Castle Road

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

People were protected from risk of harm and abuse. Staff received safeguarding training and understood their duty to keep people safe. People were involved in understanding and formulating plans to reduce the risks associated with their care. Risks associated with peoples on going care needs were identified and acted on. There were sufficient staffing levels and oversight to ensure people’s needs were being met and people received their medicines as prescribed. Some people had medicines prescribed to be given when required. Staff did not always have up to date guidance available to help them make consistent decisions about when these medicines might be needed.

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.

People experienced good quality care from a service which was open and honest.

Staff were able to describe how they would manage and report accidents and incidents. One staff member we spoke with told us “I would write out an accident or incident report, update the persons daily notes and hand it over to my manager”. We spoke with both the registered manager and nominated individual who confirmed this and described the actions they would take next, which included making onward referrals to healthcare professionals if necessary.

Records showed complaints had been dealt with in line with the provider's complaints policy. The registered manager and provider explained how accidents and incidents were recorded. The CQC sets out specific requirements that providers must follow when things go wrong with care and treatment. This includes informing people and their relatives about the incident, providing reasonable support, providing truthful information and an apology when things go wrong. The provider understood their responsibility under the duty of candour to be open and honest when things went wrong.

People told us they had access to healthcare and dentistry. People could choose if they wished staff to support them with their needs or not. One person told us “sometimes I ask for support, it really does depend on what it is. (Relative) comes with me sometimes”.

Observations, discussions with leaders and records confirmed the service worked with healthcare professionals such as, G.P's and dentists, to ensure people received effective and responsive care.

Where appropriate the service worked in partnership with healthcare professionals to ensure people received the support they needed.

People told us they felt safe. One person told us “sometimes it can get noisy but staff step in and manage this. I feel staff do their best to keep us safe”.

People were supported by staff that had received adequate training and knew how to raise and report safeguarding concerns. One staff member told us I would report it to my manager. I would wait to see if anything was done and ask my manager for an update. If nothing had been done, I would go to (nominated individual). I would also contact the main office and the (local authority safeguarding team). The registered manager, staff and nominated individual were committed to ensure people were safeguarding from avoidable harm. We found examples of where concerns had been reported to the appropriate local authority safeguarding teams.

People appeared safe and well kept and people were comfortable in the presence of staff. From our observations and speaking with people that used the service we were satisfied that appropriate action was being taken to keep people safe.

The service had safeguarding systems and processes to identify, report and investigate, allegations of abuse. Systems were aligned to the providers policies and procedures.

One person described how their risks were well managed and how staff ensured they were involved in managing the risks associated with their care. The persons care plan and risk management plans demonstrated they were involved in managing their risks.

Without exception the registered manager and staff had in depth knowledge of people’s individual risks and the action they needed to take to mitigate the risk of harm associated with people’s care.

From our observations and speaking with the registered manager, people and staff it was evident that people were involved in the risk management processes within the service.

The provider had systems in place to review the risks associated with peoples care needs and people told us they were involved in these processes. One person said, “I’m always having reviews”.

People told us peoples living environments were safe. One person told us "No problems (in relation to the environment) and its clean and we can come and go as we want”. People were able to come and go from the service as they wished.

The registered manager carried out quality assurance audits which included maintenance and safety checks. The leadership team and staff fully understood their responsibilities to keep people safe within the service.

From our observations we were satisfied that peoples living environment was safe and suitable for its intended use.

The provider had effective systems in place to ensure people were protected from untoward incidents.

People told us there were sufficient staff to meet people's needs. Comments included, “There is always some available for help if needed” and “Yes there is enough staff”.

The nominated individual and registered manager were aware of the staffing ratios needed to support people effectively. They described what contingency plans they had to support staffing shortfalls that could happen due to sickness and holidays. Staff told us there were enough staff to meet people’s needs. Comments included: “We have a clear staffing structure and enough staff. I feel well supported”, “We have enough staff we don’t use agency anymore”, “We all do a bit of everything “and “If you had asked me that a year ago, I would have said we don’t have enough staff however, now we do and it is a nice place to work”. Staff told us and records confirmed that they received training and supervision to carry out their roles effectively. Comments included “I really enjoy the training”, “I get supervision and we discuss how things are going and if I’m up to date with my training” and “You can always ask for more training it’s never a problem”.

From our observations and talking to staff and people we identified there were sufficient numbers of staff to meet people's needs. Staffing rotas confirmed planned staffing levels were being maintained.

Records showed that staff completed training which included safeguarding, Mental Capacity Act (MCA) and infection control. Records showed newly appointed care staff went through an induction period. This included training for their role, shadowing an experienced member of staff and having their competencies assessed before working independently with people. People were protected against the employment of unsuitable staff because the provider followed safe recruitment practices. We observed, and staffing rotas confirmed, there were sufficient staff to meet people's needs.

People we spoke with did not raise any concerns about the cleanliness of the service.

The registered manager and staff described the measures used at the service to support safe infection prevention and control practices. Staff told us they had free access to personal protective equipment (PPE).

The environment was clean and well maintained.

The service managed the control and prevention of infection well. Staff were trained in infection control and had access to protective personal equipment such as gloves.

People told us and we observed people received their medicines as prescribed.

The registered manager and staff were able to describe how they ensured people received their medicines as prescribed. Staff told us they received medicines training. One staff member told us “I have had medication training and I really enjoyed it”.

Additional information was not always available to support staff to make consistent decisions about when to give people a required medicine. Although staff had received training to administer medicines, they did not have their competencies checked in line with national guidance. However, we were satisfied that people had not come to any harm as a result of these shortfalls. We were also satisfied that people were receiving their medicines as prescribed. We raised these concerns with the provider during our inspection and they took immediate action to ensure they now had protocols to support consistent decisions surrounding when staff should give required medicines and to introduce a system to check staff competencies Which was in line with best practice. Medicines were ordered, checked and available when people needed them. Medicines were stored, administered, recorded and disposed of safely.