We inspected Wisma Mulia on the 24 and 30 April 2018. Wisma Mulia is registered to provide accommodation and personal care to 17 older people. The service also provided community care to people who lived at Wisma Mulia through extra care sheltered housing. At the time of our inspection 17 people were receiving accommodation and personal care support and two people were being supported through extra care sheltered housing support provided by the service.

Wisma Mulia is based in its own grounds within Frampton on Severn, very close to range of amenities and the Severn canal. The service grounds contain a main house, self-contained flats and additional buildings which people can rent or use without receiving care. Wisma Mulia which means “honoured home” is closely linked to SUBUD (a spiritual movement) and has its own Latihan (which also provides a meeting hall facility) for spiritual services. This was an unannounced inspection.

We last inspected the home on 4 and 5 February 2016 and awarded an overall rating of “Good”. However we rated the “Is the service safe?” as “Requires Improvement” as we found that people did not always receive their medicines as prescribed which could have a negative impact on their health and wellbeing. We carried out a focused inspection regarding people’s prescribed medicines on 20 March 2017. In March 2017 we found the provider was meeting the requirements of the regulation, however further actions were required in relation to the safe administration and recording of people’s prescribed medicines. At our April 2018 inspection we found improvements had been sustained and we rated the service ‘Good’ overall.

There was no registered manager however, there was an interim manager in post while the provider recruited a manager with the intention of them registering with CQC. 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 were safe living at Wisma Mulia. There were enough staff deployed to ensure people’s needs were being met. People received the support they required to meet their health and wellbeing needs. People enjoyed engaging and interacting with care staff. People were supported to maintain their independence and many people enjoyed accessing the community independently.

Care staff treated people with dignity and ensured they had their nutritional needs met and received their medicines as prescribed. Care staff were aware of and met people’s individual needs. Staff spoke positively about the support and communication they received. All care staff felt the interim manager and head of care were approachable and that they had access to the skills and support they required to carry out their role.

People and their relatives felt their concerns and views were listened to and acted upon. Relatives told us the management team was responsive and approachable. The provider and care staff worked alongside healthcare professionals to ensure people’s ongoing needs were met.

The interim manager, head of care and provider had systems to monitor and improve the quality of service people received at Wisma Mulia. Some staff had not received supervision as frequently as the provider planned. Where people were living with dementia care assessments did not always reflect the support they required. Neither of these concerns were having an impact on people receiving a service. Therefore, we have made a recommendation to the provider which is designed to help the service continuously improve.

We carried out an unannounced comprehensive inspection of this service on 4 and 5 February 2016. At this inspection we found that the people had not always received their medicines as prescribed. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on the 20 March 2017 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Wisma Mulia’ on our website at www.cqc.org.uk’

Wisma Mulia provides residential care for up to 18 older people. They also provide extra sheltered care accommodation for four people. The service is closely linked to Subud (a spiritual movement) and many of the people living at the service follow this movement. This was an unannounced inspection.

The home has 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 and associated Regulations about how the service is run.

At our focused inspection on the 20 March 2017, we found that the provider had followed their plan and the legal requirements had been met.

People mostly received their medicines as prescribed. Where mistakes in the administration of people’s medicines had occurred, care staff took immediate action to ensure people were safe. The service maintained a clear record of people’s prescribed medicine stocks, and following our last inspection had reduced the amount of boxed medicines and sought advice from healthcare professionals. People’s prescribed medicines were stored securely, however a record of medicine room and fridge temperatures had not been maintained

We inspected Wisma Mulia on the 4 and 5 February 2016. Wisma Mulia provides residential care for up to 18 older people. They also provide extra sheltered care accommodation for four people. At the time of our visit 18 people were receiving residential care and four people were receiving personal care in extra care sheltered accommodation on the home’s grounds. The service is closely linked to Subud (a spiritual movement) and many of the people living at the service follow this movement. This was an unannounced inspection.

We last inspected in March 2014 and found the provider was meeting all of the requirements of the regulations at that time.

There was registered manager in post on the day of our inspection. 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 did not always receive their medicines as prescribed. Care staff did not always keep an accurate record of when people had received their medicines.

People were extremely positive about the home, the staff and management. People felt safe and looked after well at the home. Everyone enjoyed living there and, spending time with care staff, other people and engaging with the local community. People were supported to follow their religious and spiritual needs and their independence was promoted.

Staff were supported by a committed management board and had access to training, supervision and professional development. There were enough staff with appropriate skills, deployed to meet the needs of people living at the service.

The management, staff and people had developed a culture for the service, which everyone respected and valued. The management had strong audits, with a focus on providing good quality care and promoting people’s independence and lives.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

There were 22 people in total living at the home and in the extracare housing at the time of the inspection; 18 people living in the residential home and four in the extracare housing, in flats connected to the back of the home. The people living in the extracare housing were supported with personal care by staff at the home and could access the home for meals and activities. We spoke to ten people and to relatives to get their views on the care provided.

Everyone we spoke to was complimentary about where they lived. One person told us "I love it, I say thank you every night" and “I was dreading it but I couldn’t be happier”. Another person told us “I feel I am home”.

People told us staff asked their permission when caring for them and we observed people's consent being consistently sought. One relative told us “if there’s anything they ring up, I don’t have to worry about (person)”.

We observed care being delivered in line with people's care plans and people told us they received the help they needed. One person told us “I don’t cook anymore, that’s one thing I don’t do anymore but the girls help me”.

We observed staff administering medicines safely. One person told us "the doctor said I needed tablets for something and now I take them. Staff bring them to us”.

There was a quality assurance system in place and people told us they felt their views were taken on board. One person told us “I can’t think that anyone would have anything to grumble about”.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an Expert by Experience (people who have experience of using services and who can provide that perspective), and a practising professional.

At the time of our inspection there were 20 people living at the home. People told us that there was a mutual respect between staff and people who lived in the home. They described it as a community living together but emphasised that individual preference and independence was promoted.

One person told us, “It’s paradise here I haven’t a care in the world. I can have anything I want whenever I want it.” Another person commented, “I can do whatever I want here, join in all the activities, or just do nothing. What I like best is that if I just want to stay in my room I can, they won’t bother me, but if I feel like some company I can join in.”

Another person told us, “We do exercise class with a lovely young man, it’s really good for you, gets you going. We have the poetry class, that’s very good and we’ve written our own book.”

People made positive comments about the food and told us there was always a choice available. The staff working at the home told us there were always enough staff available to meet people’s needs.

People told us that the home prioritised and respected their spiritual needs, one person told us they had chosen the home for that reason.

We were also told, “I’ve been here a couple of years and it’s great in the summer but I wish there was more to do in the winter. “

All the people living in the home consistently described an atmosphere of mutual respect and affection. People we spoke with in the home were very relaxed, lively and complimentary about the staff and how the home was managed.