The inspection took place on 15 September 2017 and was unannounced.

Wisteria lodge is a residential care home that provides accommodation and personal care. There were 4 people living at the home when we inspected.

At the last inspection the service was rated good. At this inspection we found the service remained good.

The majority of people who lived at the home were unable to communicate verbally but we observed staff supporting people with a range of communication aids, which included signing and interpreting people’s body language with regards to meeting their needs and wishes. A relative also said they felt their family member was kept safe.

Individual risks to people were appropriately assessed, identified and managed.

There were enough competent staff to provide people with support when they needed it. Staff had been recruited through a robust recruitment process and had received appropriate training and support to help enable them to carry out their roles effectively.

People received appropriate support to eat and drink sufficient amounts to maintain their health and well-being in relation to nutrition and hydration.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). People were supported to have maximum choice in relation to all aspects of their lives.

People, relatives and staff told us, and we observed that people were treated with kindness by staff who respected their privacy and maintained their dignity.

People and their relatives were given the opportunity to feed back on the service and their views were listened to and acted upon.

People received personalised care that met their individual needs. People were given appropriate support and encouragement to access and participate in meaningful activities and to pursue hobbies and individual interests both within the home and in the community.

People were supported to share their views by giving feedback through residents’ meetings or by recording their dissatisfaction in a comments and complaints book located in reception. People knew how to complain if they were unhappy with any aspect of the service and were confident they would be listened to.

There was an open, transparent and inclusive atmosphere within the service. People and staff had regular meetings to discuss the service and think about future developments and improvements they could make.

There were systems and processes in place to monitor the overall quality and safety of the service and shortfalls identified were promptly acted on to improve the quality of the service. People gave positive feedback on the management of the service.

Further information is in the detailed findings below

The inspection took place on 15 September 2017 and was unannounced.

Wisteria lodge is a residential care home that provides accommodation and personal care. There were 4 people living at the home when we inspected.

At the last inspection the service was rated good. At this inspection we found the service remained good.

The majority of people who lived at the home were unable to communicate verbally but we observed staff supporting people with a range of communication aids, which included signing and interpreting people’s body language with regards to meeting their needs and wishes. A relative also said they felt their family member was kept safe.

Individual risks to people were appropriately assessed, identified and managed.

There were enough competent staff to provide people with support when they needed it. Staff had been recruited through a robust recruitment process and had received appropriate training and support to help enable them to carry out their roles effectively.

People received appropriate support to eat and drink sufficient amounts to maintain their health and well-being in relation to nutrition and hydration.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). People were supported to have maximum choice in relation to all aspects of their lives.

People, relatives and staff told us, and we observed that people were treated with kindness by staff who respected their privacy and maintained their dignity.

People and their relatives were given the opportunity to feed back on the service and their views were listened to and acted upon.

People received personalised care that met their individual needs. People were given appropriate support and encouragement to access and participate in meaningful activities and to pursue hobbies and individual interests both within the home and in the community.

People were supported to share their views by giving feedback through residents’ meetings or by recording their dissatisfaction in a comments and complaints book located in reception. People knew how to complain if they were unhappy with any aspect of the service and were confident they would be listened to.

There was an open, transparent and inclusive atmosphere within the service. People and staff had regular meetings to discuss the service and think about future developments and improvements they could make.

There were systems and processes in place to monitor the overall quality and safety of the service and shortfalls identified were promptly acted on to improve the quality of the service. People gave positive feedback on the management of the service.

Further information is in the detailed findings below

The inspection team was made up of one inspector. We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, the staff supporting them and looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We spoke with two people who used the service and they both said that they were happy with the service they had received and felt safe living at the home.

The home held a copy of Hertfordshire safeguarding procedures. Some staff we spoke with were not able to explain what constituted abuse and were unclear as to what action they should take if they believed that someone was being abused.

The provider had not made any applications to the local authority for the Deprivation of Liberty Safeguards (DoLS), however we found that the provider did not have protocol in place for staff to follow should the need arise for a DoLS application to be made. Staff had received training in the Mental Capacity Act (MCA) and in the Deprivation of Liberty Safeguards (DoLS) however, most of the staff we spoke with were not able to explain what MCA or DoLS was and what steps they would take should a person using the service was unable to make decisions for themselves.

We asked the provider to tell us what they would do to meet the requirements of the law in relation to safeguarding vulnerable people from abuse.

Is the service effective?

We found that the service was providing the support people needed. People told us that they were happy with the care that they had received. Care plans showed that people and/or their relatives had been involved in the care planning process and their wishes were taken into account and where possible, acted on.

Is the service caring?

During our inspection we saw that staff interacted with people in a caring and supportive manner. People we spoke with all stated that staff were caring and helpful. Care plans showed that people were encouraged and supported to undertake activities in the home as well as in the community.

Is the service responsive?

We saw that people were supported to attend medical appointments. Records of those appointments as well as the outcome of the appointments were kept.

Is the service well-led?

The service did not have a robust quality assurance system in place in order to seek the views of people who use the service and/or their relatives.

We asked the provider to tell us what they would do to meet the requirements of the law in relation to assessing and monitoring the quality of the service provision.

Records were not readily available and the provider was not able to locate all the records we had requested during our inspection.

We asked the provider to tell us what they would do to meet the requirements of the law in relation to records being kept securely and could located promptly when required.

We spoke with the three people who lived at Wisteria Lodge. They told us that they were happy with the care and support they received. One person said, “I am well looked after. The staff are good and so is the food.” Another person said, "I like living here and I have no concerns."

We found that the provider was compliant with the standards we inspected. People’s needs had been assessed and were met appropriately. There were systems in place to ensure that people received their medicines safely, regularly and on time. Staff had received relevant training to enhance their skills in assisting people using the service. Confidential records had been held safely and securely.

People said that they liked their home and the staff that worked there. People said there was a good choice of food available and they always had plenty to eat and drink. They enjoyed the social activity that was available to them. They found staff to be approachable and caring. People told us that staff interacted well with them. Comments from people about the staff included "All the staff are nice", and "they listen to me".

We consider all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask, Is the service safe, Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

This is a summary of what we found.

Is the service safe?

During our inspection we looked at the staffing rotas for Wisteria Lodge and Shepherd’s Lodge as we were told that staff worked across both homes. The rotas covered the period of 06 July 2014 to 26 July 2014 we found there were not enough staff to safety meet people’s needs. For example, one member of staff had completed day shifts at one home then worked a waking night shift at the other home. This practice happened regularly and had been done for up to five days and nights consecutively. This meant the staff member could potentially have fallen asleep on duty and been unable to meet people’s needs and ensured their safety and wellbeing. We also found that one staff member recorded as working at Wisteria Lodge had never worked at the home. This mean the staff rotas were not correct.

Is the service effective?

We looked at the kitchen and found the kitchen was clean and tidy. The senior carer explained that people had access to the kitchen and food. However, we found that there were some foods both stored in the fridge and in cupboards which were out of date, for example, there were twelve eggs dated 12th July 2014, a used lettuce dated 13 July 2014, carrots dated 15th July 2014 and in the cupboards we found noodles dated 31 December 2012. This meant people were at risk from using food that May not have been fit for consumption.

Is the service caring?

Not assessed during this inspection

Is the service responsive?

Not assessed during this inspection

Is the service well led?

Not assessed during this inspection