About the service Castle Grange is a care home providing residential care to 86 people (both younger and older adults) some of whom are living with dementia. At the time of our inspection there were 69 people using the service.
The service is within a purpose-built care home, with accommodation and communal spaces over three floors. The second floor specialises in proving care to people living with dementia.
People’s experience of using this service and what we found
The quality assurance and audit systems in the service were not used effectively. Shortfalls in quality and practice were not identified and people’s health and safety were put at risk.
Care plans and risk assessments were not always in place or reviewed when people’s needs changed.
There were a high number of falls in the service over the last three months. Staff were not following the provider's slip, trips and falls policy with regard to recording and monitoring.
Although medicines were generally well managed within the home there were some aspects that required further work to keep people safe.
Staff did not always receive the support they needed to ensure they fulfilled their roles effectively.
People did not always receive person-centred care and support as insufficient numbers of staff meant they did not always have time to meet people’s needs effectively. We have made a recommendation about reviewing the staffing tool.
On one floor of the service staff were observed not wearing personal protection equipment (PPE) appropriately. However, people lived in a clean, comfortable and homely environment, designed to be dementia friendly.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
Staff had positive links with healthcare professionals which promoted people’s wellbeing.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 07 August 2019 and this is the first inspection.
Why we inspected
This was a planned inspection based on it being a new service and requiring its first rating.
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.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
During the inspection the registered manager spoke with staff about IPC and wearing of PPE. Following our inspection, the provider increased care staff levels throughout the home.
The overall rating for the service is requires improvement. This is based on the findings at this inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to risks to people’s health and safety, record keeping and quality assurance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.