Wisteria Care

Wisteria Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of the inspection the service supported 99 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

Improvements had been made. The service was now working within the principles of the Mental Capacity Act 2005. People were supported to make individual decisions. Where they lacked capacity, the service ensured those important to them were involved and acted in their best interest.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff supported people to access specialist health and social care support in the community when required.

Right Care

Care plans reflected a good understanding of people’s needs. This included their needs, abilities and preferences. Training and refresher courses helped staff continuously apply best practice. This included training in how to support people with a learning disability and autistic people. Staff encouraged people to eat a healthy and varied diet to help them to stay well.

Right Culture

People and those important to them, including advocates, were involved in planning their care. People received good quality care and support because trained staff could meet their needs and wishes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 27 October 2022).

Why we inspected

This was a focused inspection to see if the service had improved under the Effective domain. This domain was rated requires improvement in 2018 (published 16 May 2018). At this inspection we found improvements had been made.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wisteria Care on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People told us they were very happy with the care they received. They provided mixed feedback about visit timings. In response the service had increased the number of staff compiling visit rotas and had introduced new documentation to set realistic expectations about preferred visit times.

People expressed confidence in the skills and competence of the staff supporting them. Relatives agreed. People and relatives told us they would recommend the service to others.

There were enough staff to meet people’s needs. At times of staffing shortages, due to sickness or vacancies, people’s needs were prioritised according to risk. There was an ongoing recruitment drive within a context of staffing challenges across the health and social care sector.

People had individual risk assessments which provided sufficient detail for staff to keep them safe and comfortable without being restrictive. Staff had a good understanding of the signs and symptoms that a person may be experiencing harm and abuse. They were confident they would be listened to and action taken in a timely way if they raised concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff spoke positively about the culture of the service and the support they received from their colleagues and the registered manager. Staff said they felt appreciated and were encouraged to obtain new skills and qualifications.

People’s, relatives and staff views about the service were frequently sought and used to help drive improvements. Action had been taken by the registered manager to help improve communication with people and relatives. This had followed feedback from a survey.

Audits were undertaken to ensure quality was maintained and areas for improvement identified.

The service had developed and maintained good working relationships with system partners such as GP surgeries, district nurses and social work teams. The service understood how it contributed to the wider health and social care system and worked with a local authority to support people to return home after a hospital stay. This included helping determine rehabilitation goals and ongoing care needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The rating at the last inspection was good (published 24 March 2021).

Why we inspected

We received concerns in relation to communication with the registered manager, staff skills and call times. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained as good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from the concerns. The service has taken action to improve communication, staff had the necessary skills and competence to meet people’s needs and there was ongoing discussion with people about call times.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wisteria Care on our website at www.cqc.org.uk.

Follow up

We continued to seek clarification from the provider to validate evidence found. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Wisteria Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection the service supported 96 people. Not everyone using the service receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

People’s experience of using this service and what we found

We received mixed feedback about people’s communication with the office. Most people spoke positively about how they were kept informed of changes. However, some people expressed frustration from contacting the office and not always getting a timely response. The registered manager had brought in a new system to help resolve this issue.

People were protected from the risk of cross infection as staff had been trained in infection control practice and procedures including effective hand hygiene techniques and wearing of all required personal protective equipment (PPE) in line with government recommendations. One person said, “They are brilliant at all that.” Staff were supported to self-isolate where required. One person commented, “During this pandemic, I don’t know what I would have done without them.”

People were supported by staff who had received safeguarding training and understood how to keep them safe from harm or abuse. People’s individual risks were assessed, and the service worked with people to manage and review these. The service had a robust recruitment and selection process that helped reduce the risk of unsuitable staff supporting people.

People and staff were given the opportunity to feedback through annual questionnaires and monthly reviews. Feedback was analysed and used to improve the service. Various audits were undertaken to ensure service quality was maintained.

The registered manager actively encouraged and supported staff professional development. This helped ensure that staff remained motivated and people were supported by knowledgeable staff in accordance with best practice guidance.

There was an open and supportive culture at the service. Staff told us they got on well and supported each other. They felt supported by the registered manager and owner. One staff member told us, “Of all the care companies I've worked they are the best.”

The service had established positive working relationships with system partners such as district nurses, social workers, GP surgeries and local authorities. This was helping people to stay well for longer and enabling timely discharge home for people after hospital stays.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 16 May 2018).

Why we inspected

We received concerns in relation to infection prevention and control (IPC). As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained the same. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wisteria Care on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults.

The service currently delivered care for 56 people in their own homes. Not everyone using Wisteria Care receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager who oversaw 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. In addition, the owner was the previous registered manager and they had maintained their registration during the transition between managers.

People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible. However, current legislation had not always been followed when decisions were made for people who lacked capacity. There were occasions when people had capacity and again, the legislation was not followed. People were supported, when required, to eat a healthy, balanced diet.

People and their relatives using the service thought they were kept safe. Most medicines were managed safely. Improvements could be made with topical creams. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. There were occasions where staff had not been given full guidance around some risks.

The management had developed positive relationships with people. People and their relatives were happy with the support they received. People, their relatives and staff told us that most of the time there were enough staff to meet their needs. There were some mixed feelings about whether there was enough time for staff to travel between visits. Inconsistencies were found with how people’s recruitment had been managed throughout the service.

People were protected from potential abuse because staff understood how to recognise signs of abuse and knew who to report it to. When there had been accidents or incidents systems were in place to demonstrate lessons learnt and how improvements were made. Staff had been trained in areas to have skills and knowledge required to effectively support people. People told us their healthcare needs were met and staff supported them to see other health professionals. Strong links had been built with other health and social care professionals.

Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. Care plans reflected people’s needs and wishes and they had been involved where possible. Staff knew people well. People and their relatives knew how to complain and there was a system in place to manage any complaints.

People and their relatives told us, and we observed, that staff were kind and patient. People’s privacy and dignity was respected by staff. Their cultural or religious needs were valued. People, or their representatives, were involved in decisions about the care and support they received. The provider was developing systems to ensure people had a dignified death.

The service was well led and concerns identified during the inspection had mainly been identified by the management. When they had not, steps were taken to immediately to resolve the issues. There was a proactive approach from management and they strove to constantly learn and make improvements. The provider had completed statutory notifications in line with legislation to inform external agencies of significant events.