This inspection took place on 10 and 13 April 2018 and was announced. This is the first inspection for the provider since the care agency became a separate entity from its care home.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults.

The service currently delivered care for 56 people in their own homes. Not everyone using Wisteria Care receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager who oversaw the service. 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. In addition, the owner was the previous registered manager and they had maintained their registration during the transition between managers.

People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible. However, current legislation had not always been followed when decisions were made for people who lacked capacity. There were occasions when people had capacity and again, the legislation was not followed. People were supported, when required, to eat a healthy, balanced diet.

People and their relatives using the service thought they were kept safe. Most medicines were managed safely. Improvements could be made with topical creams. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. There were occasions where staff had not been given full guidance around some risks.

The management had developed positive relationships with people. People and their relatives were happy with the support they received. People, their relatives and staff told us that most of the time there were enough staff to meet their needs. There were some mixed feelings about whether there was enough time for staff to travel between visits. Inconsistencies were found with how people’s recruitment had been managed throughout the service.

People were protected from potential abuse because staff understood how to recognise signs of abuse and knew who to report it to. When there had been accidents or incidents systems were in place to demonstrate lessons learnt and how improvements were made. Staff had been trained in areas to have skills and knowledge required to effectively support people. People told us their healthcare needs were met and staff supported them to see other health professionals. Strong links had been built with other health and social care professionals.

Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. Care plans reflected people’s needs and wishes and they had been involved where possible. Staff knew people well. People and their relatives knew how to complain and there was a system in place to manage any complaints.

People and their relatives told us, and we observed, that staff were kind and patient. People’s privacy and dignity was respected by staff. Their cultural or religious needs were valued. People, or their representatives, were involved in decisions about the care and support they received. The provider was developing systems to ensure people had a dignified death.

The service was well led and concerns identified during the inspection had mainly been identified by the management. When they had not, steps were taken to immediately to resolve the issues. There was a proactive approach from managem