Welham 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

We identified breaches in relation to people’s needs being assessed. People’s risk assessments and care plans did not reflect peoples’ current needs. There was a lack of managerial oversight. Staff did not always follow best practice guidance for the management of positive behavioural support.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s relatives told us that in the past they had felt their loved one’s needs had been assessed and needs were well met. There loved one had been at the service for over 7 years. They told us that there had been changes in how their loved one was presenting. They were not aware of any reviews of care plans or new assessments.

Staff said that they knew people at the service well. However, peoples care plans and risk assessments did not support staff to be able to manage peoples needs. The manager and the provider told us that they were planning on reviewing/updating all care plans and risk assessments.

There was no system in place to ensure people’s risks were assessed or reviewed as their needs changed. There was no system to ensure staff had all the information they needed to provide care that met people’s needs.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

People at the service were assumed to have capacity to make decisions about their day to day lives. However, due to having been assessed to not have capacity to make all complex decisions some people at the service had restrictions such as Depravation of Liberty Safeguards (DOLs) and Ministry of Justice restrictions in place.

Not all staff understood the restrictions that were in place due to some peoples lack of capacity or mental health. Peoples care records did not give staff enough information for staff to support them correctly. For example, 1 person had a plan in place that staff were to check the persons electronic devices weekly. The persons care plan and risk assessment did not give staff enough information for them to know what they were checking for. Staff did not always carry out these checks. We did not see any mental capacity assessment to support staff when they were acting in the persons best interests.

The provider failed to have systems to record and maintain records of Deprivation of Liberty Safeguards (DoLS) applications. There were people at the service whose DoLS applications had expired with no evidence that the service had requested a review.