Our inspection took place on the 11 and 12 December 2014. The first day was unannounced so no one knew we would be inspecting that day. We last inspected the home in December 2013. At that inspection we found no breaches of legal requirements.
Castlecroft is registered to provide accommodation and personal care to a maximum of 64 people. On the day of our inspection 62 people lived at the home. People living there had a range of conditions related to old age. Accommodation is purpose built and is arranged over three floors.
A manager was registered with us as required by law. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We found that staffing levels did not always ensure that people’s needs were met in the way that they wanted them to be. We identified a breach in the law concerning this. You can see what action we told the provider to take at the back of the full version of this report.
Staff were not always following the Mental Capacity Act 2005. The provider had not made an application under the Mental Capacity Act Deprivation of Liberty Safeguards for all people who may have had their liberty restricted. The requirements of the Deprivation of Liberty Safeguards (DoLS) is a legal framework that may need to be applied to people in care settings who lack capacity and may need to be deprived of their liberty in their own best interest to protect them from harm or injury. We identified a breach in the law concerning this. You can see what action we told the provider to take at the back of the full version of the report.
People told us that they felt safe living at the home. There were systems in place to minimise the risk of abuse. Staff we spoke with understood that they had a responsibility to take action to protect people from the risk of harm.
People told us that they received their medication on time and in a way that they wanted. Arrangements in place ensured that medication was stored safely.
Staff knew about people’s needs. However training had not always been effective in ensuring staff have all the skills and knowledge they needed to provide safe and appropriate care to people.
People received the drink and food they needed to reduce the risk of dehydration and poor health. However, some people told us that the choice and quality of food could be improved. If people needed staff support to help them eat, this was provided.
People told us that staff listened to them and they knew how to raise concerns. The provider had a complaints system that was made available to people. However, the arrangements in place for listening and learning from concerns had not always been effective.
We found the overall quality monitoring processes required improvement to ensure that the service was run in the best interest of the people who lived there.