About the service:

Wisteria Lodge is a care home. People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were 27 people aged over 65 living at the home.

The service had a manager who is registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

People’s experience of using this service:

• People felt safe and well-supported living at Wisteria Lodge, with management having put systems in place to train and make sure staff knew how to safeguard people. The management had also made sure the premises were safe for people; with systems to ensure equipment was tested, fire safety maintained and other risks minimised.

• People’s needs were met because there were enough staff deployed throughout the day and night. Staff had been recruited robustly with all required checks carried out and records in place.

• People’s medicines were managed safely and overall, infection control measures in place were effective in minimising the risks of cross infection.

• Staff had been trained appropriately and they were supported through supervision by management.

• The service respected people’s right to be involved in decisions about their care. They had followed the Mental Capacity Act 2005 in circumstances where people could not make specific decisions or there was a potential deprivation of a person’s liberty.

• The home provided a good standard of food to meet people’s individual dietary needs.

• Assessments of people’s needs had been carried out and care plans put in place. The service was in the process of moving to an electronic recording system. There were some lessons to be learnt in this process that management were addressing.

• Everyone involved in informing us about the service were very happy with the care provided. Staff were kind and considerate and respected people’s dignity.

• The registered manager was stepping down from this role at the time of this inspection and were in the process of handing over responsibility to a new manager. Overall, there was good management of the home, clear leadership and a positive morale amongst the staff.

Rating at last inspection:

The home was last inspected in July 2016 and was rated as Good.

Why we inspected: This was a planned, unannounced, comprehensive inspection.

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Wisteria Lodge is registered to provide nursing care for up to 30 people.

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 2008 and associated Regulations about how the service is run.

People using the service and their relatives said they felt safe and protected by the staff when they provided care and support. Risks to people were carefully assessed and appropriate actions were taken to minimise potential harm. Systems were in place to monitor environmental health and safety issues.

Staff were fully aware of their responsibilities to keep people safe and showed a genuine commitment to protecting people from any abuse. Appropriate systems were in place to report any safeguarding incidents. Accidents and other significant incidents were closely monitored and actions were taken to minimise the risk of further accidents.

Staff were trained and monitored to ensure people were supported to take their medicines safely.

There were sufficient staff deployed to keep people safe from harm, and to identify and report any safety issues. Staff recruitment systems were thorough, and protected people from the risks of unsuitable workers being employed.

People told us they felt the staff team had the skills and experience needed to meet their needs effectively. There was a strong commitment to staff training. Staff received good induction and on-going training in all relevant areas. Any training needed to meet the individual needs of people using the service was identified and carried out promptly.

Staff were given good support to carry out their roles and responsibilities, and were given regular supervision and performance appraisal by the management team. Staff told us they took pride in their work and felt valued and respected.

The service protected the rights of people who lacked the mental capacity to make significant decisions about their lives. Any decisions made about such issues were taken in their ‘best interests’. Decisions were taken in conjunction with the person, their families and involved professionals and followed a careful assessment of the person’s capacity.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005. These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom. We saw the provider had submitted appropriate applications to the local authority for authorisation to place restrictions on certain people’s movement, in their best interests to protect them from harm.

People were routinely asked for their consent before any staff carried out tasks for them. They told us staff respected any decision by them to refuse such interventions. People were also asked to give written consent to significant areas of the care, such as having their medicines administered.

Care was taken to make sure people’s nutritional needs were fully understood and met.

People told us they were very well cared for, and they were always treated with respect and courtesy. Relatives we asked confirmed this. They said their privacy and dignity were respected at all times, and they were consulted about their care and given the necessary information to make decisions. We observed staff members were pleasant, sensitive and caring in all their approaches and interactions with people. People were encouraged and supported to be as independent as possible. We noted staff had been trained in equality and diversity issues and saw no evidence of any discriminatory practices.

People and their families were fully involved in the assessment of their needs, and their wishes and preferences about their care were sought and recorded. Detailed, person-centred ca

During our visit we spoke with four people who were using the service, three members of staff and the manager. People who use the service told us that they liked living at the home and that the service met their needs.

We spoke with an external professionals who was visiting the home at the time of our inspection. They stated that they had no concerns about how people's health and care needs were met.

People told us that they were involved in decision making and the staff would ask them if they required support and respected their decisions. People told us they were always offered choice giving examples such as meals, drinks, what time they would like to wake up. People told us they could choose to live how they liked and the staff respected their wishes.

We saw that people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

Staff had received safeguarding training and were able to say what action they would take if concerns were raised or observed.

Staff told us that they had received regular training and that they felt that they were supported to carry out their roles and meet the needs of people who used the service.

We saw that regular audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Wisteria Lodge is a home for older people and they are registered for up to 19 people. On the day we inspected there were 17 people living at the home many of whom had memory impairment. During our inspection we spoke with four staff and five people who use the service.

As not everyone who lived at Wisteria Lodge was able to tell us what they thought about the care and support provided, we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spent time in their company in the communal areas observing the support people received before, during and after their meal. We saw that the staff were friendly and respectful and that they were quick to respond if anyone appeared unhappy or distressed. We observed people receiving assistance and support in a timely manner and people were spoken to in a respectful manner.

In the afternoon we spoke with people in their rooms about the building works that were taking place and life in the home. Some people were aware of the building works as they were happening outside their room, they said “It is a droning noise, but I have got used to it”. They said that the home was “As good as you could expect, the food is nice but I don’t eat much, I enjoy what I have”.

Comments from staff included “It is lovely working here; we work hard to make people’s lives alright”.

We carried out an inspection on 30 April 2012 to review the progress the provider had made in taking action to be compliant in the areas where we had assessed them as non complaint or needing improvement. We identified concerns with how the provider was maintaining records for the care and treatment of people who lived at Wisteria Lodge.

We carried out an inspection on 24 July 2012 to review the progress the provider had made in taking action to be compliant in the area where we had assessed them as non compliant.

During our visit we spoke with two people who live at the home, three staff and the manager. People told us that they had been asked about their care and remembered reading their care plans; they told us that they had been able to say if they agreed with them and had been able to ask questions.

We carried out an inspection in November 2011 as part of our routine schedule of planned reviews. We identified concerns in relation to care planning, risk assessments and safeguarding of people. We made compliance and improvement actions asking the provider to take action in order that we were reassured that people were in receipt of safe and adequate care.

We carried out an inspection on 30 April 2012 to review the progress the provider had made in taking action to be compliant in the areas where we had assessed them as non compliant or needing improvement.

During our visit we spoke with five people who live at the home, two visitors, three staff and the manager. People told us that they were happy at the home; it was easy for them to move about the home if they were able and access facilities such as the lounges and dining room. They said they were able to give their opinion, for example about the food and they felt they were respected and heard.

Staff we met on the day told us about the training they had attended since our last visit and of the changes that had taken place in the care plans.

During our visit we spoke with three people who live at the home, four visitors, five staff and a director. We observed interactions between staff and people using the service in the dining area and lounges.

We observed lunch being served and how staff interacted with people and ensured they had a choice of meal. Visitors told us that they were happy with the care and that staff were very friendly, “ten out of ten”.

Staff told us that they received regular training, are supported by the management of the home and that they can speak with senior staff about any concerns they have about the running of the home.