Castlehill Specialist Care Centre

Updated 3 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team comprised of one inspector, a Specialist Nursing Advisor 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. On the second day of inspection, only the inspector was on site.

Service and service type

Castlehill Specialist Care Centre is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Castlehill Specialist Care Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This first day of this inspection was unannounced with an announced second day of inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We reviewed information available through Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people and 4 relatives about their experience of the care and support provided at the home. We also spoke with 9 staff, including care, domestic and nursing staff; the registered manager, the nominated individual and the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed 9 care plans and 4 staff files and a variety of records relating to the management of the service. These included audits, policies and processes, training for staff and medicine records. We received feedback from a visiting clinical professional.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 3 June 2023

About the service

Castlehill Specialist Care Centre is a residential care home providing personal and nursing care to up to 84 people. The service provides support to people who are living with dementia. At the time of our inspection there were 74 people using the service.

The care home is an adapted building across three floors comprising the separate units The Shires, Coppice, Brooklands, Sandhills and Beeches. The home had a number of communal lounges, a cinema room and access to an outside space on each floor.

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

People, relatives and staff told us they felt the care provided at the home was safe. Staff had received training on how to keep people safe and knew what to do if they had concerns. Risks to people were appropriately managed and reviewed regularly to reflect any changes in medical conditions.

At the time of our visits, there were enough staff members on duty to meet people’s needs. The provider had safe recruitment processes in place. Some people were assessed as needing 1 to 1 support from staff, we observed this was in place. Medicines were administered safely. We found there were effective infection control measures in place.

The provider had used and continued to use agency staff. The registered manager and nominated individual had been taking steps to reduce the use of agency staff with the recruitment of permanent care and nursing staff. Where agency staff were being used, the registered manager had tried to make sure they were block booked to maintain consistency. The agency staff we spoke with were knowledgeable about people’s support and care needs.

People’s care and support needs had been assessed and were reviewed. People and relatives told us they had been involved in those reviews. Staff had received training to support them in their roles. People’s dietary needs were being met alongside support from external healthcare professionals. People told us they were offered a choice of food to make sure their dietary needs were being met. People were supported by staff to access health and social care services with regular support from the community nursing and health teams. The home had facilities such as a bar area on the ground floor where visitors were able to spend time with their loved ones.

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 and relatives told us they felt able to raise concerns and approach the registered manager. Regular audits had been carried out to make sure ensure the quality and safety of the care was maintained. Surveys and meetings were held with people, relatives and staff to gather their views and make any 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 good (published 14 April 2022).

Why we inspected

We had received a number of safeguarding concerns relating to people’s safety. These included high number of falls, poor personal care, unsafe moving and transferring practices, unexplained bruising, poor nutrition and hydration, high use of agency staff and staff shortages. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. We found no evidence during this inspection that people were at risk of avoidable harm from these concerns.

Please see the safe, effective and well-led sections of this full report. 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 remained the same.

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 Castlehill Specialist Care Centre 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.