Wisteria Lodge is registered to provide nursing care for up to 30 people. The service had a registered manager. 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 using the service and their relatives said they felt safe and protected by the staff when they provided care and support. Risks to people were carefully assessed and appropriate actions were taken to minimise potential harm. Systems were in place to monitor environmental health and safety issues.
Staff were fully aware of their responsibilities to keep people safe and showed a genuine commitment to protecting people from any abuse. Appropriate systems were in place to report any safeguarding incidents. Accidents and other significant incidents were closely monitored and actions were taken to minimise the risk of further accidents.
Staff were trained and monitored to ensure people were supported to take their medicines safely.
There were sufficient staff deployed to keep people safe from harm, and to identify and report any safety issues. Staff recruitment systems were thorough, and protected people from the risks of unsuitable workers being employed.
People told us they felt the staff team had the skills and experience needed to meet their needs effectively. There was a strong commitment to staff training. Staff received good induction and on-going training in all relevant areas. Any training needed to meet the individual needs of people using the service was identified and carried out promptly.
Staff were given good support to carry out their roles and responsibilities, and were given regular supervision and performance appraisal by the management team. Staff told us they took pride in their work and felt valued and respected.
The service protected the rights of people who lacked the mental capacity to make significant decisions about their lives. Any decisions made about such issues were taken in their ‘best interests’. Decisions were taken in conjunction with the person, their families and involved professionals and followed a careful assessment of the person’s capacity.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005. These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom. We saw the provider had submitted appropriate applications to the local authority for authorisation to place restrictions on certain people’s movement, in their best interests to protect them from harm.
People were routinely asked for their consent before any staff carried out tasks for them. They told us staff respected any decision by them to refuse such interventions. People were also asked to give written consent to significant areas of the care, such as having their medicines administered.
Care was taken to make sure people’s nutritional needs were fully understood and met.
People told us they were very well cared for, and they were always treated with respect and courtesy. Relatives we asked confirmed this. They said their privacy and dignity were respected at all times, and they were consulted about their care and given the necessary information to make decisions. We observed staff members were pleasant, sensitive and caring in all their approaches and interactions with people. People were encouraged and supported to be as independent as possible. We noted staff had been trained in equality and diversity issues and saw no evidence of any discriminatory practices.
People and their families were fully involved in the assessment of their needs, and their wishes and preferences about their care were sought and recorded. Detailed, person-centred care plans were drawn up to meet those needs and preferences.
Systems were in place for responding to complaints and other matters of concern, but people told us they never had anything to complain about, and felt they could resolve any issues informally. The provider’s representatives and staff all demonstrated a clear and genuine commitment to listening and responding sensitively to any issues that arose. They used such feedback to improve the service.
The registered managers and all levels of the management team displayed clear and appropriate values and provided strong leadership to their staff. Staff members told us they knew what was expected of them, and were given the support, encouragement and training they needed to meet people’s needs in a timely and caring way. The service was open and responsive to feedback and new ideas, and had robust systems in place for monitoring its progress in meeting its goals.