Castle View

Updated 4 June 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection site visit took place on 20 November 2018 and was unannounced. The inspection was carried out by one inspector and a specialist nurse advisor on day one. It continued on 22 November 2018 with one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their experience related to older people and people living with dementia.

Before the inspection we reviewed all the information we held about the service. This included notifications the home had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive.

We used the information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with 11 people who used the service and three relatives. We spoke to the registered manager, clinical lead, clinical manager, training and development partner, companionship team leader, nine staff and two health and social care professionals.

We reviewed eight people’s care files, four medicine administration records, policies, risk assessments, health and safety records, consent to care and quality audits. We looked at four staff files, the recruitment process, complaints, training and supervision records.

We walked around the building and observed care practice and interactions between care staff and people who live there. We used the Short Observational Framework for Inspection (SOFI) at meal times. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We asked the registered manager to send us information after the visit. This included policies and the staff training record. They agreed to submit this by 23 November 2018 and did so via email. The registered manager also sent us a copy of a recent quality monitoring report carried out by local commissioners.

Updated 4 June 2019

The inspection took place on 20 and 22 November 2018 and was unannounced.

People living at Castle View receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is registered to accommodate 57 people and specialises in providing care, treatment and support for older people. The service was split over three floors which were all accessible by stairs or a lift. There were 55 people using the service at time of inspection.

There was a strong emphasis on eating and drinking well. Staff had a good knowledge of people's individual dietary needs. A 'night owl menu' was available to people for snacks and light meals during the evening and overnight. There was a smoothie menu to increase people's nutritional intake. There were systems in place to carefully monitor people's nutritional needs.

Care and support was provided by staff who had received an induction and continual learning that enabled them to carry out their role effectively including. Staff training was tailored to meet staff member's individual training styles and ensure they were able to meet people's needs. Nurses were provided with opportunities to maintain and develop their clinical skills. Staff felt supported by the management of the service and were confident in their work.

There were champions in dementia care, moving and handling, health and safety and end of life care to help improve outcomes for people.

Technology was used to support care delivery. The provider had introduced a tool which looked at patterns for falls, wounds, accidents/incidents, safeguarding alerts and infections. This information was used to help determine quickly whether any changes were required in the support people receive.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse and who to report this to both internally and externally if abuse was suspected.

Staffing levels were adequate to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults. Registered nurses had the necessary permissions to practice.

Risk assessments were individual and detailed which meant that staff understood safe practices which helped keep people safe.

Medicines were administered and managed safely by trained and competent staff. Medication stock checks took place together with regular audits to ensure safety with medicines.

People knew their responsibilities about the prevention and control of infections within the service. Staff had received training and there was protective equipment readily available.

People had been involved in assessment of their care and support needs. They had their choices and wishes respected. The service worked well and in partnership with professionals.

People were supported to have maximum 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.

The registered manager actively sought to work in partnership with other organisations to improve outcomes for people using the service.

People, their relatives and professionals described the staff as kind and caring. People had their dignity and privacy respected and their independence promoted.

People had their care needs met by staff who were knowledgeable about their individual needs and how they communicated.

The service had a complaints procedure and people were aware of it. People knew how to make a complaint. The service actively encouraged feedback from people and this was used in making changes and improvements.

A variety of activities were available and people could decide what they wanted to do. The service actively encouraged people to be involved.

Relatives and professionals had confidence in the service. The home had an open, honest and positive culture that encouraged the involvement of everyone.

Leadership was visible within the home. Staff spoke positively about the management team and felt supported. The registered manager and clinical lead actively kept themselves updated.

There were effective quality assurance and auditing processes in place and they contributed to service improvements. Action plans were completed and those responsible kept things up to date.

The service understood their legal responsibilities for reporting and sharing information with other organisations.

Further information is in the detailed findings below.