Casterbridge Lodge

Updated 13 January 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

This inspection was undertaken by two inspectors. An Expert by Experience spoke to relatives by telephone. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Casterbridge Lodge is a 'care home' with nursing care. People in care homes receive accommodation, personal and nursing care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since it was registered under the current provider. We sought feedback from the local authority’s quality team. 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 used all this information to plan our inspection.

During the inspection

We spoke with nine people and 13 of their relatives. We also spoke with 14 staff including the registered manager, the deputy manager, senior care staff, care staff, activities person, a housekeeper, the cook and the maintenance person.

We contacted six health and social care professionals who support people at the service to ask their views, we were able to get feedback from three of them.

We reviewed a range of records. This included three people's care records and a sample of medication records. We looked at a variety of records relating to the management of the service, including training records, incident records, complaints, compliments, two staff recruitment files, supervision program, quality assurance processes and various policies and procedures.

After the inspection the registered manager sent us additional information about the service provided at Casterbridge Lodge and actions they had taken as a result of our feedback.

Updated 13 January 2023

About the service

Casterbridge Lodge is a residential care home in Winterbourne Steepleton, a village in south west Dorset, five miles away from Dorchester the county town of Dorset. People are supported in a detached adapted building across two floors. The home provides personal care and accommodation to up to 35 older people. At the time of our inspection there were 29 people using the service.

Although registered with the Care Quality Commission (CQC) to provide nursing care at the home, the provider had made the decision not to provide nursing care at the home.

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

People and their relatives spoke positively about the home and the staff. Comments included, “The staff are very friendly” and “The guys at Casterbridge have been absolutely amazing. They’re brilliant people.”

Staff were not always deployed within the home to ensure there were enough staff with the skills to meet everybody’s needs. Improvements were made during the inspection to improve staff deployment and numbers.

Although staff had completed the providers mandatory training, they had not always received a robust induction and had their competency assessed. Recruitment processes needed to be more robust to ensure employment gaps were always explored and demonstrated who had given new staff a reference.

Risks to people were regularly reviewed. We were not assured people were receiving adequate diet and fluids. The system to monitor people identified at risk of malnutrition and dehydration was not robust. Staff were not completing diet and fluid monitoring charts and the oversight by the senior staff was not identifying if people had received a poor input.

Staff did not always promote people’s independence, choice and dignity and ensure people were always shown respect. People's did not always receive personalised care and were not always involved in planning their care.

People and relatives were positive about the food at the home. Improvements were needed to ensure everybody had a good dining experience. People had the opportunity to undertake activities, but these were not always meaningful.

People usually received their medicines safely.

People were supported by staff who had received safeguarding training and were aware of the different types of abuse.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Accidents and incidents were, on the whole, managed appropriately. Each accident or incident was reviewed by the registered manager to ensure staff had taken appropriate action. After a discussion they said they would be looking at potential trends to be identify and minimise the risk of future incidents.

Environmental risks were managed well. This included fire checks and drills and regular testing of fire and electrical equipment, and maintenance issues being dealt with effectively. A lot of refurbishment had taken place across the home with further improvements planned. Improvements were made during the inspection to check water temperatures to ensure people were not placed at risk of being exposed to hot water that could scald them.

The registered manager had a monthly program of audits which had been completed. However, it was not clear actions had been taken when areas of concern were identified. Improvements were made to ensure actions were clearly recorded. Where the audits had not identified the areas of concern we highlighted, an action plan had been completed to improve the auditing and quality monitoring at the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 23 September 2021 and this is the first inspection.

Why we inspected

This inspection was carried out as it is a newly registered service.

Follow up

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