Windsor 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. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (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. Staff assessed people’s needs, wishes and goals. We found personalised, detailed care plans were in place for staff to follow to ensure their needs were met. Monthly care plan reviews had been completed to check if any changes had occurred. A relative told us “The staff know [person] well I can tell because of the content when they talk to me.”

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. For example, we found people who required support with periods of distress had positive behaviour support (PBS) plans in place. PBS is a structured framework used to help people with behavioural support needs, to improve their quality of life. It focuses on understanding the reasons behind the behaviours and developing proactive and preventative strategies to meet the individual's needs, rather than just managing the behaviours themselves. This had been used for one person who had an increased incidents and successfully had a reduction of behaviour incidents. We found the provider worked within the framework called “Stop Over Medication of People” (STOMP) with a learning disability and autistic people. For example, a person was prescribed a psychotropic medicine, as needed. We found in the last 2 months this had been administered twice as staff used other strategies such as PBS and not wanting to use medicines if not required.

The provider worked well across teams and services to support people. They did not always make sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff supported people to attend their health appointments such as annual health check, dentist and optician. A relative told us, “They did go to the optician and reading glasses were suggested but my relative cannot read so doesn't have any glasses.” However, care plans were not always updated to show the person had attended the appointment and their outcomes. This meant there was a risk of not having current and updated records to share with relevant health professionals. The provider took action and told us they will update the records to show the outcomes of the appointments.

The provider had not always 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. We found a person did not always access the community; we were told since covid they had declined. However, daily notes did not demonstrate when the person was offered support to go into the community and we observed when a staff member asked the person to go out during our assessment they said yes and was excited to leave the home. This meant people were at risk of being socially isolated that could impact their mental health. Communication care plans were in place to support people’s preferred communication methods, and we observed these were understood by staff. This meant people were supported to have choice and control. For example, we found for one person’s photo cards and object of reference was used to help them make their choices on what they wanted to eat and drink.

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. For example, there was a care plan review process in place to monitor and record any changes. Goals were set for people to achieve, however, the goals had not always been updated. For example, we found goals planned for 2024 in a person’s care plan. The registered manager told us 2025 goals had been set and were missing from the care plan. Health issues such as weight was monitored monthly to identify any risks or concerns and staff recorded how people’s wellbeing was within their daily records.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The management team understood the Mental Capacity Act. Where consent to care could not be obtained due to a person deemed to lack capacity, the management team had completed mental capacity assessments and best interest decisions. Best interest decisions had been made with people who knew people well, such as relatives. Where people could, they were asked for their consent and were supported to make their own decisions regarding what they wanted to wear or eat. A staff member told us, “We have mental capacity assessments in place for people who cannot consent, the management complete the forms. We still ask for consent to be respectful." They did have choices on how they wanted to fill their time at home.