About the service:

Castleview Residential Care Home is registered to provide accommodation and personal care for up to 13 people. At this inspection 13 people were living there including some who were living with dementia.

People’s experience of using this service:

• People received safe care and support as the staff team had been trained to recognise signs of abuse or risk and understood what to do to safely support people. Potential risks to people, associated with their care, had been assessed and managed appropriately by the provider and the staff team.

• People received their medicines safely and as prescribed. They were supported by sufficient numbers of staff to ensure that risk of harm was minimised.

• Staff members followed effective infection prevention and control procedures.

• Staff had been recruited appropriately and had received relevant training so they were able to support people with their individual care and support needs.

• People’s individual human rights were protected by those supporting them. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

• The environment where people lived suited their individual needs and preferences. The provider supported staff in providing effective care for people through person-centred care planning, training and supervision. People were promptly referred to additional healthcare services when required. People were supported to maintain a healthy diet that reflected their personal preferences.

• People were treated with kindness and compassion. People’s rights to privacy were respected by the staff who supported them and their dignity was maintained. People were supported to express their views and be actively involved in making decisions about their care and support needs.

• People’s choices and independence was respected and promoted by a staff team that knew them well and who responded appropriately.

• People were provided with information in a way that they could understand by staff members who understood their individual communication styles. The provider had systems in place to encourage and respond to any complaints or compliments from people or visitors.

Rating at last inspection:

At our last inspection published on 27 January 2016 we rated the service as good. At this inspection we found the evidence continued to support the rating of good.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated as Good overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

This was an announced inspection which took place on 11 December 2015. Castleview provides accommodation with personal care for 13 older people. At the time of this inspection 12 people were living at the home. At our last inspection in May 2014 the provider was compliant with the regulations we assessed.

There was a registered manager at the home. 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.

We received a high level of praise from people and their relatives in relation to this home. They were very complimentary about the quality of the care they received. We found the registered manager and staff were motivated and committed to providing a high standard of care to people.

People had no concerns about their safety. Risks to their safety had been identified and staff had training in how to recognise and report abuse.

Staff were recruited in a safe way and had relevant training and support to enhance their skills in providing people with quality care. There were enough trained and experienced staff to support people and meet their needs in a personalised manner.

People had their medicines when they needed them and the arrangements for the management of people’s medicines was safe.

Care was focused on people’s individual needs and we saw this was effective in managing risks to their health such as weight loss, falling or developing pressure sores.

Staff were aware of how to support people’s rights, seek their consent and respect their choices. We saw staff worked within the principles of The Mental Capacity Act 2005 (MCA) to ensure that the human rights of people who may lack capacity to make decisions are protected. The MCA Deprivation of Liberty Safeguards (DoLS) requires providers to submit applications to a ‘Supervisory Body’ for authority to deprive someone of their liberty. We saw staff understood this legislation and had followed it to ensure the safety of some people was promoted.

People told us they enjoyed the meals and we saw that risks to their dietary intake were known and staff supported them to eat and drink enough. People’s health was supported by access to appropriate health professionals.

We saw that staff were attentive and caring towards people. People described the staff as being friendly and kind. Relatives told us the staff were polite, patient and respectful towards people.

People told us that they were happy living at the home. They and their relatives knew how to raise any concerns if they needed to and were confident their concerns would be listened to and acted upon.

People described the management of the home as very friendly and approachable.  Staff felt supported by the provider. We found quality monitoring systems were in place and that the provider had continued to make improvements so that the home was run in the best interests of the people who lived there.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who use the service, the staff supporting them and from looking at records. We spoke with seven of the twelve people using the service, two members of staff, the cook, provider, manager and three visiting relatives. We looked at four people's care records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People we spoke with told us they felt safe and a relative said they had, “Specifically chosen this service on the recommendations of others”. Another relative said, “Our previous experiences were poor, we chose this home because it has a reputation of being safe, caring and good staff and manager, I’ve not been disappointed”.

We saw that systems were in place to make sure that staff learned from events such as complaints, accidents and incidents. This had helped the service to improve the safety of people for example by increasing staff at peak times in the day when people were more likely to fall.

We saw staff practiced in a way that protected a person’s safety who through illness had temporarily lacked capacity with regard to their own safety. The service had policies and procedures in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). This is legislation that makes provision relating to persons who lack capacity, and how decisions should be made in their best interests when they do. No DoLS applications had needed to be submitted. This means that people will be safeguarded as required.

We found that people were protected against risks of infection because staff followed infection prevention and control procedures. We saw the facilities were clean, fresh and ventilated. Cleaning schedules were in place to promote infection control standards and staff wore personal protective equipment (PPE).

We found that the safety and welfare of people using this service was protected because the provider had followed safe recruitment practices. There was a record of work history, previous conduct and references and checks by the Disclosure and Barring Service, (DBS). These checks ensure that staff are suitable to work with vulnerable adults.

Is the service effective?

Visiting relatives told us that the service was effective in meeting people’s needs. For example through ensuring their health care needs were addressed in a timely manner and through ensuring staff had the right knowledge and skills to understand people’s needs. One staff member told us, “The owners teach by example, they are very knowledgeable, supportive to us and give us the direction we need".

People who used the service, relatives and staff told us that people’s care was regularly discussed and planned with them. This meant that staff had the information they needed to promote people’s wellbeing.

We found staff had appropriate support once they were recruited to effectively meet people’s needs. We saw that staff received an induction and on going supervision to ensure they could reflect on their practice and develop the skills necessary to effectively meet people’s needs.

Is the service caring?

We saw staff interact with people in a caring and responsive way. One person told us, “Staff are lovely; they take me out, look after me nothing is too much trouble”. A relative said, “The manager and staff are interested, caring and responsive, anything they can do they do and mom is so much better here”.

Is the service responsive?

We found that the provider had regularly asked and acted upon the comments and views of people using the service and their relative’s. We saw this had led to improvements in staffing levels and activities for people both inside the home and in the community. We saw the daily routines necessary in running a home provided choices to people in response to their needs. For example where people ate, and when, times of personal routines and providing more staff contact time with people in response to their emotional needs.

Is the service well-led?

The service was led by a registered manager and business partner both qualified nurses with a wealth of health care experience. We saw that they had put in place systems to ensure good standards of care. They ensured staff were regularly supervised and that competency checks were carried out to ensure staff performed at the required standard.

Staff told us they had, "Good leadership, guidance and direction". We saw care plans had been improved to provide staff with better guidance in meeting people’s needs.

We saw that a number of audits were carried out in order to assess the quality of care provided. The provider had sourced external legal consultants to ensure the systems they used met their needs.

This was the home’s first inspection since the new owners took over in February 2013. There were 11 people living there on the day of our inspection. We spoke with five people, the provider, care manager, senior carer, one of the care staff and a visiting relative. Not everyone was able to share their views about the home verbally, so we went spent time observing how staff provided their care.

Staff understood the importance of obtaining consent from people before they commenced care tasks. One person said, "The staff ask me first before they help because I like to do things for myself.”

People’s care plans showed how their health and care needs were met. People told us they were ‘very happy’ and ‘loads of things are better like activities and staffing’.

Arrangements were in place to ensure that people were protected from harm.

Staff were supported in their care role. One staff told us, "We have so much more support and direction, the people have a better choice, and it’s really good here now.”

A visiting relative said, “Things have vastly improved here since the new owners took over, my relative and everyone else has more care and attention, more activities to do, all round a much better place.”