Archived: Castle Dene Care Home

Previously we obtained 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?

We found that action was needed to ensure the service was safe.

At our inspections in June 2014 we found that people were not protected from the risk of infection as appropriate standards of cleanliness and hygiene could not be carried out. Laundry rooms did not contain a separate sink for staff to wash their hands. The floors and walls in the garage which was used as a laundry could not be washed and cleaned thoroughly. The sluice sink in the laundry was used to steep commode pots.

At this inspection we found that the provider had taken action to ensure the service was compliant. The facilities in the laundry had been improved and staff now used disposable commode pots, which meant they no longer needed to steep them.

The inspection team was made up of one adult social care inspector and an expert by experience. The expert by experience spoke with ten people who used the service, two relatives and staff. The inspector spoke with three people who used the service, a relative, the manager, care co-ordinator, the domestic, laundry assistant and to two care staff.

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, speaking with people using the service, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Care plans and risk assessments were in place and were updated as people's needs changed. Care records detailed the support people required and encouraged people to be independent where possible. People we spoke with during the inspection told us that they felt safe.

We found that people had been weighed and that nutritional screening had been undertaken to identify those people who were under nourished or at risk of malnutrition or obese.

Staff we spoke with during the inspection were knowledgeable about the people they cared for. Staff we spoke with were aware of risk management plans that had been written for people with particular needs.

We saw that appropriate systems were in place for the management of medicines. People confirmed that they got their medication as prescribed and on time.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The home had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The provider might find it useful to note that policies and procedures contained limited information and did not detail action that staff should take when an application to deprive someone of their liberty was made. At the time of the inspection there wasn't any person who used the service who was subject to a DoLS. Staff had received training in relation to these topics along with the safeguarding of vulnerable adults and had an understanding of the actions to take. This meant that people were safeguarded as required.

People were not protected from the risk of infection as appropriate standards of cleanliness and hygiene could not be carried out. Laundry rooms did not contain a separate sink in which to ash hands. The floors and walls in the garage which was used as a laundry were not able to be washed and cleaned thoroughly. The sluice sink in the laundry was used to steep commode pots.

We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to protecting people from the risk of infection.

Is the service effective?

People's health and care needs were assessed and people and their relatives had been involved in writing the plan of care. Care and support plans were reviewed and updated on a regular basis.

We saw that people's needs were regularly reviewed. There was evidence of people being involved in assessments of their needs and planning of care.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people.

People who used the service, their relatives and friends were regularly asked for their views on the care and service provided. Where shortfalls or concerns were raised, however small, these were taken on board and dealt with.

Is the service responsive?

People knew how to make a complaint if they were unhappy. Discussion with the manager during the inspection confirmed that any concerns or complaints were taken seriously. We looked at the complaints. Records confirmed that the manager had taken appropriate action to deal with complaints in the agreed timescale.

Is the service well led?

The home had a registered manager, who was supported by the provider and administrative systems. The manager and staff had a good understanding of quality assurance processes and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. There was also regular input from the provider, including visits to the service.

Staff told us that they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and all senior staff understood and shared the responsibility of quality assurance processes. This helped to ensure that people received a good quality service at all times.

What people told us.

During the inspection we spoke with thirteen people who used the service and three relatives. We also spoke with the manager, the care co-ordinator, the domestic, the laundry assistant and to two care staff.

People who used the service told us that they were very happy with the care and service received. One person said, 'I have been in here a while and have no complaints, the girls are all lovely, but I do have my favourites.' Another person said, 'There are some absolutely fantastic members of staff here who will go the extra mile.'

People told us that they like to join in the activities that were organised by staff at the home. One person said, 'Anything that is going on I will join in.' People told us that they enjoyed going out for a pub lunch.

People told us that they got their medicines as prescribed and on time. One person said, 'I get my medicine when I should.'

People thought that the home was kept clean and tidy. A relative we spoke with said, 'My mum's room gets dug out every two weeks, the cleaners do their best.'

People told us that if they were unhappy or had any concerns they would feel comfortable talking with the manager. They told us that they were confident that action would be taken to resolve any issues.

We were able to observe the experiences of people who used the service. We saw that staff treated people with dignity and respect. We saw that people had their needs assessed and that care plans were in place.

People were supported to eat and drink sufficient amounts to meet their needs. One person we spoke with said, 'The food is absolutely gorgeous. We get plenty of dinners with mash and vegetables, which I really enjoy.'

We saw that the service had appropriate equipment. We saw that regular checks and servicing of equipment was undertaken to ensure that it was safe.

We saw that there was sufficient staff with the right knowledge and experience to support people.

We found that records were accurate and stored securely.

We found that people where able to make decisions about different aspects of their care and staff were aware of the Mental Capacity Act 2005 and how to act in accordance with legal requirements.

We saw that there was a friendly and relaxed atmosphere between people living and working at the home. We observed staff interacting well with people and supporting them which had a positive impact on their wellbeing. We found that people had their needs assessed and care plans were in place.

We found that people where able gave consent for different aspects of their care however assessments of mental capacity were not undertaken.

We found that people had their needs assessed and that care plans were in place. However we found that people's needs were not always being met.

Systems were in place to protect vulnerable adults from abuse.

We found processes for the administration and management of medicines were being followed.

There were appropriate arrangements in place for the recruitment of staff.

We saw the home had a complaints procedure in place and this was accessible to people who used the service and their relatives.