Wytham 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 63 (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 had systems in place to assess people’s needs, however, they were not robust and did not always ensure care plans and risk assessments were updated regularly.

Although there were care plans and some risk assessments in place, they were not fully reflective of people’s needs. For example, risk assessments were not always reflective of people’s mobility needs, they did not provide guidance on what support was needed with people’s mobility or what equipment they used. Assessments did not always cover the risk to oral care, pressure care concerns, medical diagnosis, or behaviours. Information about people’s needs was not always consistent throughout care plans. This meant staff did not have enough information to support the person safely.

Staff knew people and their needs well, they were updated within changes to people’s care needs explained how they would seek support from external services where people’s needs changed.

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.

There were meal choices at lunch time and people were shown alternatives before making their selections. One relative told us, “The food is so much better, and [person] gets the correct food here.”

During the inspection we observed limited drinks being offered throughout the day. Some care plans contained details about people’s likes and dislikes around foods with good information about how to support them.

People were referred to appropriate services when required. Nationally recognised tools were used to ensure people were supported correctly with their eating and drinking needs. The chef was experienced and demonstrated a passion and a good knowledge of the people’s dietary needs as well as their likes and dislikes.

The provider worked well across teams and services to support people. There were processes in place to ensure staff worked well together.

Relatives told us they were kept updated about their loved ones changing health needs.

The home carried out team meetings, handovers were being carried out and the provider worked closely with external health professionals.

Although some staff told us about workload being difficult with staffing at time, we heard the team worked well together. Staff told us, “We have seniors who support on many occasions” and “Carers listen and respond positively, my colleagues are very supportive.”

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.

People were supported to access health care professionals when they needed them and received ongoing care from healthcare professionals. There was a regular GP round, and professionals told us staff were organised and proactive.

Physical activities were carried out by the service, we heard from one relative, “I came and enjoyed the athletics yesterday, I saw that all the staff enjoyed themselves and most of the residents loved it too.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. The service did not ensure people’s care plans were updated to reflect changes in their care needs. This made it difficult to monitor outcomes.

People’s care was monitored weekly within clinical meetings to ensure there was oversight of people’s clinical needs. There was limited detail documented about action required, or who was responsible for the action, in order to direct staff to ensure positive outcomes were achieved. Clinical audits did not always capture incidents, and did not always pick up on missing actions. This meant there were some cases where incidents were not always investigated in a timely manner.

There were good wound plans in place and staff were aware of peoples changing needs.

Relatives we spoke with felt they had not had to raise concerns about safety or incidents and reported positive outcomes since moving to the home. One relative told us how staff were proactive at ensuring their loved one was seen quickly when unwell. We also heard, “We are so pleased that the GP here is the one we knew before- everything is so much better here [person] is physically much better now.”

The provider respected people’s rights when delivering care and treatment. However, information about people’s capacity was not always consistent within people’s care planning documentation and did not always evidence who had Lasting Power of Attorney, or how decisions had been made. However, there was a clear understanding of the Deprivation of Liberty Safeguards (DoLS) and this was only used when it is in the best interest of the person.

There were some practices seen on the day where language around supporting people, did not always consider the person, however, staff we spoke with understood the importance of obtaining consent before they delivered care or treatment.

Staff provided examples of how they would support people with dementia and demonstrated empathy and understanding. Staff told us, “I give people lots of different questions to people who are non-verbal, for example, until we get it right. You need to be proactive and responsive to anticipate people’s needs. We know people well. I always try to put myself in the person’s position, I use patience to understand people, although they may not be able to communicate effectively, they can listen, I always apply empathy.”