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Inspection carried out on 18 November 2019

During a routine inspection

About the service

Castle House is a residential care home providing personal to ten people with learning disabilities and autism. At the time of inspection, the home was full.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to ten people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People enjoyed living at the home and told us they were treated well by kind and helpful staff. Staff supported people with patience and understanding.

People received safe care, and staff understood safeguarding procedures and how to raise concerns. Risk assessments were in place to manage risks within people’s lives, and staff we spoke with felt safe supporting people with a wide range of needs.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out. Medicines were stored safely, and records showed that they were administered correctly.

Staffing support matched the level of assessed needs within the service and staff were trained to support people effectively.

People were supported to have their nutritional needs met. Healthcare needs were met, and people had access to health professionals as required. Care plans outlined any support people required to manage their healthcare needs.

People's consent was gained before any care was provided, and they were supported to have maximum choice and control of their lives. Staff treated people with kindness, dignity and respect and spent time getting to know 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.

Care plans reflected peoples’ likes, dislikes and preferences. An activities programme was in place, and people were supported to pursue holidays and activities they enjoyed with staff support.

A complaints system was in place and used effectively. The registered manager was keen to ensure people received good care and support and listened to feedback when provided.

Investigations took place into accidents, incidents and any events that could be learnt from. Learning was shared with the team and improvements were made when required.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 6 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to vi

Inspection carried out on 16 June 2017

During a routine inspection

Castle House is a residential care home for 10 people with learning disabilities. The accommodation is set over two floors with one self-contained flat on the first floor of the home.

At the last inspection, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive safe care and support. People had plans of care that were followed by the staff providing their care to mitigate their known risks. Appropriate action was taken when people were identified as being at risk of harm. People could be assured that they would receive their prescribed medicines and that staff had been subject to robust recruitment procedures.

People received care from staff that had received the appropriate training, supervision and support that they needed to work effectively in their role. People were supported to maintain good nutrition and to access healthcare services.

People were supported to have 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.

People received care from staff that knew them well and consistently treated people with respect and dignity.

People were involved in developing their plans of care which enabled people to receive care and support in line with their preferences. People knew how to complain and could have confidence that their complaints would be managed appropriately.

There was a system of quality assurance in place overseen by the provider, regional manager and registered manager which was successful at ensuring people consistently received good quality care and support. There was an on-going programme of refurbishment of the home.

Inspection carried out on 30 June & 1 July 2015

During a routine inspection

This unannounced inspection took place on 30 June and 1 July 2015. The home provides support for up to 10 people with Learning Disabilities. At the time of the inspection there were 10 people living at the home.

There was a registered manager 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.

People told us that they felt safe in the home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed. We observed that on the day of our inspection there were sufficient staff on duty. The recruitment practice protected people from being cared for by staff that were unsuitable to work at the home

Care records contained risk assessments to protect people from identified risks and help to keep them safe. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

People were actively involved in decision about their care and support needs There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People felt safe and there were clear lines of reporting safeguarding concerns to appropriate agencies and staff were knowledgeable about safeguarding adults.

Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People participated in a range of activities both in the home and in the community and received the support they needed to help them do this. People were able to choose where they spent their time and what they did. Pictorial formats of weekly timetables and medical appointments were in place.

Staff had good relationships with the people who lived at the home. Complaints were appropriately investigated and action was taken to make improvements to the service when this was found to be necessary. The registered manager was visible and accessible. Staff and people living in the home were confident that issues would be addressed and that any concerns they had would be listened to.

Inspection carried out on 31 July 2013

During a routine inspection

We spoke with two people. Both people said that they were happy living in the home.

We observed the relationship between staff and three people who lived in the home. This was carried on in a friendly and encouraging way. For example, we saw a staff member help someone with food preparation in the kitchen.

We had concerns from the last inspection that the service was not meeting a number of essential standards of quality and safety, so we followed up these issues.

This was a positive inspection. People we spoke with told us they were satisfied with the care provided. The essential standards we reinspected were found to have been met.

There was one suggestion made; new staff should not be given too much responsibility too soon and need to interact more with the people in the home.

Inspection carried out on 5 April 2013

During a routine inspection

We spoke with seven people who lived in the home at the time of the inspection. They said that they were satisfied with the care they received from staff.

A person told us that staff; ��are always there to help you if you need them��.

We spoke with six relatives. Everyone told us that the care staff provided was of a very high standard.

One relative said; ��I don't think you could better this home. My son is always eager to get back there when he comes to see me��.

There were a small number of suggestions made to improve the service; to ensure that the outside rubbish bin was secured so that rubbish did not escape home, that people were given more opportunities to go on outings, for example, to the seaside (management informed us that it will be organised in due course), for staff not to sit on the home's furniture (management stated this was an isolated occurrence), and for more variety and availability of food. The manager said she would follow up these suggestions.

This was a mixed inspection. People living in the home were satisfied with the care that staff supplied. Relatives said that they were very satisfied with the care supplied by staff. Some essential standards were met. Other standards were not fully met. These were to ensure care plans were fully sufficient to meet people's needs, that people have their nutritional needs met, and that quality assurance systems are fully in place to ensure a quality service.

Inspection carried out on 21 June 2012

During a routine inspection

There were ten residents living at the service when we visited on 21 June 2012. We spoke with four people about their experiences.

One person we spoke with said, �it�s nice�. Another said, �I enjoy it�. People said they were involved with a range of activities in the community such as going to a day centre, exercising at the gym and shopping trips. People said they were happy with the support they received from the manager and staff.

Inspection carried out on 15 December 2011

During a routine inspection

There were ten residents living at the service when we visited on 15 December 2011. We spoke with four residents, and two staff to ask for their comments. We spent an hour in a communal area of the home with residents, observing and assessing the quality of support residents received.

Reports under our old system of regulation (including those from before CQC was created)