About the service:

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.

Castlemead Court Care Home is managed by Castlemead Court Care Centre Limited and provides residential and nursing care for up to 79 older people including people living with dementia. On the day of our inspection there were 71 people using the service.

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.

We spoke in private with three people who used the service and with other people, including three visitors, in communal areas throughout the home. Everyone we spoke with said they were pleased with the care and treatment provided at ‘Castlemead’. One visitor commented that the staff were “very kind and patient”. All the visitors said they were free to visit their relatives or friends at any reasonable hour.

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 décor 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 spoke with five people who used the service and they all told us they were pleased with the care and treatment they received. We spoke with a visitor who told us the staff were very kind and patient.

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.

Whilst talking to people we observed some differences in opinion. Whilst, most people were happy with the care and support they received from staff, one person commented ‘care staff just tell you what they are going to do; if they did ask it would be nicer!’ People said they liked the food; most people said they had choices of what food to have and sometimes were told the next day’s menu in advance. People said they could make their own drinks, although drinks would also be offered.

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.

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.