This inspection took place on 28 February 2018 and was unannounced.

This was the second comprehensive inspection carried out at Wisteria House Residential Home - Rutland. At the last inspection the service was rated as Good. At this inspection we found there were areas that required improvement.

Wisteria House Residential Home 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. The care home accommodates up to 17 people in one adapted building. On the day of our visit, there were 16 people using the service.

The service had a registered manager. 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 and associated Regulations about how the service is run.

The provider had not ensured that people were always protected from health and safety risks associated with accessing areas such as the kitchen and laundry; or ensured there were adequate systems in place with the closure of fire doors.

There was a very positive culture within the home where staff communicated well and people’s needs were met.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. Risk assessments were in place and were reviewed regularly; people received their care as planned to mitigate their assessed risks.

Staffing levels ensured that people's care and support needs were safely met. Safe recruitment processes were in place. People received care from staff that had received training and support to carry out their roles. People were supported to have enough to eat and drink to maintain their health and well-being.

People were supported to access relevant health and social care professionals. There were systems in place to manage medicines in a safe way.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA). Staff gained people's consent before providing personal care. People were involved in the planning of their care which was person centred and updated regularly.

People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

People were supported to express themselves, their views were acknowledged and acted upon and care and support was delivered in the way that people chose and preferred.

People using the service and their relatives knew how to raise a concern or make a complaint. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

At this inspection we found that Wisteria House Residential Home - Rutland were in breach of two regulations relating to the health and safety of the home.

The inspection took place on 23 November 2015 and was unannounced. At our last inspection on 10 October 2013 the service was meeting the regulations in force at the time.

Wisteria House Residential Home – Rutland provides care and support for older people. The service can accommodate a maximum of 13 people. At the time of our inspection 10 people were using the service.

There is a registered manager at the service. 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.

People felt safe at the service and were happy with the care and support they received. People told us they were able to do the things that they wanted to do and where they were able to they could access the community independently when they chose to do so.

People were treated with dignity and respect. People were supported by staff who understood their needs and knew about people’s likes, dislikes and preferences. There were enough staff to keep people safe and meet their needs.

Staff had a good understanding of the various types and knew how to report any safeguarding concerns. Staff received a thorough induction and regular training to ensure that they had the right knowledge to understand and meet people’s needs. Staff did not always receive regular supervisions or have regular staff meetings to ensure that they were supported effectively within their roles.

People’s medicines were managed safely and people were supported to access healthcare services as required.

The registered manager and deputy manager had a good understanding of the Mental Capacity Act 2005 and knew how and when they would need to use it.

People were supported to maintain a balanced diet. They were complimentary about the food and enjoyed mealtimes. People were able to choose where they ate their meals.

People’s care needs were assessed and care plans were developed with people and their relatives where appropriate to ensure that people’s needs were met. Where risks associated with people’s care had been identified risk assessments had been carried out and control measures to reduce the risks had been put in place. These were regularly reviewed.

The registered manager and staff members had a consistent understanding of the services visions and aims. The service provided a homely environment for people where they were able to do the things that they wanted to do and enjoy things that were important to them.

The provider had procedures for the monitoring of the quality of the service. These included holding meetings with people that used the service and sending out annual quality assurance questionnaires.

We spoke with three people who used the service. They told us they liked living at Wisteria House. One person said "I think this is the best care home. Its exceptional". People told us they had confidence in the registered manager and in the staff. Interactions between staff and people who used the service where positive and respectful. People were occupied and engaged in meaningful activities. The atmosphere was relaxed and homely. People had choice and autonomy to make decisions.

Care and support was delivered in a person centred way. This meant that people's preferences and individual needs were respected. The registered manager communicated with and consulted with people who used the service on a daily basis. Staff recruitment procedures ensured that staff were only employed following pre employment checks. This minimised risk for people who used the service.

People told us they enjoyed the meals provided. All the meals were home cooked. The cook ensured that the menu reflected the needs and preferences of people who used the service.

We spoke with five people who used the service. Everyone spoken with told us they were very satisfied with the service they received. One person said 'the staff treat me very well, I like them. Another person said 'I don't think it could be better'.