Westminster 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.

This is the first assessment for this newly registered service. This key question has been rated 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's health and social needs were assessed before they came to live at Westminster House. This ensured the service could meet the person’s needs and that staff had the necessary training to keep them safe and well.

The provider used an electronic care planning system. This enabled the registered manager and home manager to monitor remotely the care people received.

Care plans were regularly reviewed using the provider’s ‘resident of the day’ system. The home manager confirmed people’s needs would be reviewed if there were any changes.

To help support people with their communication needs, the provider had developed a tailored tool, which included 1 to 1 discussions, observations, reactions and feedback.

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.

Staff knew about people's needs and demonstrated clear person-centred approaches. They viewed people as individuals and discussed the importance of their relationships with people.

A relative told us, “There are very good communications with us, they will phone or text us as soon as anything happens. The home manager is also available when its needed.”

People’s rooms were personalised, some having pictures mounted in their bedroom. A professional said, “The décor of Westminster House is very similar to [person’s] previous home. This supported [person] with their transition between the homes as it was a familiar environment that [person] was comfortable in. [Person] likes their bedroom and has photos of special occasions for him on their walls.”

Staff training was refreshed at regular intervals to maintain their knowledge and skills. Staff responsible for training reviewed training content to ensure it was up to date and in line with current best practice guidance.

Each person had a full and complete initial assessment in place. These were supported with the use of best practice tools and evidenced based practice. For example, the provider supported STOMP (Stopping the Over-Medication of People with Learning Disabilities, Autism or both), an initiative to support the reduction of overuse of psychotropic medication for people with learning disabilities. This ensures that medication is only prescribed for the right reasons, in the right dose, and for the shortest possible time. This practice was supported with the consistent use of positive behaviour support to identify the causes of people’s anxieties to support and reduce them.

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.

Staff told us morale within the team was very good and they worked extremely well together as a team, to meet people's needs. A staff member said, “We are led by people who live here, people do what they want every day.”

Professionals said that the management and staff were effective in information sharing and partnership working. Appropriate and timely referrals were made when needed. Information was shared between teams and services to ensure continuity of care, for example when people are referred between services or people required medical treatment.

One person had experienced a reduction in challenging behaviour because staff had worked closely with medical professionals, social services, and their family. The management team told us how this had positively impacted the individual, enabling them to access the community more—such as attending the leisure centre, shops, parks, and community hubs. This had improved their quality of life and contributed positively to their health and wellbeing.

One professional said, “Consequently, complex persons have presented with significant progress, with a substantial reduction in dangerous behaviours of concern, such as biting others. The persons have also increased engagement on the learning centre and other meaningful activities.” People had hospital passports in place, which shared key information with hospital staff, should they require hospital treatment.

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.

Staff worked closely with the local GP practice ensuring people received consistent, preventative healthcare tailored to their needs. People at risk of malnutrition were supported to maintain safe and consistent diets. Referrals to speech and language therapists were made for those needing assistance with swallowing, and meals were fortified to improve nutritional intake. Staff was knowledgeable about individuals' specific dietary requirements, including allergies and preferences.

Mealtimes were an extremely positive experience; people were supported in a calm environment, warm, friendly environment. We observed staff to be patient, kneeling at eye level when talking with people and reassuring when assisting people with their meals.

People were supported to eat healthily. There was a weekly menu in place with options chosen based on people’s choices and favourites. Staff told us that people could eat when they wished but that they often enjoyed meals communally.

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.

Regular care plan reviews enabled the management team to have full oversight of the health and social care needs of all people. People and their relatives were involved as partners in their care and supported to maintain their independence around decision making.

Outcomes of people’s health and well-being were monitored by staff. Care plans, risk assessments were consistently reviewed and updated to reflect people’s changing needs and to ensure that safe and effective support continued. Training, effective communication and information sharing to and between staff meant they were clear on the standard of care expected from the provider.

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

The management team had ensured they were working within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.

We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty; CQC had been made aware of these via statutory notifications.

Staff used detailed communication plans as guidance, as well as communication tools, such as PECS, (Picture exchange communication system) so that people’s needs and wishes could be expressed.

Where people did not have the capacity to make certain decisions, appropriate assessments had been carried out, with decisions made in conjunction with those involved in the care, such as family members or health professionals, so that decisions could be made in their best interests.