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Inspection Summary


Overall summary & rating

Good

Updated 8 July 2017

This inspection was a comprehensive inspection and took place on 12 June 2017.

At the last comprehensive inspection, completed in March 2016, we rated the service as overall ‘requires improvement’. We issued requirements in relation to care planning, risk assessments and management of medicines. We also issued a warning notice in relation to the risk of fire safety.

We followed this up in a further focussed inspection completed in July 2016. We found fire risks were being monitored and the service had met the warning notice. We also found that although some improvements had been made in respect of medicine management, further improvements were still needed.

The registered manager sent us an action plan to show how they intended to meet regulations.

Castle House is registered to provide personal care for up to 33 people. They provide care and support for frail older people and those people living with dementia. On the day of the inspection there were 22 people living at the home, including one person who was having a short stay there (respite).

There was a registered manager who had been in post for 12 months. 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.

At this inspection we found improvements had been made in the way care and support was being planned for people. This included ensuring any risks were understood, monitored and actions taken to mitigate any assessed risks. Care plans and daily records gave a good account of the needs and the support people had. It included what staff were doing to ensure people’s needs and wishes were being met.

There were improvements in medicines management, but records relating to these required further improvements. The service’s own audit had already picked up this issue. They had implemented further training and ‘spot checks’ for staff completing medicine rounds including the records. They had also been completing competency checks on staff skills in relation to medicines and had been proactive when they had identified issues in staff competencies.

There were sufficient staff with the right skills, knowledge and experience on duty to ensure people had effective care and support. People said staff were kind and caring. We observed staff providing support in a respectful and compassionate way. There were good relationships between staff and people who lived at the service. There was lots of laughter and good humour throughout the day.

Staff had the right support and training to do the job effectively. The staff team felt the views were valued and that the management approach was open and inclusive.

Staff understood how to protect people’s human rights, ensure any concerns were reported and that people felt safe.

There was a range of activities available for people to enjoy. This included occasional trips out into the local community. Those people who spent most of their time in their room were offered support to try new activities and to help ensure the prevention of loneliness and isolation.

People were offered a wide choice and variety of food. Menus were regularly discussed and amended to include people’s preferences. Where people were at risk of poor nutrition due to their health conditions, staff monitored their weight and their daily intake of food and fluid. People whose weight had decreased, were referred to their GP for advice and support with maintaining their weight through supplements.

The service had safe recruitments processes which ensured staff were only employed once their pre-employment checks had been completed. Staff knew how to report possible concerns about abuse.

Inspection areas

Safe

Requires improvement

Updated 8 July 2017

The service was mostly safe.

The risks to people were assessed and actions were put in place to ensure they were managed appropriately.

There were enough staff with the right skills to meet people’s needs.

Medicines were well managed, although improvements were needed in record keeping.

Staff knew their responsibilities to safeguard vulnerable people and to report abuse.

Effective

Good

Updated 8 July 2017

The service was effective.

People were supported by staff who were trained and supported to meet their physical, emotional and health care needs.

People were enabled to make decisions about their care and support and staff obtained their consent before support was delivered. The registered manager knew their responsibility under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards to protect people.

People’s dietary requirements were well met and mealtimes were unrushed and enjoyable for people.

Caring

Good

Updated 8 July 2017

The service was caring.

People were treated with dignity, kindness and respect.

People were consulted about their care and support and their wishes respected.

Responsive

Good

Updated 8 July 2017

The service was responsive.

Care and support was well planned and any changes to people’s needs was quickly identified and acted upon.

People or their relatives concerns and complaints were dealt with swiftly and comprehensively.

Well-led

Good

Updated 8 July 2017

The service was well-led

The home was well-run by the registered manager and deputy who supported their staff team and promoted an open and inclusive culture.

People’s views were taken into account in reviewing the service and in making any changes.

Systems were in place to ensure the records; training, environment and equipment were all monitored on a regular basis.