Wyndham House Care

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. The service was in breach of legal regulation in relation to fit and proper persons employed.

This service scored 46 (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. The provider had not fully assessed people’s changing health needs, which meant people did not get the right support promptly. For example, one person’s fluid and nutrition record showed they were hardly eating or drinking, but we found no evidence the provider had put measures in place to support better nutrition and hydration. Staff told us changes were not always communicated to them. A staff member told us. “When we have noticed changes in people and reported them to the seniors, we don’t always get feedback on what measures have been taken.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. The senior support workers showed good knowledge of people’s needs, and we saw that staff recorded changes in people’s health and abilities. One family member told us, “Yes, their [relative] health is looked after very well. If anything, they will be on the phone letting me know”. We saw that people’s care plans had been reviewed, but records showed inconsistencies in documented diagnoses and care needs. Care plans referenced clinical conditions that staff were expected to manage, but without sufficient guidance. This meant staff could not always be confident they were delivering care in line with the best available evidence.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. We saw the provider sent referrals to external providers. However, one person’s referral was over 4 months old, and we could not see evidence that the provider had followed up, and their care plan had not been updated. An external professional told us, “They [Provider] call us regularly. They do their best to support people.” The service had established contact with a local district nursing team for routine support, but wider multi-disciplinary working was inconsistent. Referrals were not always timely, and outcomes were not routinely recorded in care plans to ensure continuity of care.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or, where possible, reduce their future needs for care and support. Daily records reviewed consistently showed people did not receive sufficient fluid and nutrition, in line with levels set by the provider. One relative told us, “Yes, they [relative] do get a choice of food, as they tend to know what they like. We found the garden space was not readily available for daily access by people, and most access tended to be around planned activities within the home. We observed good interaction with people during lunch time, and staff offered people choice.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. People’s changing needs were not consistently managed, and care plans were not always updated to reflect changing needs. For example, one person with a high risk of pressure sores identified by the provider had no reposition schedule for daytime sitting, and no record of a pressure cushion for their chair.

The provider did not always tell people about their rights regarding consent and did not always respect their rights when delivering care and treatment. The provider had failed to adhere to the Mental Capacity Act 2005, and legal consent for the care and treatment delivered was not consistently in place. Although the provider completed Mental Capacity Assessments (MCAs) for people, we could not see any input from anyone other than the assessor, and best interest decisions were not always clearly stated; we could not see if people had consented to care and treatment or lacked capacity. One family member told us, “They [the provider] sometimes call us for big decisions. But most of the time we have to ask when we visit.” The provider had a Facebook page where they celebrated events for people and staff. However, we could not see that people’s consent had been sought for such publication.