Castletroy Residential Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement.

This meant people’s needs were not always met.

The service was in breach of legal regulations in relation to safeguarding and person centred care.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

We observed that people did not always receive person centred care. During lunch service we saw that people were not offered condiments with their lunch and everyone received their drink in a coloured plastic cup. Staff confirmed the plastic cups were used for all people throughout the service and were in place for safety. The provider had not considered that people may prefer to drink from a different type of cup. We also saw that people who required pureed food did not have this shaped to improve its appearance and make it more appetising. Staff told us they no longer did this as people had dementia and weren’t worried about the presentation of the food, they were unable to say how they knew this.

People's care plans required more detailed information to enable staff to understand their support needs and relevant risks. We saw the same generic information about people’s mental health needs across different people’s care plans.

Where people were known to resist personal care, their care plans provided no guidance for staff in how to support them. Records showed people could sometimes require support from 2 or more members of staff due to due their emotional distress, there was no information on how these staff members should provide the support.

People’s care plans required more detail about their current likes and dislikes, daily routines and activities. For example, people’s night care plans contained no information about their preferred nighttime routine.

People’s care plans did not always reflect the care that people preferred. For example, we saw one person was distressed, staff stroked the person’s hair and held their hand, the person was comforted by this interaction. However, their care plan said the person did not like personal touch.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Systems and processes were in place to promote effective information sharing between stakeholders involved in people’s care, we saw that the provider regularly shared information with other professionals involved in people’s care. For example, the registered manager and staff referred people to the Dementia Intensive Support Service when advice and support was needed.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communication needs were assessed to ensure information was provided to them in a format most appropriate to their needs. For example, care plans described how people preferred to received information; pictorial menus were available to support people to choose their meals.

The registered manager and senior staff kept people informed about the service through regular face to face and telephone contact. One person’s relative said, “I always get email or a phone call with updates as and when needed. I have met the manager many times, they are all very open with me.”

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Surveys were in place to gather people’s views, however, the provider had not responded in enough detail to specific concerns raised by people, for example negative feedback about staffing deployment. People and staff described the systems in place to obtain feedback and involve people in decisions such as regular reviews of people’s care.

There were systems to manage concerns and complaints. A complaint policy was in place that detailed the process of managing complaints, and this had been followed in practice. People’s relatives told us the registered manager and senior staff were accessible and listened to and dealt with any concerns they raised. One person’s relative said, “[Senior staff member] has told me I can ring any time and have a chat, they are always ready to listen.”

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

We found evidence that people were being subjected to restrictive practices that had not been adequately assessed by the provider for safety, dignity risks or to provide justification for the necessity. This increased the risk of people not receiving equitable care under the Mental Capacity Act.

The home environment had been adapted to ensure it was accessible for all people who lived there.

Systems and processes were in place to ensure staff would be able to support people to access additional support should it be required.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Safeguarding concerns were not always identified or reported. Documentation regarding instances of emotional distress and the monitoring of individuals' health needs was often incomplete or ineffective.

Care plans did not consistently reflect peoples’ individual needs and did not always contain sufficient guidance on how to support them in managing known risks. This meant important information was not always available to ensure people were receiving safe, consistent and fair treatment, especially when they were unable to advocate for themselves.

Staff did not always have the necessary skills, competence, and training to support people in accordance with their needs.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

There were no people receiving end of life care at the time of inspection. Staff had not received training in end of life care. Not all people had been given the opportunity to discuss their wishes as part of planning their care and limited information was recorded in their care plans.