Castle Road

Castle Road is a large detached property close to the centre of Torquay. It is registered to provide accommodation and personal care for up to 13 people with mental health needs. People living at Castle Road were independent in many areas, but often needed prompting and support in order to lead fulfilling lives.

This unannounced inspection took place on 23 November 2015 when there were 12 people living at the service. The service was last inspected on 12 February 2014 when it met the relevant requirements.

A registered manager was employed by the service. 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. The registered manager managed two other Parkview Society services and was not present during the inspection. A deputy manager supported the registered manager and was in day to day control of the service in the absence of the registered manager. The deputy manager was available throughout the inspection.

Throughout the inspection people approached staff in a relaxed manner, smiling and laughing. This indicated they felt safe in the company of staff. Risks to people were assessed and plans put in place to minimise and manage any identified risks. Risks included suicide, self-neglect, aggression and poor health.

People were protected by robust recruitment procedures. All the required checks were made before staff were employed. People were protected from the risks of abuse because staff knew how to recognise and report suspicions of abuse. Staff had received training in this area as well as a variety of other training including, first aid and food hygiene. There were safe systems in place to manage people's medicines. Medicines were stored safely and staff had received training in administering medicines.

People were supported by staff who had received training in the principles of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards (DoLS). No-one was subject to a deprivation of liberty authorisation.

People’s needs were met in a safe and timely way as there were enough staff available. Staff and people living at the home said there were enough staff available to support people if they wanted to go out of the home.

People were supported to maintain a healthy, balanced diet. People took turns to prepare the main meal for everyone. One person told us “Meals are first class – the food is always fresh, never tinned. The standard is very high and the quantities are very generous”. People were supported to receive the healthcare they needed. People told us they regularly visited their GP and dentist. One person said “A doctor is easily arranged when I do need one and I saw the dentist recently”. A social care professional told us staff always supported their client to attend any appointments.

Staff were kind and caring and ensured people’s privacy and dignity was respected. We observed positive relationships between staff and the people we met at the service. There was much fun, laughter and appropriate banter between staff and the people they supported. People were supported by staff that knew them well. The home operated a key worker system where each person had a nominated member of staff who coordinated their care. Staff told us this helped them build relationships and get to know people well. People told us how staff supported them to be more independent.

Staff displayed empathy for people as well as a good knowledge of their needs and histories. They told us how one person had managed to reduce their medicines with the health of staff and outside professionals. This had resulted in their health improving. They said staff were there “for the right reasons”, that was, to support people. They said it was hard to motivate some people but when one succeeded, “it is very rewarding”.

Care plans were detailed and gave good information to staff about people’s needs. People were supported to be involved in making decisions about their care. Care plans showed that people had been involved in completing their plans and were happy with them. Several people told us their care plans were regularly reviewed and had just been done. One person told us “I have recently seen and signed my care plan. It is reviewed regularly”.

People told us they were involved in everyday matters such as cooking and cleaning. One person told us “We take turns cooking and doing other jobs in the house. There is a rota”. Two people felt they didn’t have much input into the running of the house. One person said: “We used to have regular meetings – that’s not happened for a while”. However, the deputy manager said this was not correct and that there had been a recent meeting. They told us that not everyone chose to attend the meetings and this may be why they felt they were not involved.

People were supported to maintain contact with people who were important to them. One person told us they were staying with their relatives over the Christmas period.

Opinions differed regarding activities available at the home. One person said “I go out most days and my friend comes round. None of us need activities organised”. However, another person told us “I wish I could be a bit more active. I would like to go out a bit more”. Staff told us there was always staff available to take people out or chat with them if they wanted to. They said it could be difficult to motivate people and that although some people said they wanted to do more, when given the opportunity, they declined.

The deputy manager was open and supportive and people told us they were confident any concerns would be dealt with.

There were effective quality assurance systems in place to monitor care and plan on-going improvements. There were monthly visits from a member of the Parkview Society committee who spoke with people living at the home, and reviewed the service provision.

Records were well maintained and kept securely. CQC had not been notified of some incidents as required by law. Following the inspection we discussed this with the registered manager. They told us they had not reported all incidents reported to the police as they had previously been advised by CQC this was not always necessary. They had agreed that in future they would ensure CQC were notified of all incidents that were reported to the police.