Castle Grange

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The manager had a clear idea of the areas within the home requiring improvement and held an action plan with tight deadlines to work through. Staff were receptive to the work that had begun to improve practice and support people to achieve better outcomes. The manager always reviewed accident and incidents forms to ensure any learning could be implemented across the team, and improvements could be made where necessary. This supported safer care by ensuring incidents were reviewed promptly, lessons were shared with staff and improvements were implemented to reduce the risk of recurrence.
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The provider had a comprehensive pre-admission process used to ensure people’s needs were captured prior to them moving in. There was evidence the provider was working to continually improve this, so more information was obtained and ensured the process of assessment enhanced any plans to move in. There was evidence the person was involved in this process as much as they were able and views were gathered from significant people in their lives. The provider developed hospital passports containing key information about people’s health needs, preferences and personal circumstances to support continuity of care during hospital admissions.
 

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider had systems in place to identify, respond to and learn from incidents and safeguarding concerns. Staff followed established processes and knew their safeguarding responsibilities. The manager had identified opportunities to strengthen incident management and oversight and had implemented improvements, including new post-fall assessment processes and revised mental capacity procedures. They recognised the need for greater consistency in updating associated risk assessments and care records and continued to monitor this through governance processes. Where necessary, the registered manager submitted Deprivation of Liberty Safeguards (DoLS) applications to help ensure people who lacked the mental capacity to consent to their care were supported in the least restrictive way. Best interests’ decisions were made where appropriate and involved relatives and others who knew the person well.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff supported people to maintain their independence while managing identified risks. The manager took a proactive approach to risk management; for example, where people were at risk of malnutrition and required support at mealtimes, additional staffing was deployed to ensure people ate safely and received timely support in line with their preferences.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. For example, regular checks were completed on fire alarm systems, emergency lighting and mobility equipment. Risk assessments identified and managed known risks to keep people safe. Where improvements were needed, the manager implemented and monitored action plans to ensure they were completed. The environment was observed to be clean and well maintained.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.Staff had been recruited safely, and the provider had developed a tool to assist with ensuring there were enough staff on each shift to effectively support people according to their needs. For example, where it was identified some people were waiting in the morning for their breakfast due to staff already supporting others, additional staff numbers were arranged to ensure people’s needs were met. The provider ensured staff had the skills and knowledge to meet people’s needs through training relevant to the people they supported, with nurses receiving additional specialist training where required. Staffing levels were sufficient to respond to people’s needs, including during busier periods. Additionally, staff knowledge was tested through a range of competency assessments completed by managers or clinical leads.
 

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.
The provider had clear policies and procedures for managing infection control. Staff had completed infection prevention control (IPC) training and were knowledgeable about what measures they would take if someone was infectious. For example, one person had additional infection control measures in place, this had been noted in their care plan to ensure staff were aware and additional personal protective equipment (PPE) was placed outside the person’s bedroom. The manager completed an IPC audit, and we saw actions had been dealt with in a timely manner. Where we observed stained carpets, the provider explained there was a plan in place to replace them.
 

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. The provider ensured processes were in place to manage medicines safely with appropriate documentation providing clear guidance to staff administering medication. Staff were knowledgeable about the health conditions people lived with, such as diabetes and epilepsy, knowing the signs of deterioration to look out for. Staff had completed medication administration training, and their competency was assessed annually in line with company policy. There was effective communication between staff and clinical leads and engagement with appropriate healthcare professionals where necessary.