Wisteria Care

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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 made sure people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People received personalised care that was responsive to their needs, wishes and preferences. Care plans were in an electronic format, staff had access to them on their smartphones. This meant any changes in people’s needs were shared immediately and staff were kept up to date with new information about people they cared for. Care plans contained person-centred details, including life histories, hobbies and interests, skills, abilities and how they preferred to manage their health.

Staff had worked closely with people, their relatives and others important to them to ensure all their wishes and feelings were recorded. Staff had spent time with people and their relatives to gain real insight, and demonstrated they knew people, their routines, wishes and preferences very well. Staff were confident in the service they provided and told us it was important to put people at the centre of their work. A member of staff said, “People have a say in the care they receive; we listen to what they would like us to do, we may give them extra options as well to consider if this makes life easier for them. Where needed we can arrange days out, shopping visits, put them in touch with friends, services and day centres activity meetings.”

Processes and systems were in place to ensure people’s changing needs were met. The provider worked in partnership with people and their loved ones. Care plans were reviewed monthly or more regularly and if people’s needs had changed. This was done with the involvement of people and their representatives. Staff completed daily notes detailing the care they had provided which helped the management team to be aware of any changes in the person’s needs and to ensure there was continuity of care. Comments from relatives included, “They regularly discuss [family member's] care plan for any changes we need.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People told us the provider worked well with other professionals when needed. This included local GP surgeries, district nurses, occupational therapists, social workers and pharmacies. Leaders were knowledgeable about people’s diverse health and social care needs. Staff made sure the multi-disciplinary team were involved when required. They gave examples of this and explained how other professionals were involved to ensure people’s well-being. We reviewed records of people who had regular input from other services; for example, there was input from the local GP surgery and frailty team. Staff worked to co-ordinate people’s appointments, making sure other professionals were aware of the person’s treatment and ongoing needs. Staff followed any guidance given, and provided information and feedback to professionals when needed, such as the effect of medication changes.

Staff had access to support in emergencies. An on-call system was in place to ensure support was available outside of office hours for both staff and people using the service.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People were provided with a ‘Service User Guide’ which outlined clear service agreements that detailed how they could raise concerns, care plan reviews and what they could expect from staff. Key documents were available in larger font sizes for visually impaired service users, a verbal explanation or an ‘Easy Read’ simplified version with pictures and plain language. The provider was also prepared to arrange translation into other languages on request.

The provider ensured people’s care plans and records captured how people were supported to engage in meaningful communication and decision-making. This enabled people to be active participants in their care if this was their wish. People’s care plans clearly identified communication needs and what staff should do to support communication for example if they need hearing aids or glasses.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider had a policy and procedure in place that set out the steps someone would need to take to make a complaint, and information on how to complain was contained within the service user guide. This ensured all complaints would be investigated and a response provided to the person.

People and their relatives confirmed they felt confident in the provider taking appropriate actions should they raise a concern or complaint, which included looking into the issue thoroughly, communicating what was happening, being open about what had been found out and what the outcome was. The provider worked with people to agree solutions to concerns raised, and to measure the impact of the changes made. People, their relatives and others important to them confirmed they had meaningful involvement in service development and improvement through regular and open communication. The provider also used surveys and quality calls to seek and share information with people and relatives. Comments from relatives included, “[Family member] went through a phase of being agitated when the male carers came and they had noticed [they] preferred female carers. I spoke to the office staff straight away. They were very understanding and changed the rota straight away to female carers only” and “Office staff ask when they visit if we are happy with the care and if any improvements are needed. We also had a questionnaire asking about the service”. Feedback forms were distributed yearly, and regular monthly care reviews were completed with people to give them an opportunity to discuss their support.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People were able to access appropriate and timely care when required, including during weekends and bank holidays. When emergencies arose, the provider was responsive and flexible to ensure people still received the care they needed. For example, rotas were reviewed in adverse weather conditions or where relatives weren’t available to support people to ensure all people received the support they needed. People and relatives told us they never experienced a missed visit. Comments included, “During the summer even with all the annual leave there was never a missed appointment. Time keeping is good, we must accept if someone needs extra assistance there will be a knock-on effect. We get a phone call if carers are late. Over the weekends carers are veryregular“ and “Sometimes 1 of the office staff comes out to cover during holidays and sickness”.

The provider monitored care calls through the electronic log-in and log-out system. Alerts were sent to the office team if a visit had not been attended or if staff were running late. When this occurred, the team contacted both the staff member and the person using the service to check on the situation. Where necessary, a supervisor was deployed to provide cover and ensure the person remained safe.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Policies relating to equality, diversity and discrimination were in place and followed current best practice guidance. These policies set clear expectations for staff on how to promote fairness and inclusion and ensure people were treated without bias. Staff were aware of their responsibilities and understood the importance of providing equitable care and support.

The care plan structure considered people’s protected characteristics and the reasonable adjustments they required. This included documenting mobility needs, communication preferences, cultural considerations and support that helped people have a positive experience of care.

Training records confirmed that staff had completed equality related training, helping them better understand how to recognise and challenge discrimination and provide inclusive care. This supported the service in delivering fair outcomes and ensuring people received the same quality of care regardless of their background or individual characteristics.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were supported to make informed choices about their needs and plan their future care where this was relevant to them. The provider had an end-of-life policy and procedure which would guide staff in the event of this being necessary. The provider recognised not everyone wanted to discuss these matters with them but if people wanted to, they were invited to discuss how they wanted to be supported when their health deteriorated. This included where they wanted to be cared for, what level of treatment they were happy with and what they would like to happen in an emergency. Care plans contained information about people's significant relationships and who they wanted to be contacted if they were unwell or in the event of an emergency.

If people had a ‘Do Not Attempt Resuscitation’ (DNAR) agreement, it was recorded in their care records. Staff had guidance on where the agreement was in case they needed to share this with emergency medical staff.