Castle Bank Care Home

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This key question was previously rated good. This key question remains good. This meant people were safe and protected from avoidable harm.

Safeguarding protocols and processes were clear. Staff knew what to do in emergencies, and to keep people safe on a day-to-day basis.

This service scored 75 (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 ensured the culture was one in which concerns could be raised and investigated thoroughly. People and, where appropriate, their relatives, were involved in describing and reviewing risks, so the provider could minimise these and keep people safe. One person told us about a time there had been an error with medicines, and they were happy with how the provider responded to this issue. One relative said, “The managers will come and see William once a fortnight to check everything is okay.”

The registered manager ensured incidents or errors were reviewed and lessons were learned. This ranged from reflecting on actual incidents to considering near-misses and developing areas of risk. Policies and procedures had regard to national guidance and best practice regarding specific areas of safety.

The registered manager and team were open and responsive to feedback and advice throughout the inspection and worked well with external partners to review practice.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and their relatives expressed confidence in the service. No one we spoke with raised concerns. One person said, “I don’t have any concerns, I trust the staff 100%”. Another said, “There are plenty of staff and they are all familiar faces.”

External professionals had confidence in the ability of staff, and the ethos of the culture, to ensure people were safeguarded from harm. They commented on the availability of leaders when they visited, and they had confidence in the provider’s ability to provide care safely.

Leaders acted quickly and transparently in response to any concern.

Safeguarding policies and procedures were up to date and in line with good safeguarding practices.

The registered manager demonstrated a clear understanding of the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received training regarding the MCA and policies were in line with the principles of the MCA.

People were supported to have maximum choice and control over their lives. Staff supported them in the least restrictive way possible and in their best interests. Staff sought consent and people and families were involved in decisions about their care. Capacity assessments were decision-specific and respectful of people’s right to make their own choices.

One person said, “[Registered manager] keeps everything in tip top order, can’t praise him enough. He sits down and listens to what you have to say, and makes you feel extremely safe.” People, relative and staff felt comfortable raising any issues.

Care records regarding people’s needs were detailed and person-centred, meaning risks were clearly set out for staff to understand. People and their families were involved in the review of these records. Where there was scope for further review and improvement of individual records, the registered manager responded proactively.

Specific risk assessments regarding how much help people would need to evacuate the building were in place. These were regularly reviewed. The provider needed to review some aspects of their fire safety record keeping. They responded positively to signposting and support from fire safety experts. Any minor improvements were made promptly.

The provider had recently moved to an electronic medicines administration system, which meant errors were easier to identify. This also allowed the provider to see if there were any pending medicines administrations/actions in real-time and avoid errors.

The provider had an ongoing schedule of refurbishment in place, which was proving effective. The service was welcoming and well maintained. Where we identified minor environmental issues, these were actioned immediately.

The provider ensured all equipment and utilities were regularly serviced and inspected, in line with requirements. When equipment needed repair or replacement this was actioned effectively.

Risk assessments included how people interacted with their environment and helped made them safer by putting instructions in place for staff.

Relevant policies had regard to up-to-date good practice and guidance.

The registered manager was open and welcoming of signposting and advice regarding fire safety and demonstrated an ability to continually review and improve practice in this area. Staff had received appropriate training and were confident in their responsibilities in the event of emergencies.

People and their relatives were positive about the level of support they received and felt there were ample staff to meet their needs. They had access to an emergency buzzer and confirmed staff responded to this if they used it. The rotas we reviewed matched the provider’s description of the number of staff on duty at various times.

Throughout our two visits to the service we observed staff responding promptly to anyone who needed help. One person said, “Staff come quickly if I use the buzzer. I don’t like being on my own when having a bath – they always stay with me and make sure I’m okay.”

The provider’s dependency tool would benefit from ongoing review to make it more person-centred, for instance detailing where there may be more support required for people with advancing dementia.

The staff team was a combination of experienced staff who had been at the service for a number of years, and some relatively new staff. The balance was working well.

The provider ensured there were a range of appropriate pre-employment checks and new staff went through an induction package, which included face to face and online training. Where pre-employment checks could be improved in terms of record-keeping, the registered manager was responsive to this feedback and made immediate improvements.

The service was clean and welcoming on arrival, and throughout our inspection visit. One person said, “It’s always nice like this.” No one said they had been inconvenienced by the refurbishment work, which was planned on an ongoing basis with the input of people who used the service.

No concerns were raised about infection control by people or their relatives. Staff confirmed they could access Personal Protective Equipment (PPE) when needed and we observed no concerns with PPR practices during our inspection.

Staff received Infection Prevention and Control training as part of their induction.

The provider had comprehensive policies and procedures in place to reduce the risks of people and staff catching and spreading infections.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.