We carried out a review of the data available to us about Castlemead Court Care Home 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 Castlemead Court Care Home, you can give feedback on this service.
We found the following examples of good practice.
¿ The service had developed a dedicated unit of en-suite rooms to care safely for people who were admitted to the service with Covid-19. The area had its own access lift and was separated from the rest of the floor by a fire door and screen. Measures were in place to keep people safe and well cared for, and to reduce the risk of infection spread to other areas. For example, staff only worked in this unit and did not access other areas of the service. All equipment was kept separate. Each room had its own television and access to music and the radio via voice activated technology. This reduced the risk of isolation for people while they remained on the unit.
¿ Indoor visits had recently started to take place. These were accompanied by robust arrangements to ensure the safety of people and visitors. This included a booking system, risk questionnaire, visitor agreement, temperature check and the use of appropriate personal protective equipment (PPE).
¿ Enhanced cleaning schedules including regular cleaning of touch areas such as handrails and door handles were in place. This reduced the risk of cross infection.
¿ The service had well developed plans in place to use social bubbles and separate zones in the event of an outbreak of infection. This meant people who found it difficult to isolate in their rooms, perhaps due to being mobile and living with dementia, could be supported as safely as possible.
¿ Creative ideas were encouraged to support people remain safe and active. For example, activity trolleys had been introduced on each floor to support people when they needed to isolate in their rooms. Activities such as bathing dolls in warm soapy water supported some people living with dementia to wash their hands more frequently.
¿ Changes to staff practice throughout the pandemic period included staff not working across different floors and having access to different exit and entry routes. This reduced the risk of infection spread. Staff had received additional training in infection prevent and control and the use of PPE.
¿ Staff employed by the service did not work in any other care setting. This meant the risk of cross infection was reduced. A team of bank staff were used to cover vacant shifts as far as possible.
¿ Staff and people living in the service accessed regular testing for Covid-19. This meant action could be taken swiftly in the event anyone developed symptoms of the virus or had a positive test result.
¿ The infection prevention and control policy was up to date. People and staff had risk assessments in place to identify their individual risks associated with Covid-19. This meant protective measures could be put in place to keep people and staff safe.
Further information is in the detailed findings below.
Castlemead Court Care Home is a residential care home providing personal and nursing care to people in a purpose-built building. At the time of inspection 77 people were using the service. The service can accommodate up to 79 people on three floors. Each floor caters for people who have differing primary needs, for example, nursing care, residential care or people living with dementia.
People’s experience of using this service and what we found
The management team and staff had made a range of sustained improvements since the last inspection. An effective action plan had been implemented and followed through, supported at all levels of the service. People received good care. The management team were keen to promote new ideas and ways of working to support people achieve good outcomes.
People had a range of care plans in place to inform staff of their care and support needs. There were some inconsistencies within these, however, we found no negative impact upon people or the care they received. Staff had good knowledge of people and their needs.
We have made a recommendation about care and support plans in the service.
Staff understood their roles and responsibilities to safeguard people from the risk of harm and abuse. Processes were in place to support the safeguarding of people. People’s risks were assessed at regular intervals or as their needs changed.
Staff were employed using safe recruitment practices. There were consistently enough staff to meet people’s care needs. People’s medicines were managed in a safe way and good infection control practices were followed. Robust processes were in place to learn lessons and share learnings when things went wrong.
People’s needs were assessed in detail, including using evidence-based tools, prior to moving into the service and reviewed on a regular basis or as needs changed. Staff received training for their roles including specialist training to meet people’s complex needs. Staff had effective and proactive working relationships with other health professionals to ensure people accessed healthcare services and support as required.
People received support from kind and compassionate staff who knew them well. Staff had a good understanding of people's needs, choices and preferences. Staff enjoyed their roles and there was good communication and teamwork which benefitted people living in the service.
People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. Staff gained people's consent before providing personal care. People were treated as individuals and positive interactions were observed between people and staff throughout the inspection.
There was a complaints system in place and complaints were seen to be responded to appropriately according to the provider’s policy. People, relatives and other professionals were confident any issues raised would be dealt with promptly and appropriately. Activities were varied and people were supported to take part in as much or as little as they chose. People were supported to follow their interests.
The management team continually monitored the quality of the service, identifying issues and making changes to improve care and outcomes. The registered manager worked transparently and promoted a positive and proactive culture where people were at the heart of the service. The management team sought to drive continual improvements for the benefit of people using the service.
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.
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 requires improvement (published 26 February 2019).
Why we inspected
This was a planned inspection based on the previous rating.
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.
Castlemead Court Care Home is a residential care home that provides residential and nursing care for up to 79 older people including, people living with dementia. At the time of our inspection 77 people were living at Castlemead Court Care Home.
People’s experience of using this service:
People told us they felt well cared for. Staff showed people respect and dignity.
Staff morale was good and everyone was committed to ensuring people received care and support based on their preferences and choices.
The registered manager had completed audits on the home to support quality checks, however for some areas, these had not identified where improvements needed to be made. This was linked to where people's needs changed the paperwork did not always reflect this.
Medicines were not always managed safely. This was evidenced through staff leaving medication in a person’s bedroom for another staff member to administer.
There was sufficient staff to support people.
People had good health care support from professionals. When people were unwell, staff had raised the concern and taken action with health professionals to address their health care needs.
The environment had been considered to support people living with dementia. There was signage to support people to orientate themselves around the building and encourage their independence.
The registered manager worked in partnership with health and care professionals.
The Provider had displayed the latest rating at the Home and on the website.
When required notifications had been completed to inform CQC of events and incidents, this helped us to monitor the action the provider had taken.
More information is in the detailed findings below.
Rating at last inspection:
GOOD (report published 06 December 2016)
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
Follow up:
Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated requires improvement.
This inspection took place 12 October 2016 and was unannounced.
The inspection was carried out by two inspectors.
Prior to this inspection we had received concerns in relation to delivery of care.
There was a registered manager in post.
A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them.
People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.
There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.
Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.
Staff received an induction process and ongoing training. They had attended a variety of training to ensure they were able to provide care based on current practice when supporting people. They were supported with regular supervisions.
People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.
People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.
People were supported to access a variety of health professional when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.
Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.
People’s privacy and dignity was maintained at all times.
People were supported to follow their interests and join in activities.
People knew how to complain. There was a complaints procedure was in place and accessible to all. Complaint had been responded to appropriately.
Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.
Castlemead Court Care Centre is registered to provide accommodation and support for up to 79 older people, ranging from frail elderly to people living with dementia. On the day of our visit, there were 74 people living in the home.
The inspection was unannounced and took place on 16 January 2015.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
People were protected from abuse and felt safe at the home. Staff were knowledgeable about the risks of abuse and reporting procedures. We found there were sufficient staff available to meet people’s individual care and support needs. Safe and effective recruitment practices were followed and people were involved in the selection of new staff.
There were suitable arrangements for the safe storage, management and disposal of medicines. We found that, where people lacked capacity to make their own decisions, consent had been obtained in line with the Mental Capacity Act (MCA) 2005.
The CQC is required by law to monitor the operation of the MCA 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. We found that applications had been made to the local authority appropriately in relation to people who lacked capacity and who lived at Castle Court Care Centre.
People had access to healthcare professionals such as GP’s and mental health specialists when needed. They were given appropriate levels of support to maintain a healthy balanced diet and were looked after by staff that had the skills necessary to provide safe and effective care. People told us they were happy at the home and that staff treated them with kindness, dignity and respect. Relatives were also positive about the care and support provided. We saw that staff knew people well and met their needs in a patient and caring way.
People told us their needs were met and they were supported to take part in meaningful activities at the home. We saw that people who lived at the home and staff had been involved in developing aspects of the service and how the home was run. They were encouraged to have their say about how the quality of services could be improved and were positive about the leadership provided by the manager. We saw that a system of audits, surveys and reviews were also used to good effect in monitoring performance and managing risks.
We found that the home had good leadership and that the staff were positive in their desire to provide good quality care for people. The manager demonstrated a clear vision and set of values based on person centred care and independence. These were central to the care provided and put into practice by staff for the benefit of everyone who lived at the home.
We spoke with five members of staff and they were all friendly, helpful and knew about people's individual needs and preferences.
We saw that the communal areas of the home, such as the lounges, dining areas and access corridors, were clean and free from odour. The bedrooms we saw on each floor were comfortable, clean, with d'cor and furnishings in good order. We saw that people had personalised their room with their belongings.
We found 'Castlemead' to be efficiently managed and appropriately staffed. We saw that people were receiving safe and effective care in a well maintained and comfortable environment.
We also spoke with a visiting healthcare professional who told us the staff worked well with them in meeting the needs of people using the service.
As part of our inspection we used our Short Observational Framework for Inspection (SOFI) tool. The SOFI observation tool helps us to capture the experiences of people using services with dementia. It helps us to make judgements as to how people with dementia are respected and involved in their care and treatment.
Using the SOFI tool we spent time observing how people with dementia were supported. We saw that people were positively engaged in one to one and group activities facilitated by the staff. We saw the environment had interactive and sensory objects available for people to engage with. For example, small musical instruments, books, magazines, accessories (hats and scarves), chests of drawers and baskets in the communal areas were full of items for people to explore.
We saw the care staff worked at a relaxed pace and respond to people with warmth and affection. They promoted the involvement of everyone who used the service regardless of their mental or physical abilities.
People confirmed the home was clean and their rooms' were comfortable. One person said there was nothing the home would need to improve upon. Another person said 'the home is quiet, nice and pleasant'. Some people said they join in the home's activities and could go out locally into town with or without a carer to support Summary of our findings for the essential standards of quality and safety them. One person said they would like more outdoor activities to be offered, whilst another person said 'the day is too long, there is nothing to do, but just sit here'.
People said they sometimes attend the home's monthly residents meetings and they felt confident giving feedback to the staff and manager at the home.