Wisteria Lodge

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 92 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider demonstrated an exceptional approach to assessing people’s needs before support began. Assessments were thorough, holistic and personalised, reflecting people’s background, communication preferences, strengths and goals. The team gathered detailed information from people, relatives and external professionals, including specialist teams who were involved in people’s care. Where previous placements had not been successful, staff explored what had not worked and what was important to the person, using this insight to inform their approach. This had a significant impact on people’s outcomes. The clinical manager described several successful admissions for people whose previous placements had broken down, which was confirmed by relatives.For example, 1 relative said, “[Person] had already been admitted to 6 other homes but had moved out without ever spending a night. Wisteria’s first success therefore was in facilitating her to stay for 1 night.”

There was a proactive approach to assessing people’s needs, using a range of nationally recognised assessment tools. This enabled staff to identify and manage risks effectively, including those associated with choking, weight loss and skin integrity. Following assessment, appropriate interventions were implemented to achieve positive outcomes. For example, 1 person was admitted to the service with pressure damage, causing them pain and affecting their well-being. Staff worked collaboratively with the person to increase their understanding of how they could promote healing and encouraged them to take an active role in their care. This approach was highly effective, with the person’s pressure damage healing within 2 weeks of their admission to the service.

People remained at the heart of ongoing reviews of their needs. Reviews were scheduled and considered all aspects of people’s care and support, including risks, well-being, personal goals and wishes. People consistently told us they were actively involved. One person said, “I am involved in all this. On [set day of the month] there is a review, [staff] ask me if I have any updates, if I’m happy with everything or have any concerns.” This demonstrated that people were empowered to influence and shape the support they received.

Care plans provided a comprehensive overview of the person’s needs, progress, preferences and any changes required.This meant care remained responsive and met people’s needs as they changed. Effective processes meant staff were kept up to date about people’s changing needs. Staff were positive about these approaches and demonstrated an in-depth knowledge of people’s needs.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

Evidence-based practice was consistently embedded within the delivery of care. Staff used recognised assessment tools and clinical guidance, alongside their knowledge of each person, to ensure care was informed by best practice and tailored to individual needs. This was demonstrated through support provided, including areas such as nutrition, dementia care and end-of-life care.

The provider had recently been re-accredited for the Gold Standards Framework (GSF) Quality Hallmark Award. The GSF is a nationally recognised approach to delivering best practice in end-of-life care. The home had achieved ‘Platinum Status’, recognising sustained excellence in embedding and maintaining GSF principles over time, demonstrating the provider’s commitment to high-quality end of life care and the positive outcomes achieved for people. The home had also been nominated for the GSF Care Home of the Year Award.

The providers ‘Food First’ strategy based on training from a specialist nutrition team improved nutritional outcomes through personalised food adaptations. Records demonstrated this had positive results and people’s weights had increased without the use of supplements. Where people were at risk of choking, the provider took proactive steps to ensure staff had the knowledge needed to support them safely. When staff identified delays in accessing external Speech and Language Therapy (SaLT) assessments, the provider arranged training for staff members so they could develop the skills to better understand and manage people’s individual swallowing needs. This knowledge, combined with staff’s in depth understanding of each person, enabled people to receive appropriately modified diets while maintaining choice and enjoyment of food.This had a highly positive impact for people. For example, 1 person had been supported safely to increase the level of consistency of their food, improving their enjoyment of meals and supporting their nutritional intake.

People and relatives told us people received a highly responsive and personalised approach to nutrition. One person told us “Staff have orderedspecial food in just for me, like continental meats. Nothing is too much trouble; I’ve just got to ask.” Relatives explained how staff had worked hard to understand their family members’ preferences and identify foods that encouraged them to eat. One told us,“[Staff have been fantastic to work out what she can and will eat” and another said, “Even his pureed food is presented beautifully.”

The provider had undertaken a dementia project which focused on enhancing the experience and quality of life for people with dementia. This included ‘dementia days’ where the focus was on meaningful occupation and resulted in increased wellbeing for people. They had also piloted a ‘traffic light’ system in partnership with the Older People’s Mental Health team to recognise any changes early and enabled staff to understand and manage distressed emotions proactively. This had very positive outcomes for people and resulted in a reduction in distress and also reduced the need for anxiety reducing medicines.

Managers attended meetings with other services. These meetings provided an opportunity to discuss best practice, share experiences, review regulatory updates and explore clinical developments with a view to ensuring any learning was embedded across the service. Information was then cascaded to staff, through meetings, supervisions, handovers, competency assessments and training.

The provider worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The provider maintained close partnerships with community-based health and social care professionals. These relationships ensured that staff received timely specialist advice and could anticipate needs early. A health care professional confirmed the quality of their partnership working with the care home and said, “I have had the pleasure to be in weekly contact with the very caring and professional staff at Wisteria Lodge. I always find the staff friendly, approachable and aware of any issues the residents may have. I hope to continue to work closely with the staff and care for the patients into the future. Well done Wisteria keep up the great work you all do.”

Exceptional partnership working enabled staff to combine their knowledge of people with specialist expertise to develop personalised solutions that improved people’s safety, comfort, independence and quality of life. For example, staff worked with an occupational therapist (OT) to identify equipment for 1 person who bruised easily due to a health condition. This reduced the need for physical contact during support, preventing bruising and improving their comfort and safety. For another person, who had become isolated and unhappy in a previous care home, staff and the OT introduced a specialist chair that enabled them to eat with others and participate in activities. This improved their social inclusion and well-being. A staff member told us,“I still remember his smile.” A third person had been admitted to the home with severe wounds and the service worked with a Tissue Viability Nurse and GP to heal these, and partnership working with a GP had meant changes in another person’s medicines which had led to a reduction in falls for them.

Staff described highly effective teamwork and were complimentary about each other. The provider had won ‘Care Team of the Year’ at the National Care Awards in 2025. We saw testimonials by healthcare professionals and relatives supporting the award due to the high standard of care people received. The registered manager told us, “We took some of our care staff to the awards event so they could take part, understand the value of their work and feel proud of it. This has had a lasting effect: the team recognise they hold a standard to maintain, which has reinforced their motivation and pride, and that consistency feeds directly into the quality and continuity of care residents receive.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Managers and staff assessed and planned for each person’s health care needs which was recorded in their care plan. People’s health was optimised due to the individualised approach staff took with people. Staff knew when people were unwell or in pain and ensured they routinely attended scheduled medical and hospital appointments. Any changes in people’s health were acted on promptly.

Care plans were focused on promoting good nutrition, mobility, hydration and wellbeing. This reflected the service’s strong and consistent focus on providing nutritious meals, promoting regular fluid intake and monitoring people’s health.

As well as individualised approaches the provider organised health‑promotion activities to support people to maintain and improve their physical, emotional and social wellbeing. For example, a ‘Nutrition Week’ where people were encouraged to try different, healthy food and ‘National Smile’ day to enhance people and staff’s understanding of good oral health.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

As described throughout this ‘Effective’ section of the report, people’s outcomes often exceeded expectations. A further example of this was for 1 person who was admitted to the service with communication difficulties due to their health condition. Staff implemented creative strategies to improve this. Their relative told us, “With the help of the carers she has improved significantly in making herself understood, greatly exceeding the original prognosis.” Another person was admitted to the service requiring end-of-life care. The clinical manager told us how they maintained a focus on closely monitoring the person's condition and responding to changes in their presentation, rather than assuming their needs and prognosis would remain unchanged. As the person's health improved, staff recognised these changes and worked with relevant healthcare professionals to review their care and treatment. Staff continued to support the person with their nutrition, wellbeing, mobility and social engagement, according to their changing needs and preferences. The person's condition improved to the extent they no longer required end-of-life care, and at the time of our inspection, the person was enjoying life at the service and regularly joining in with activities. This demonstrated the service's focus on continually reviewing people's potential and maximising their quality of life.

Staff maintained continuous oversight of people’s clinical needs and quality of life, through daily observation, reviewing of their needs, clinical monitoring and by working in partnership with health care professionals. Any concerns were documented by staff within the electronic care record system. Basic observations, such as a person’s blood pressure and temperature were monitored, and the appropriate action taken where required.

Training provided to staff in topics related to promoting safety and prevention, for example falls awareness, diabetes and pressure ulcer prevention meant staff had the necessary skills to identify and respond to changes to improve people’s quality of life.

The provider demonstrated a person-centred approach, ensuring individuals remained central to decisions about their care. People and their relatives told us staff understood their needs, reviewed them regularly, and responded promptly when any changes occurred.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff respected people’s choices and consistently sought consent before providing support. A relative told us, “They (staff) talk to him and tell them what they are doing and ask him if it’s okay to help him and are very kind to him.” People told us they had choices, could spend the day as they wished and staff respected their decisions.

Where people lacked capacity to make specific decisions, capacity assessments had mostly been completed and best-interest decisions made in consultation with those involved in the person’s care. Where we identified an omission in records, which had no impact on people, the provider took prompt action to address this.