Wisteria Care

Updated 9 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 12 and 27 March 2018 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be at the office and able to assist us to arrange home visits. Telephone calls to people in their own homes took place on 12 March. The inspection continued on the 27 March with visits to the office and people homes.

The service is registered to provide personal care to people living in their own homes. At the time of our inspection the service was providing personal care to 80 people.

Before the inspection we reviewed all the information we held about the service. This included notifications the home had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We contacted the local authority to obtain their views about the service.

We had requested and received a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed this information during the inspection.

During the inspection we visited four people who used the service and spoke with four people and their relatives. We also spoke with seven members of staff, the registered manager, office manager, team leader, care coordinator. We spoke with one professional who had knowledge of the service, and received information from other professionals by way of email. We telephoned five people who used the service and five relatives.

We looked at a range of records during the inspection, these included seven care records. We also looked at information relating to the management of the service including quality assurance audits, health and safety records, policies, risk assessments, meeting minutes and staff training records. We looked at five staff files, the recruitment process, complaints, training and supervision records.

Following our inspection visit, we requested further documentation from the service. This included contact details of relatives who had given consent for us to possibly contact them and also feedback survey responses. This information was provided.

Updated 9 May 2018

Wisteria Care office is situated in Shaftesbury. It provides support to people living in Gillingham, Blandford Forum, and surrounding areas.

There was a registered manager in post. 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 we spoke with told us they felt safe using the service and said they trusted the staff that supported them. People and their relatives were extremely satisfied with the quality of the service they received and the caring approach from staff. People said about the service, “‘Very good, my dignity is well upheld” and “I’m really happy with the care I get”.

Some people needed the support of staff to either give or prompt them to take their prescribed medicines and creams. We identified gaps on the MAR [medication administration records] for both prescribed medicines and creams. The manager told us some of the gaps were linked to family members who also gave out medicines without signing.

Risk assessments clearly identified any risk and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence. People had a copy of their records in their home and a copy was retained in the office. People told us they looked through the records and were happy with how the information was recorded.

People were supported by enough staff to provide effective, person centred support. Staff were recruited safely with appropriate pre-employment checks and received training and support to ensure that they had the necessary skills and knowledge to meet people’s needs. Rotas showed that people had staff who visited regularly and staff told us that they generally visited the same people each week.

People were supported to make choices about all areas of their support and staff understood the principles of mental capacity. Where people had medical decisions in place around their end of life care, these were recorded. Some care plans reflected that end of life wishes and preferences had been discussed. The registered manager told us that they would ensure that people’s choices and preferences were consistently discussed and reflected in people’s care plans.

People and those important to them were involved in planning the support they would receive and were asked for their views about the support and any changes to people’s needs. Reviews identified where people’s needs had changed and reflected changes to the support provided in response to this.

People were supported by staff who respected their individuality and protected their privacy. Staff understood how to advocate and support people to ensure that their views were heard and told us that they would ensure that people’s religious or other beliefs were supported and protected. Staff had undertaken training in equality and diversity and understood how to use this learning in practice. Interactions with people were kind and caring, and relatives told us that they had peace of mind

People were supported from the spread of infection by staff who understood their role in infection control and used appropriate Personal Protective Equipment (PPE).

People were supported to maintain a healthy lifestyle. Staff supported some people with their food shopping and assisted them with the preparation and cooking of their meals. People's choices of the foods they wished to purchase were respected.

Staff were aware of the reporting process for any accidents or incidents that occurred and there was a system in place to record incidents. Where accidents, incidents or near misses had occurred these had been reported to the service's managers and documented in the service's accident book.

When people started using the service, senior staff carried out the support visits to ensure the care records reflected what the person wanted. Care planning was reviewed regularly and whenever people's needs changed. Where people's needs had changed or when people went into hospital, they were visited to ensure the service could still meet their needs. People consented to their support and family members were given the opportunity to contribute and agree with the plan.

People were supported to access healthcare professionals when required and the service worked with a number of external agencies to ensure that people received joined up, consistent care.

Staff were confident in their roles and felt supported by the registered manager and office team. Feedback from people and relatives indicated that the registered manager and management team were approachable, listened and took actions where necessary.

The registered manager and office manager told us that they learned from mistakes. To do this they held team meetings and discussed as a whole team what happened and what can be done different to improve and prevent the same mistake from occurring again

Quality assurance measures were used to highlight whether any changes to policy, processes or improvements in practice were required. The registered manager and provider were working on ensuring that systems were proportionate to the type and size of service and provided consistent oversight.