Archived: Castle Grove Nursing Home

Castle Grove is a detached Georgian, two storey property located in the Devon village of Bampton. It is within easy walking distance of local shops, restaurants, and the Church. People have access to a well-maintained garden. The service provides accommodation and nursing and personal care for up to 26 older and younger people. At the time of the inspection there were 21 older people living at the home.

The provider also provides personal care to people living in sheltered accommodation within the grounds of Castle Grove. At the time of the inspection nobody living in the self-contained apartments were receiving the regulated activity of personal care.

People’s experience of using this service and what we found

People looked comfortable and relaxed with the staff who supported them and felt safe. People were treated with kindness and respect by enough staff, who had been recruited safely and had the skills and required training to support their needs.

People lived in a home which was pleasant, welcoming, and well maintained. Risks were managed effectively for individuals and the environment.

Risks of infection to people was minimised because staff followed up to date infection control guidance and had access to personal protective equipment.

People’s medicines were managed safely, and they received them as prescribed for them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager promoted and encouraged open communication amongst everyone who lived at the home. People and those important to them were involved in making decisions about their care and asked their opinions about the home. They said they were happy with the care and support they received and said they would recommend it to others.

The provider, registered manager and senior leadership team were constantly looking to make improvements where needed.

The provider recognised the importance of supporting and caring for their staff team and had a good staff retention. They were actively recruiting and used the services of consistent agency staff where their own staff could not fill any duty gaps.

Staff felt supported and valued by the provider and said staff morale was good.

The provider's governance systems were being embedded within the service to monitor quality and drive improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (Published 8 February 2018).

Why we inspected.

This inspection was prompted by a review of the information we held about this service and the length of time since the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

This was a focused inspection looking at safe and well-led key questions only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Castle Grove Nursing Home on our website at www.cqc.org.uk.

The overall rating for the service has not changed from good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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.

Care and treatment was planned and delivered in a way intended to ensure people's safety and welfare. The home sought specialist professional advice in caring for people with complex high needs. Call bells were quickly responded to. People told us they never had to wait long for anything they needed.

Staff said they were kept well informed and were always told what was going on which ensured they were able to offer appropriate care and support to meet people's needs. Staff said they knew other members of the team would always help out in any situation where there was uncertainty, they said, 'there is always someone on hand to help'. Staff worked as a team and were well trained and supported, with opportunities offered to develop their skills.

People told us they were 'happy at the home' and 'very satisfied with the care'. One person said they had 'no regrets at all since moving in', 'everything is done for me' and another 'I don't have to tell anyone if I need anything, they just seem to know'. One person said 'you can put up with anything if there is kindness and there is kindness here'.

Freshly prepared healthy nutritious foods were provided. Nutritional and hydration screening was unedrtaken which ensured the risk of poor nutition and dehydration was reduved. People told us the meals were 'excellent', 'always fresh' and 'most enjoyable'.

There was an open culture in the home which encouraged people to talk about anything they chose at any time. People told us that if they had any concern they had no hesitation in speaking to one of the staff. People felt confident that they would be listened to and any issue raised addressed.

A visitor we spoke to told us they visit a friend at the home every week. They said they always considered the home 'more like a hotel' and that they 'would be happy to put their name down for a place'. We also read a file which included comments from relatives and friends of people who had lived at the home. One read 'comfort and dignity were maintained to the very end, not just professionalism but sensitivity and kindness'.