Castleford Home for Older People

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

People told us they felt safe living in the home, and they were happy with the service provided. Improvements had been made to the management of medicines and risks. However, we noted there were signature omissions in the administration of topical creams. Following the inspection, the registered manager confirmed additional checks had been introduced to ensure the topical cream administration records were fully completed.

Individual and environmental risks had been assessed and managed. There were sufficient numbers of staff deployed to meet people's needs and ensure their safety. The provider operated an appropriate procedure for the recruitment of new staff. People were protected from the risks associated with the spread of infection. Whilst the premises had a satisfactory standard of cleanliness throughout the building, a shower room had been left unclean. The registered manager took immediate action to have the room cleaned during the inspection.

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 management team carried out a series of audits to check and monitor the quality of the service. The registered manager considered the views of people, their relatives and staff in respect to the quality of care provided. The registered manager and staff used the feedback to make ongoing improvements to the service.

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 requires improvement (published 5 November 2019).

At our last inspection we recommended that the provider make improvements to management of risks and medicines and strengthen their quality assurance systems. At this inspection we found the provider had acted on the recommendations and made improvements to the service.

Why we inspected

We carried out an unannounced focused inspection of this service on 1 and 3 October 2019. We made three recommendations in respect to the management of risks and medicines and the governance systems. We undertook this focused inspection to follow up on the recommendations made at the last inspection.

This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those recommendations. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Castleford Home for Older People on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Castleford Home for Older People provides accommodation and personal care for up to 47 older people. The home is located close to the centre of Clitheroe. Accommodation is provided on two floors in 47 single bedrooms. The home is divided into four areas, known as Henthorn Court, Edisford Court, Castleview Court and the community beds area. This area provided support for people up to a maximum of six weeks, whilst longer term decisions were made. Henthorn Court and Edisford Court provide care for people living with dementia. At the time of our inspection there were 41 people living in the home.

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

People told us they felt comfortable and safe living in the home. The registered manager and staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. While staff had carried out risk assessments, we noted risk assessments had not been carried out in respect of risks posed by two people’s healthcare conditions. We also noted medicines had not always been handled safely. We made recommendations about the management of medicines and the risk assessment process. Following discussion of our findings on the first day of the inspection, the management team took the necessary action to address the shortfalls. Cleanliness and hygiene were maintained throughout the home, which reduced the risk of infection.

Whilst we observed sufficient staff were deployed during our visit, people and their relatives had mixed views about the staffing levels. The registered manager told us the deployment of the management team would be reviewed. The provider followed an appropriate recruitment procedure to ensure prospective staff were suitable to work for the service.

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 provider had appropriate arrangements to ensure all staff received training relevant to their role. New staff completed an induction training programme. People’s needs were assessed prior to them moving into the home. People were supported to eat a nutritionally balanced diet. People were supported to maintain their health and a visiting healthcare professional provided positive feedback about the service.

Staff treated people with kindness and respect and spent time getting to know them and their specific needs and wishes. Our observations during the inspection, were of positive interactions between staff and people who lived in the home.

All people had a support plan which detailed their needs and preferences. However, three support plans required updating to reflect people’s current needs. The staff updated the plans after the first day of the inspection. People and/or their relatives had discussed their care needs with staff. People were aware of how they could raise a complaint or concern if they needed to and had access to a complaints procedure.

The provider's systems to review the quality of care were not always effective. Whilst audits and checks had been carried out, shortfalls found had not always been acted upon and sustained. We made a recommendation about strengthening the quality assurance processes. Following the inspection, the registered manager sent us an action plan which addressed our findings. The senior operations manager explained a new quality assurance system was currently in progress and would be implemented in due course. We did not see any details about the new system during the inspection.

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 20 April 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 visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Castleford Home for Older People provides accommodation and personal care for 46 older people. The home is located close to the centre of Clitheroe. Accommodation is provided on two floors in 46 single bedrooms. The home is divided into four areas, known as Henthorn Court, Edisford Court, Castleview Court and the community beds area. Henthorn Court and Edisford Court provide care for people living with dementia. At the time of our inspection there were 45 people living in the home.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the last inspection on 11 and 12 May 2014, we asked the provider to make improvements to the recruitment process for new staff and ensure people were appropriately supported to eat and drink. Following the inspection, the provider sent us an action plan which set out what action they intended to take to improve the service. During this inspection, we found some improvements had been made in order to meet the regulations.

Safeguarding adults’ procedures were in place and staff understood how to protect people from abuse. Risks associated with people’s care were identified, assessed and recorded. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Safe staff recruitment procedures were in place which ensured only those staff suitable for the role were in post. People's medicines were managed appropriately and people received their medicines as prescribed by health care professionals.

Staff had completed an induction programme when they started work and they were up to date with the provider's mandatory training. The registered manager and staff understood the main principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation. There were appropriate arrangements in place to support people to have a varied and healthy diet. People had access to a GP and other health care professionals when they needed them.

Staff treated people in a respectful and dignified manner and people's privacy was respected. People were involved in the development and review of their care plans. This meant people were able to influence the delivery of their care and staff had up to date information about people’s needs and wishes. We observed people were happy, comfortable and relaxed with staff. Care plans and risk assessments provided guidance for staff on how to meet people’s needs and were reviewed regularly. People were encouraged to remain as independent as possible and supported to participate in a variety of daily activities.

The complaints procedure provided information on the action to take if a person wished to raise any concerns. People were aware of the complaints procedure and processes and were confident they would be listened to.

Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. The registered manager took into account people’s views about the quality of care provided through discussion, meetings and satisfaction surveys. The registered manager used the feedback to make ongoing improvements to the service.

People's care was planned and delivered in accordance with their needs. People had individual care plans which were supported by risk assessments and daily care records. The manager took immediate action to rectify some shortfalls found in the care plans and developed a detailed care plan audit tool to prevent issues reoccurring.

People were provided with a well maintained and comfortable environment. Appropriate arrangements were in place for routine repairs and maintenance.

There were sufficient numbers of staff on duty to meet people's needs. People made complimentary comments about the staff team and staff were observed to have a respectful and sensitive approach to meeting people's needs.

We found there were established systems to monitor the quality and operation of the service. We saw evidence to demonstrate that people were regularly consulted about their opinion of the service and their comments were used to shape future developments in the home.

People's care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments and daily care records. This meant people's care could be readily monitored and evaluated.

Staff had an understanding of safeguarding vulnerable adult procedures and knew who to contact in the event of a concern.

Suitable arrangements were in place to manage medication.

Staff were provided with appropriate training opportunities and received regular supervision.

There were effective systems in place to monitor and assess the quality of the service.