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Inspection Summary

Overall summary & rating


Updated 21 December 2016

This inspection took place on 9 and 10 November 2016 and was unannounced.

Castel Froma provides nursing and rehabilitative support to a maximum of 57 people suffering from a neurological disability. Most people also have highly complex medical conditions requiring continuous care and support or highly specialised nursing. The home is divided into three units over two floors. On the lower ground floor there is a therapy unit with a hydrotherapy pool, physiotherapy room and an occupational therapy assessment room. A range of on-site therapists provide rehabilitative input. There are large communal areas and extensive grounds which are accessible to the people living in the home.

We last inspected the home in October 2015. After that inspection we asked the provider to take action to make improvements in management of medicines in the home. The provider sent us an action plan to tell us the improvements they were going to make. At this inspection we found improvements had been made.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission 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.

Staff were proud of the service they provided and committed to providing high quality, compassionate care. Staff were friendly and thoughtful and took time to understand the needs of people with no or limited verbal communication. Staff treated people with dignity and respect and understood the importance of making them feel valued.

Friends and family were welcomed into the home and able to visit when they wished. Staff showed an awareness of how families and friends needed their support to manage their emotional needs and understand people’s conditions.

There were enough skilled and experienced staff on duty to meet people’s care and support needs safely and effectively. Staff had the necessary knowledge and information to ensure people were kept safe from abuse or harm. The provider’s recruitment process was thorough and ensured, as far as possible, staff were of a suitable character to work with people who lived at Castel Froma.

Staff had clear guidance on how to mitigate identified risks associated with people's health and well-being. Risk assessments were an essential part of keeping people safe, and some risk assessments were for ‘positive risk taking’ which promoted people's independence. The provider had procedures and policies to ensure the safety of the environment and equipment in the home. People's medicines were managed, stored and administered safely.

People received care from a multi-disciplinary staff team who were qualified and trained to meet their needs effectively. Staff were encouraged to undertake additional training and qualifications relevant to their roles. Nurses were offered reflective practice sessions where they could discuss any issues with their work.

The rights of people who were unable to make important decisions about their health or well-being were protected. Staff followed the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People were assessed on an on-going basis by dieticians and speech and language therapists (SALT) who visited the home every week to ensure people’s nutrition plans met their medical and health needs.

People's medical and personal needs were assessed and care and support was planned and delivered in line with their individual care plans. Each person had a named nurse who co-ordinated their care and regularly evaluated care plans to ensure they continued to meet the person's health and medical needs. Staff knew and understood people’s needs and how to support them. Staff worked closely with a range of external healthcare professionals to monitor and maintain people's h

Inspection areas



Updated 21 December 2016

The service was safe.

There were enough staff to provide effective care in a safe way. The provider checked staff’s suitability for their role before they started working at the home and that they had the appropriate skills and qualifications. Risks to people’s health and welfare were assessed and plans implemented to minimise the identified risks. Staff ensured people who lived in the home were safe and protected from abuse and harm. Medicines were stored, given and managed safely.



Updated 21 December 2016

The service was effective.

Staff had the training they required to meet people’s needs safely and effectively. Staff worked within the principles of the Mental Capacity Act 2005 and supported people to take part in the decision making process. Relatives and the appropriate healthcare professionals took part in the best interest decision process when people lacked capacity. People were supported to eat and drink enough to maintain a balanced diet that met their individual needs. The provider worked with a range of health professionals to ensure people received the support they needed to maintain their health.



Updated 21 December 2016

The service was caring.

Staff were compassionate and thoughtful and communicated effectively with people. Staff made time to know and understand people so they could build positive relationships with them. Staff showed kindness and knew how to show empathy when people and their relatives faced challenging situations. People were treated with dignity and respect.



Updated 21 December 2016

The service was responsive.

Care plans were personalised and people and their relatives were fully involved in the planning of care, treatment and support. Staff knew and understood people’s needs and delivered support in accordance with their care plan. Staff were flexible and responded to people’s changing needs or wishes. People were supported to achieve personal goals through rehabilitative input from the therapy team and were encouraged to take part in a range of activities.


Requires improvement

Updated 21 December 2016

The service was not consistently well-led.

People were happy with the care they received and staff were proud of delivering a high quality service. There was a clear management structure in place to support the management and governance of the home. Not all staff felt included, valued and supported within the home because communication between managers and some staff was not always effective. The quality assurance system involved asking people and their relatives about their experience of the service. Audits and checks were carried out to ensure people received a good quality service that was effective, safe and responsive to their needs.