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Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 June 2019

About the service:

Castle Grange provides accommodation, care and support for up to 40 people over 65 years old living with dementia-related conditions. The home provides permanent and short stay care. At the time of our inspection, there were 30 people living at the service.

People's experience of using this service:

People and relatives told us they felt safe with the care provided. One person said, “I’m very safe here, having all these people around me.”

We found the service had deteriorated in the safe and effective domains and continued requiring improvement in the well led domain since last inspection.

The service met the characteristics of requires improvement in three our of the five key questions. This was not the first time this service was rated as ‘requires improvement.’

We found not enough improvements had been made since our last inspection in relation to the quality assurance processes in place and the recording of people’s medicines. We also found the quality of the recording of people’s food and fluid intake, consent and daily care was not always consistent and detailed.

We found people’s medicines were administered in a person centred way. However, we found inconsistency in the quality of the recording of protocols for people who needed ‘as and when’ required medicines and instructions from the prescriber were not always being followed.

The provider had systems in place to assess and manage risks to people’s care. We found some known risks to people’s care were not being safely managed and there was inconsistent recording of risks related to people’s moving and handling requirements and skin integrity.

People were supported by staff who were motivated, enjoyed their job and felt well supported through regular supervisions and training.

Staff had a good understanding about dementia care.

Care plans were individual and met the needs of people using the service. They included people's choices and preferences.

Feedback from people, relatives and staff was positive and they felt the service was well-led. They told us the management team was always available to speak with and was responsive.

The registered manager had developed several links with the community to support care provision and service development.

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

Rating at last inspection:

At our last inspection the service was rated good . Our last report was published on 20 October 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people received safe, high quality care.

Further inspections will be planned for future dates. We will follow up on the breaches of regulations and recommendations we have made at our next inspection.

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

Inspection areas

Safe

Requires improvement

Updated 11 June 2019

The service was not always safe

Details are in our Safe findings below.

Effective

Requires improvement

Updated 11 June 2019

The service was not always effective

Details are in our Effective findings below

Caring

Good

Updated 11 June 2019

The service was caring

Details are in our Caring findings below.

Responsive

Good

Updated 11 June 2019

The service was responsive

Details are in our Responsive findings below.

Well-led

Requires improvement

Updated 11 June 2019

The service was not always well-led

Details are in our Well-Led findings below.