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Inspection Summary


Overall summary & rating

Good

Updated 8 February 2018

This inspection took place on 19 January 2018. The inspection was unannounced which meant that the staff and provider did not know that we would be visiting.

At our last inspection of this service in October 2015, we awarded an overall rating of Good.

At this inspection we found the service remained good.

Castle Grove is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Castle Grove Nursing home is a grade two listed Georgian building situated within its own extensive grounds that contain a range of fruit trees, well tended lawns, a fish pond, a fountain and free range chickens. The service is registered to provide care and accommodation for up to 26 people. They provide care and support for frail older people and some living with dementia. There were 22 people living at the service when we visited. Two of these people were staying at the service for a period of respite.

There was an experienced registered manager who had worked at the service for 23 years. A registered manager is a person who has registered with CQC 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.

Why the service is rated Good:

People told us they felt safe at the home and with the staff who supported them; one person said “They make sure I am safe all of the time.” There were systems in place to keep people safe. Staff were aware of safeguarding processes and how to raise concerns if they felt people were at risk of abuse or poor practice.

Medicines were safely managed and procedures were in place to ensure people received their medicines as prescribed.

People were supported by staff who had the required recruitment checks in place. Staff received an induction and had received training and developed skills and knowledge to meet people’s needs. Staff were supported; they had an annual appraisal with an external company and regular supervisions with their line managers.

There were adequate staffing levels to meet people’s needs.

People received person centred care. Staff knew people well, understood their needs and cared for them as individuals. They were familiar with people’s history and backgrounds and supported them fairly and without bias. People were relaxed and comfortable with staff that supported them. Staff were discreet when supporting people with personal care, respected people’s choices and acted in accordance with the person’s wishes.

Care plans were personalised and guided staff how to meet people’s needs. We discussed with the registered manager adding further information to guide staff how to manage some people’s mental health needs.

People were referred promptly to health care services when required and received on-going healthcare support. The healthcare professional was very positive about the quality of care provided at the home and the commitment of the whole team to provide a good service.

People’s views and suggestions were taken into account to improve the service. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them. One health care professional said, “The staff's knowledge of the residents I see is excellent, they always inform me of anything that has changed if appropriate.”

People knew how to make a complaint if necessary. They said if they had a concern or complaint they would feel happy to raise it with the registered manager. There had been no complaints received at the service since our last inspection. The registered manager was very active within the service and was well informed about people’s changing needs and any concerns arising.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. Where people lacked capacity, mental capacity assessments were completed and best interest decisions made in line with the MCA.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide legal protection for those vulnerable people who are, or may become, deprived of their liberty. The registered manager was aware about how to make applications for people they had assessed that required to be deprived of their liberty to the local authority DoLS team if required.

People were supported to follow their interests and take part in social activities. A new activity person was working with people to provide activities people would enjoy which they could attend as they chose.

People were supported to eat and drink enough and maintain a balanced diet. People and relatives were very positive about the food at the service.

The provider had a range of quality monitoring systems in place which were used to continually review and improve the service.

The premises were well managed to keep people safe. The home was clean and very homely with a welcoming atmosphere. Arrangements were in place to ensure the environment was kept clean and safe with audits being completed on all aspects of the building and equipment. There were emergency plans in place to protect people in the event of a fire or emergency.

Further information is in the detailed findings below.

Inspection areas

Safe

Good

Updated 8 February 2018

The service remains Good.

Effective

Good

Updated 8 February 2018

The service remains Good.

Caring

Good

Updated 8 February 2018

The service remains Good.

Responsive

Good

Updated 8 February 2018

The service remains Good.

Well-led

Good

Updated 8 February 2018

The service remains Good.