thickener levels, and mobile apps used by staff had been updated to reflect correct guidance. Staff also demonstrated awareness of appropriate equipment and positioning, and food was ordered in the correct consistency following previous concerns.

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.

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. Outcomes were recorded with more detail, and improvements had been seen in documenting what mattered to people and their goals. Care plans reflected progress, and staff were more aware of people’s preferences and achievements. However, further work was needed to strengthen and embed these improvements into practice to ensure records consistently demonstrated that people had experienced their goals and outcomes. People told us about the positive things they were doing which they enjoyed and how they were involved in various festive activities. Staff told us of the events planned for Christmas, including a big dinner for people and their families to attend. Staff said, “We try to make it homely here.”

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Improvements were planned in relation to the Mental Capacity Act (MCA), and some work had already been completed on mental capacity assessments. Staff were trained in MCA and understood their roles in gaining consent, and where required, deprivation of liberty safeguards (DoLS) authorisations had been applied for and followed up. Capacity had been considered for some areas, and best interest decisions, such as those relating to video monitoring, were in place. However, other decisions still needed to be considered, for example where people used lap belts on equipment, to ensure these reflected people’s best interests. The provider acknowledged this and included further work on MCA documentation and decision-making within their improvement plan.