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Castle Keep Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 1 April 2020

About the service

Castle Keep is a residential care home providing personal and nursing care. The care home accommodates 61 people across two designated wings; Nightingale for people living with dementia and Willow for people with complex health care needs. Each wing has a separate entrance and adapted facilities to suit the needs of people living there. At the time of the inspection, there were 39 people living in the service.

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

Two people had not received their medicines as prescribed, as they were often asleep at the time nurses administered them. This needed to be checked out with the prescriber so the timings could be altered. There was also clearer guidance needed for staff when administering medicines ‘as and when needed’. We have made a recommendation about this aspect of medicines management.

There was no manager registered with the Care Quality Commission. An experienced manager from another unit had been supporting the service but, as they were leaving, an operations manager had been identified to take over the post. The operations manager will apply for registration with CQC and will oversee the service until a new manager is recruited.

There were some areas of the environment that needed attention in relation to unsafe furniture and cleaning routines. These were addressed on the day and the manager assured us a more robust checking system would take place. Other aspects of the provider’s quality monitoring were good. Following the inspection, we were told the refurbishment plan, which was already in place, would be adjusted to address the priority actions identified on the first day.

Staff were recruited safely and there was enough staff on duty. The manager told us when more people were admitted to the service, the staffing levels would be adjusted.

Staff knew how to safeguard people from the risk of abuse or harm.

Staff assessed people’s needs and identified risks so these could be minimised. Care plans provided guidance for staff in how to meet people’s needs in the way they preferred. 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.

People’s health and nutritional needs were met. Staff ensured people had access to health care professionals when required. The menus provided choices and alternatives; those people at nutritional risk were monitored closely.

People’s privacy and dignity were respected. There were positive comments about the staff team and their approach when supporting people.

The provider had a complaints procedure and people felt able to raise concerns.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 26 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas

Safe

Requires improvement

Updated 1 April 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 1 April 2020

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 1 April 2020

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 1 April 2020

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 1 April 2020

The service was not always well-led.

Details are in our well-led findings below.