The Porthouse

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 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.

Family members reported being actively involved in the care of their relatives, explaining that they received regular updates via phone, email, and in-person visits. They felt well informed and able to raise any queries. People’s care plans were up to date and regularly reviewed, with input from family members and the staff team.

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.

People’s food choices were respected, including what, and where they wished to eat. We observed individuals going out for a meal and purchasing takeaway food for a housemate in line with their preferences. A family member commented, “The variety [of food being provided by the service] is good, healthy, and home-cooked.”

Care plans included detailed information about the support required at mealtimes, outlining what people could do independently, their meal preferences, and any food intolerances. Staff demonstrated a good understanding of individuals’ dietary needs and confirmed these were consistently followed in practice.

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.

Processes were in place to support effective communication within the staff team. This included regular team meetings to discuss individuals’ needs, as well as key topics such as safeguarding and training.

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.

The service worked in partnership with a range of healthcare professionals to support individuals effectively. This included involvement from a psychiatrist, behaviour specialist, occupational therapist, and GP, ensuring that people received appropriate and targeted support for their health and care needs.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

People provided positive feedback about living at the service. One person described it as “home,” reflecting a strong sense of comfort, belonging, and satisfaction with their environment. A family member further endorsed the quality of care, stating, “Yes, [my relative] receives excellent care” demonstrating confidence in the service’s standards and support.

The service provision was outcome-focused and aimed at achieving meaningful, long-term improvements through a person-centred approach. The registered manager told us they took great pride in celebrating each individual’s journey, ensuring that achievements, ranging from small daily progress to significant life milestones, were recognised and built upon.

Through a well-planned and proactive positive risk-taking approach, one person was successfully supported to achieve a significant milestone, undertaking their first holiday despite known challenges with unfamiliar environments and health risks. Comprehensive preparation, robust risk assessments, and a strongly person-centred approach enabled a safe, enjoyable, and confidence-building experience, marking a transformative moment in their wellbeing. This achievement has led to sustained progress, with further holidays successfully completed and plans underway for future travel, including the aspiration of an overseas trip.

A tailored, individualised approach successfully supported another individual to increase their motivation and engagement in physical activity, positively improving their overall health and wellbeing. Through gradual progression and achievable goals, they built confidence and went on to exceed expectations by completing a structured walking challenge, with their achievement recognised and celebrated. This has led to sustained, meaningful outcomes, with the individual now enjoying regular walks and demonstrating increased confidence, motivation, and a proactive approach to their wellbeing.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

We found that the service had failed to follow the MCA as required to support people in the decision-making process. Mental Capacity Assessments and Best Interest decisions were not always completed to evidence decisions regarding restrictions, particularly in relation to blanket restrictions. The failure to undertake Mental Capacity Assessments and Best Interest decisions resulted in a lack of oversight of the restrictions in place, meaning the provider could not be assured restrictions were proportionate or the least restrictive options. In addition, without appropriate Mental Capacity Assessments and Best Interest processes, restrictions were not subject to regular review to consider whether they could be reduced.

This meant that restrictions were imposed on individuals within their own homes without the necessary legal authorisation. This constitutes a breach of Regulation 11, as the provider failed to ensure that decisions made on behalf of individuals were appropriately recorded and evidenced in line with the MCA.