Wilton House

Updated 13 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 16 and 19 November 2018 and was unannounced.

It was carried out by one adult social care inspector.

The provider had completed a Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We spoke with other health and social care professionals and looked at other information we held about the service before the inspection visit.

Some people who lived at the home were unable to verbally express their views to us. We therefore used our observations of care and discussions with staff to help us form our judgements. We spoke with two people who used the service and spent time with others carrying out observations. We spoke with six staff as well as, the registered manager, deputy manager and area manager. We also spoke with three relatives. We received feedback from two health care professionals.

We looked at three people’s care records. We also looked at three staff files, information received from the provider, staff rotas, quality assurance audits, staff training records, the complements and complaints system, medicines records, health and safety records and a selection of the provider’s policies.

During the inspection we asked for further information including quality assurance documents to be emailed to us. We received all of this information in the time scales given.

Updated 13 February 2019

This inspection took place on 16 and 19 November 2018 and was unannounced.

Wilton House is situated close to Taunton town centre. The home can accommodate up to 12 people and it specialises in providing care to adults who have a learning disability and concurrent physical disability. Twelve people were living in the home at the time of the inspection.

The care service has been developed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the time of the inspection there was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection we rated the service good with one domain outstanding. At this inspection we found the evidence had improved with two domains rated outstanding this meant the overall rating for the service moved to outstanding.

The registered manager and staff went above and beyond what was expected of them to ensure people received care and support in a caring, respectful and dignified way. Even with limited verbal communication people could express an opinion about the care provided and contributed to their care plans.

People received responsive care and support which was personalised to their individual needs and wishes. Staff were innovative in finding ways to improve people’s lives and help them to achieve their goals and expectations. People were supported to live meaningful and active lives with staff emphasising what people could do not what they could not do. Staff were passionate about ensuring people continued to have a say about the way they were supported and the activities they took part in. People enjoyed a variety of activities which included joining in at local clubs and going on holiday.

Staff used and explored innovative ways to assist people to express their views and enhance their ability to communicate. The provider employed an assistive technology development manager who provided support and training to staff and people who lived at the home.

People indicated they felt safe living at Wilton House. One relative told us, “[The person] is really safe living here, the staff are brilliant and very well trained, but above all they really care about the residents.”

There were processes and practices in place to keep people safe. The provider had a robust recruitment programme which meant all new staff were checked to ensure they were suitable to work with vulnerable people. All staff had received training in safeguarding vulnerable people. All staff spoken to were able to tell us what they would look for and how they would report anything they thought put people at risk of harm or abuse.

People received effective care and support from staff who had the skills and knowledge to meet their needs. All staff attended an induction which included the companies’ mandatory training before they started to work with people. The in-house induction was focused on people’s specific needs and the way they preferred to live. Staff also received training about specialist needs people had for example, the safe management of epilepsy.

People were supported by a team that was well led. Everybody spoken to said they thought the service was well led. Staff, relatives and health professionals spoke highly of the registered manager. They all said they were open, approachable and honest. The registered manager was passionate about making people’s lives meaningful and different; this was reflected by all the staff we spoke to. During the inspection we noted that the registered manager always spoke with people when they passed her or she passed them.

There were systems in place to monitor the quality of the service, ensure staff kept up to date with good practice and to seek people’s views. Records showed the service responded to concerns and complaints and learnt from the issues raised. The provider learnt from issues raised at CQC inspections at other services in the organisation and shared them with the registered managers to ensure improvement was ongoing and cascaded through the organisation. The registered manager closely monitored the progress being made in the home with the adoption of the new working practices and kept staff informed.

Further information is in the detailed findings below