The inspection took place on 19 November 2018 and was unannounced. Wisteria House Dementia Care Limited is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Wisteria House Dementia Care Limited accommodates up to 22 people in an older style building. On the day of the inspection 22 people lived at the home. At the last inspectionin 2016 we rated Wisteria House Dementia Care Limited as Outstanding in the areas of caring and well led. At this inspection we found the areas of safe, effective and responsive were also outstanding. The provider, Wisteria House Dementia Care Limited also runs Wisteria House (Plymstock) which was rated as Outstanding at their last inspection in 2018. The provider continues to use their passion and experience to provide outstanding care and ensure people are living their best lives.

Why the service is rated Outstanding

The home's website stated, "My aim for the people living at Wisteria House is to firstly reduce stress and anxiety, by creating a world that is calming, friendly, affectionate and familiar. Then promote choice and control over one’s life that adds meaning and purpose. Introducing activities, stimulation and independence to a level where individual’s can experience living positively with dementia.” The national care homes review website had many positive reviews from relatives of people using the service. Most rated the service as excellent. We saw that people received outstanding care and were supported to have the best quality of life possible.

Wisteria House Dementia Care Limited had achieved a Level 1 (Level 1 being the highest) Butterfly award in January 2018. The Butterfly award is awarded by "Dementia Care Matters" a leading UK organisation inspiring culture change in dementia care across the UK. This was reported as being a tremendous achievement ‘The team demonstrates an approach that is spontaneous, skillful and committed to creating wellbeing with lots of positive social interactions. The team share caring and warm relationships with the people who live at Wisteria House Dementia Care Limited and there is a real sense that the priority is ‘being’ with people.’ We found this to be the case during our inspection and noted that this was the fifth year in a row, showing a long standing commitment and embedded ethos to ensure a high level quality of life. This home and the provider’s other home Wisteria House (Plymstock) are both Level 1 status, making them two out of the eight awarded this level nationally.

There was a full time registered manager supported by two deputies. These deputies worked 12 hour shifts over seven days a week for continuity with a handover day in the week. They also had two days allocated to complete paperwork. They worked closely with people, relatives and the staff team, being visible and working ‘on the floor’. They knew people very well. The registered manager said, “We have time to oversee how people’s needs are being met and are able to take a step back. The people living here give me back more than I give to them. We eat together to create a social event and we all enjoy the ‘family’ atmosphere.” 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.

There was a very detailed daily dependency tool which enabled the provider to plan high staffing levels which supported outings, escorts and quality staff time for people, gave staff time to complete paperwork, organise events and further champion role projects which directly benefitted people and families.

People were living a ful

The inspection took place on 30 January 2016 and was unannounced. Wisteria House Dementia Care Limited provides care and accommodation for up to 22 older people, many of whom are living with dementia. On the day of the inspection 21 people lived at the home with an additional person being admitted during our visit.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

One person said; “This place is unique. They have theme days where staff dress up and if it’s your birthday they make you feel important and always make a cake.” One professional said that of all the care homes they visited this was their favourite.

Wisteria House has achieved a Level 1 (level 1 being the highest) Butterfly award. The Butterfly award is awarded by “Dementia Care Matters” a leading UK organisation inspiring culture change in dementia care across the UK.

People were busy and were enjoying the company of the staff. There was a calm and relaxed atmosphere within the service when we arrived early in the day. As the day went on people were busy and enjoying a wide selection of activities and interaction from the staff. People were encouraged to live active lives and were supported to participate in community life where possible. Activities were meaningful and reflected people’s interests and individual hobbies, for example football.

People, relatives and professionals were happy with the care the staff provided. Everyone spoke about the staff and the care provided as being; “Unique” “Very dedicated” “Very good and very kind.” They agreed staff had the skills and knowledge to meet people’s needs. People were encouraged and supported to make decisions and choices whenever possible in their day to day lives.

People had their privacy and dignity maintained. Staff were observed supporting people with patience and kindness. Compassionate care was really important to the values of the service and was clearly reflected in how staff cared for people. One person said; “Staff do a great job-they do a difficult job well.” A relative said; “Dad is very happy and very safe living here. We are pleased he came here.” People said they were very happy living at the service.

People were protected from harm as staff demonstrated they had the knowledge and skills to recognise and keep people safe from abuse. Staff had safeguarding of vulnerable adults training and had the knowledge on how to report any concerns and what action they would take to protect people.

People were assessed in line with the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguarding (DoLS). People who did not have capacity to make decisions for themselves were supported by staff to make sure their legal rights were protected and staff worked with other professionals in their best interest. The registered manager had sought and acted on advice where they thought people’s freedom was being restricted.

There were sufficient staff on duty at any one time to meet people’s needs safely. People were protected by safe recruitment procedures. Staff were supported with an induction and an ongoing training programme to develop their skills and staff competency was regularly assessed. Staff received training in dementia care to support people living with dementia.

People had their health needs met. People received visits from healthcare professionals, for example GPs and district nurses, to ensure they received appropriate care and treatment to meet their health care needs. Professionals confirmed staff followed the guidance they provided. This ensured people received the care they needed to remain safe and well, for example people had r