Wisteria Care

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvements. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had established a process of learning from events that placed individuals at risk of harm. Staff understood their responsibility to raise concerns and report incidents and near misses; they were fully supported when they did so. Incident and accident records were completed, reviewed and scrutinised by the manager. The manager used oversight processes to identify patterns, trends and opportunities for learning, with a focus on improving practice rather than attributing blame.

When identified, lessons were learned, discussed and communicated to staff at monthly staff meetings, regular supervisions and visits. The manager was proactive in sharing lessons learnt and good practice with staff, to prevent re-occurrence, promote safety and to further enhance the quality of care. Openness and transparency about safety was actively encouraged and learning embedded across the service, with updates to care records, changes in people’s needs and key learning points communicated promptly to staff. This helped ensure care continued to be delivered safely and consistently.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider worked with people and those close to them to establish their plan of care and individual transition plans, prior to the person moving between services. This helped eliminate any risks of harm and ensured the person received continuity of care. Pre-assessment paperwork was always completed involving people, relatives and partners prior to services commencing and these assessments were shared with staff.

We received overwhelmingly positive feedback about continuity of care provision from all 3 healthcare professionals working with Wisteria Care. Comments included, “The service consistently achieves strong outcomes for the people it supports. More than 50% of individuals using the hospital discharge pathway regain independence following a short period of support, which is an excellent outcome and reflects the team's commitment to promoting independence and recovery.” People and their relatives confirmed their involvement in creating and reviewing people’s care records and were also complementary about maintaining continuity of care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their relatives confirmed they felt the service provided by Wisteria Care was safe. One relative told us, “They provide very good and safe care. [Family member] always looks forward to their visits.”

The provider had established effective safeguarding systems, policies and procedures and managed safeguarding concerns promptly using local safeguarding procedures whenever necessary. There was a consistent approach to safeguarding and matters were always managed in an open, transparent and objective way. Where required, investigations were thorough. As appropriate, people and those important to them were involved in this process and informed about what action would be taken to keep people safe.

All staff had participated in safeguarding training and demonstrated a comprehensive awareness and understanding of their roles and responsibilities. Staff knew how to recognise the signs and symptoms of abuse and who they would report concerns to both internally and externally. They told us they felt confident management would listen and act 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. People had the necessary assessments in place to ensure their rights had been fully respected. The provider followed principles and requirements of the Mental Capacity Act (MCA) where people were deprived of their liberty under the Deprivation of Liberty (DoL) in the community setting through an order by the Court of Protection. Deprivation of liberty occurs when an individual is not free to leave a community setting due to restrictions placed on them, for their safety and well-being. There was a clear understanding of DoLS, they were used appropriately and only when it was in the best interest of the person.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People were involved in decisions about their daily lives and how risks were managed, and were able to make choices about their routines, activities and support.

Risk assessments were detailed, individualised and provided guidance for staff on how to support people safely. Staff demonstrated an understanding of risks and how to respond appropriately, including balancing safety with people’s preferences and independence.

People and their relatives felt involved in managing risks, and risk assessments were person-centred, proportionate and reviewed regularly. People and relatives, including legal representatives, confirmed they were, when appropriate, involved in creating and reviewing people’s care plans. There was evidence of positive risk-taking in practice, with people supported to access the community, pursue their interests and maintain independence, while staff were available to provide support where required. One relative described being involved in discussions about the care needs of their family member which resulted in the reduction of daily care visits. The relative told us, “Both of us were fully involved in the assessments along with occupational therapist (OT). We talked about getting [family member] out of bed to keep strength in [their] legs. OT arranged [equipment] and carers now encourage [family member] to stand up for a little while. [Family member] had been having a lot of falls but now feels quite safe.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider supported people in their own homes, they were not responsible for the upkeep of these premises. However, risk assessments were in place to ensure the environments in people’s homes were safe, to help protect people and staff from harm. For example, there were effective arrangements in place to manage risks associated with fire or slips, trips and falls. When people used equipment, there was a system in place to make sure that this was serviced, checked and safe for use.

The provider made sure staff could always contact them in an emergency. One staff member told us, “If I need help with anything I know I can call any office member of staff and they will help and that if I report anything It will be followed up.”

People and their relatives felt that carers always left their homes neat and tidy after their visit. Comments included, “Bedroom is always left tidy, dressing gown and towels always hung up” and “They tidy away anything they use, and towels are either hung up to dry or placed in the laundry.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

We received overwhelmingly positive feedback about staff. People and their relatives expressed they were happy with staff supporting them describing staff as ‘kind’, ‘knowledgeable’, ‘caring’ and ‘cheerful’.

People told us the provider ensured staff’s skills and experience were carefully matched to the needs and preferences of people they supported. People were supported by a regular staff team, and care was delivered through agreed routines which meant people experienced continuity of care. Comments from relatives included, “[Family member] has regular carers, they always come and introduce themselves” and “My [family member] lives with dementia. [They] tend to have the same person, regular as clockwork which suits [them]”.

Staff had the right mix of skills to make sure that practice was safe, and they were able to respond to unforeseen events. Staff were supported through regular supervision, performance checks and spot checks, with records showing open and constructive 2-way discussions. Staff told us they received appropriate training and supervisions to enable them to fulfil their roles.

Appropriate recruitment checks were carried out as standard practice. Safe recruitment processes were followed to help ensure suitable staff were employed. Required pre-employment checks were completed before staff started work, including enhanced Disclosure and Barring Service (DBS) checks. The manager told us they had enough staff employed to cover all care visits and they had not needed to use agency staff to cover absences.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were protected as much as possible from the risk of infection because their home environment and equipment were kept clean and hygienic. They were supported to maintain their own personal hygiene in line with their needs and preferences. Staff were provided with and used personal protective equipment (PPE) such as disposable gloves and aprons, which met recommended national guidance and were appropriate for the care they were delivering and the level of infection risk.

There were clear roles, responsibilities and procedures around infection prevention and control that met current and relevant national guidance. Staff received appropriate training on infection prevention and control (IPC) and understood their role and responsibilities for maintaining high standards of cleanliness and hygiene.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

There were safe procedures in place for the ordering and administration of medicines. People received their medicines as prescribed. Care plans correctly reflected the level of support a person required with their medicines. Protocols were in place to guide staff on how and when to administer medicines prescribed to be given when required. The provider used an electronic medication administration record system (eMAR), which was linked to the tasks staff were required to complete during each visit. Alerts from the system informed the manager if a medicine was late, or not given, action was then taken to support the compliance with medicines.

Staff received relevant training and had their competency and knowledge regularly assessed when administering medicines, to ensure safe practices. The provider had systems and processes in place to monitor medicines management, including regular audits and checks. These helped identify any concerns and supported safe medicines administration. Policies and procedures were available to guide staff and reflected current best practice.