We carried out a review of the data available to us about Castle Grange on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Castle Grange, you can give feedback on this service.
People’s experience of using this service and what we found
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 told us they felt safe navigating the home and with the staff who supported them. Staff had received training in safeguarding and felt confident in the processes in place to report any concerns. Risks to people's health, safety and wellbeing had been assessed and staff understood how to help keep people safe.
The service was a modern build with a safe, homely environment. Risk assessments were used to keep staff and visitors safe and promoted good access to internal and external communal areas.
Medicines were managed and administered safely, with regular checks completed. We were assured by the measures taken to help ensure the prevention and control of infection. Where areas of the home required maintenance, actions were swiftly implemented to maintain standards. For example, to maintain a clean and pleasant environment.
Staff responded promptly and were attentive to people’s needs. The registered manager monitored staff deployment and ensured enough staff were always on duty. Ongoing recruitment meant there was a reduction on the reliance of agency staff which improved people’s experiences. Processes in place ensured staff recruitment was appropriate with a range pre-employment checks completed.
People were supported by caring, friendly staff who knew their needs well. People told us staff were skilled in their roles. Staff received required training and checks to ensure they followed best practice guidance.
People received an initial assessment of their needs. Care records included up to date information which evidenced people’s involvement with their care, support and regular reviews. Care provided was personalised and supported people’s preferences and wishes.
People’s health needs were being met. The service worked closely with other health professionals and external agencies to support them with their health and wellbeing. A health professional told us the service pro-actively sort external support to ensure people’s needs were met and responded positively to any guidance provided.
People and staff spoke positively about the management of the service and their openness to feedback. The management team was approachable, maintained regular communication, and listened to the views of others.
A range of audits and checks were completed to maintain and where required, implement any required improvements.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at least inspection and update
The last rating for this service was requires improvement (published 18 November 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service. 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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Castle Grange is a care home providing residential care to 86 people (both younger and older adults) some of whom are living with dementia. At the time of our inspection there were 69 people using the service.
The service is within a purpose-built care home, with accommodation and communal spaces over three floors. The second floor specialises in proving care to people living with dementia.
People’s experience of using this service and what we found
The quality assurance and audit systems in the service were not used effectively. Shortfalls in quality and practice were not identified and people’s health and safety were put at risk.
Care plans and risk assessments were not always in place or reviewed when people’s needs changed.
There were a high number of falls in the service over the last three months. Staff were not following the provider's slip, trips and falls policy with regard to recording and monitoring.
Although medicines were generally well managed within the home there were some aspects that required further work to keep people safe.
Staff did not always receive the support they needed to ensure they fulfilled their roles effectively.
People did not always receive person-centred care and support as insufficient numbers of staff meant they did not always have time to meet people’s needs effectively. We have made a recommendation about reviewing the staffing tool.
On one floor of the service staff were observed not wearing personal protection equipment (PPE) appropriately. However, people lived in a clean, comfortable and homely environment, designed to be dementia friendly.
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.
Staff had positive links with healthcare professionals which promoted people’s wellbeing.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 07 August 2019 and this is the first inspection.
Why we inspected
This was a planned inspection based on it being a new service and requiring its first rating.
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.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
During the inspection the registered manager spoke with staff about IPC and wearing of PPE. Following our inspection, the provider increased care staff levels throughout the home.
The overall rating for the service is requires improvement. This is based on the findings at this inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to risks to people’s health and safety, record keeping and quality assurance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.
Castle Grange is a residential care home providing personal and nursing care to 49 people aged 65 and over at the time of the inspection. The service is separated into two units, one provides residential care and the other specialises in providing care to people living with dementia. The service can support up to 86 people.
People’s experience of using this service and what we found
People and their relatives were happy and spoke positively about the care received and the management of the service. Procedures were in place to ensure infection control was well managed. Staff received regular training and showed understanding of their responsibilities to maintain infection control and how to manage infectious diseases. There was sufficient staff to meet people's needs and requirements in a timely manner.
Within the context of the Covid-19 infection risk, 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 best practice.
The provider, registered manager and staff promoted a person-centred care approach and placed people's wellbeing at the heart of their work. Quality assurance systems in place, monitored the service effectively and drove improvements when they were needed. Lessons learnt were used as learning opportunities to continuously develop the service.
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
This service was registered with us on 7 August 2019 and this is the first inspection.
Why we inspected
We undertook this targeted inspection to check on specific concerns we had received about staffing levels, staff training, management of risk and the governance of the service.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
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.