We carried out a review of the data available to us about Castle House Nursing Home Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Castle House Nursing Home Limited, you can give feedback on this service.
We found the following examples of good practice.
To minimise the risk of infection transmission, procedures were in place for staff and visitors on arrival to the service. This included taking temperatures, the wearing of personal protective equipment (PPE), checking vaccination status and the provision of a negative lateral flow test (LFT) result.
A visiting policy was in place in line with current guidance. Due to a COVID-19 outbreak at the service additional measures were currently in place.
The service had appropriate donning and doffing areas and staff wore PPE in line with guidance.
Staff had received training in infection control, including handwashing and how to use PPE. Staff were clear on procedures they should follow and were updated about changes by the registered manager. Staff had a designated rest area and took staggered breaks.
The service was spacious which enabled social distancing to be maintained within communal areas. Chairs had been positioned to allow distancing whilst retaining social contact. The service had adapted the environment to enable the use of different entrances, created additional eating and snack areas, enabled zoning of the home, created suitable visiting areas and a visiting pod.
During our inspection, we observed and were told there were sufficient numbers of skilled staff to meet peoples’ needs. Measures, such as staff not working in other services and no agency staff use, meant risks were reduced.
Regular COVID19 testing was carried out for people, staff and essential care givers. The registered manager had clear system and processes in place.
We received positive feedback about how the service had been well managed through the COVID-19 pandemic. Including comments about good communication, dedicated and caring staff and clear infection prevention and control practices and systems.
Castle House Nursing Home is a care home and provides personal or nursing care for older people and those living with dementia. The home can accommodate a maximum of 47 people. The building is divided into three corridors, comprising of 46 single rooms and 1 double room. Eighteen of the bedrooms have en-suite private wet-rooms and all the others have en-suite facilities.
People’s experience of using this service and what we found
People told us they felt extremely safe living at Castle House Nursing Home. The provider had effective safeguarding systems, policies and procedures. Staff managed safeguarding concerns promptly, using local safeguarding procedures whenever necessary. Where required, investigations were thorough.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the providers policies and systems supported this practice.
People were supported by staff that were extremely well led. The management team were passionate about giving high-quality person-centred care for people living at Castle House Nursing Home. Staff empowered people to keep control over their lives. People and their relatives were fully involved in how their care was delivered.
People received effective care and support from staff who were exceptionally well trained. The provider supported staff to progress within the care home and several staff took on additional responsibilities such as championing a specialist area. Staff used these roles to share good practice and ensure all staff were working consistently.
Castle House Nursing Home looked at ways of reducing social isolation for people without it having a financial impact on them. For example, they recruited volunteers to help with social activities that people enjoyed, such as bible reading. The activities team offered one to one and group activities every day, so people could choose what they wanted to do. People confirmed this had a positive impact on their lives.
The provider worked closely with other organisations to improve the experience of people receiving care and support. Staff raised any problems, or changes in people’s health care needs with relevant health care professionals in a timely manner.
Staff morale was very high, this was reflected in the high standard of care provided. Staff felt listened to and their opinions were valued. Comments from people included, “It’s a very happy atmosphere here and calm and friendly.”
There were quality assurance systems in place. These systems were effective, they monitored standards and ensured any shortfalls were addressed. People and relatives felt listened to and said they could speak with a member of the management team at any time. Any complaints made were fully investigated and treated as learning to enable the service to improve.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Outstanding (published 27 March 2017)
Why we inspected
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Castle House Nursing Home is registered to provide accommodation and nursing care and is situated in rural surroundings at the edge of a village. The home specialises in the care of older people including people living with dementia.
The home now has 47 beds, comprising of 46 single rooms and 1 double room. 18 of the bedrooms have en-suite private wet-rooms and all the others have en-suite facilities. The house was extended in 2016 providing new bedrooms and communal facilities. The new accommodation has been completed to a very high standard.
The last inspection of the home was carried out in January 2014. No concerns were identified with the care being provided to people at that inspection.
There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. The registered manager of Castle House Nursing Home is also the registered provider. They are resident on the site of the home and family members are also registered providers and contribute to the running of the service. 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.
Feedback from people about all aspects of the service was very positive. One person said “I have been here a while. I am doing fine. It is very pleasant.” A relative said “Staff are incredibly warm and patient. Care is very, very good.” A doctor who visited the home regularly said “It is fabulous. There is not a bad word I can say about the place. I would live here myself.”
The staff morale at the home was high which led to a happy relaxed place for people to live. Staff were proud to work for the Castle House Nursing home and had great respect for the people they cared for.
The was an excellent activities programme and ad hoc activities offered people entertainment and ensured they received social stimulation and companionship when they wanted it. Activities were arranged in accordance with people’s interests and abilities and were continually reviewed and developed.
The building was designed and maintained to promote people’s independence. There was a range of social and quiet spaces. The newly completed environment had been completed to a very high standard to promote people’s well-being and comfort. There was access to garden areas with innovative design to keep people safe.
There were sufficient numbers of well trained and experienced staff to support people safely and ensure they were not rushed with their care. The training staff received enabled them to deliver excellent care which promoted people’s health and well- being. Staff told us there was good team work and support from senior staff and management.
People’s nutritional needs were assessed and met and mealtimes were considered important social occasions. The variety of food offered and the attention to the quality of food provided people with a hotel standard provision. Where people were identified as requiring support and encouragement to have a good diet skilled staff were readily available.
People received effective care and treatment which took account of their preferences and needs. Care plans gave staff clear information about how people wished to be supported. This enabled staff to provide very individualised care to people.
People and/or their representatives felt involved in all aspects of their care and support. There were systems in place to make sure people had an active voice in the running of the home.
People told us they would be comfortable to make a complaint and were confident any concerns would be listened to. The registered manager told us they valued feedback from people and used it to continually improve the service offered.
People’s health needs were monitored and changes were made to people’s care in response to any changes in their needs
People felt safe at the home and with the staff who supported them. A robust recruitment procedure for new staff and staff training on how to recognise and report abuse minimised the risks of abuse to people.
People's dignity and privacy were respected in the home. All people spoken with were pleased with the care they received and felt staff treated them with respect. One person told us "I am very satisfied. If I have to come into a care home I couldn't be in a better one.'
People were supported to be as independent as possible and to enjoy the time they spent in the home. We saw there was an emphasis in care plans on what people could do for themselves and the help they required to maintain their daily living skills. Staff made adjustments to the care they provided and the person's daily routine so they could live as comfortable a life as possible.
People lived in an environment that was safe and attractive. The surrounding grounds were accessible and attractive and contributed to people's welfare.
People spoken with told us they were very happy with the care and support they received at Castle House Nursing Home. One person told us, 'I can't complain, they treat us all very well. They are all very good'. A visitor to the home told us, 'They are brilliant, it's a lovely home. They look after dad really well, I can't fault them'.
We observed staff organised meaningful activities and treated people who lived in the home with respect and dignity.
We found care planning was person centred and agreed by the individual, a family member or an advocate. Regular reviews were carried out and involved the individual.
We found people were protected from harm or abuse by the systems in place. These ensured staff received appropriate training in safeguarding vulnerable people. The systems for recruiting staff included all the relevant checks to protect people from harm.
Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the registered manager. The provider had quality assurance systems in place that ensured people were safe and changes could be made to improve the service provided.
People told us staff were cheerful, kind and caring. They felt they were treated respectfully and said that staff were patient. People told us staff talked to them about their likes and dislikes. They said they were asked how they like to be treated, what activities they enjoyed and the types of food they preferred. People said they could talk to the staff about any concerns they had and felt confident they would be listened to and the issue would be resolved quickly. Staff met with people regularly to discuss their care and recorded monthly updates on changes or issues raised.
During our inspection we found the atmosphere to be relaxed and cheerful. We observed staff supported people in a caring and respectful manner. Staff were seen to knock on people's doors before they entered and used hoists in a sensitive manner. Staff were observed spending time with people, reading magazines together, chatting and doing activities.
Relatives were very happy with they care their relative received. They told us they found the home was always clean and smelt pleasant. Relatives said staff were friendly and welcoming. They said they were fully involved in the assessment process and the care and treatment of their relative.
We observed people at lunchtime and spoke with the cook. We saw that people were offered choices in food and drink. The atmosphere was relaxed and cheerful. Staff took their time assisting people in a patient and respectful way. The cook had a good knowledge and recorded information on people's special dietary needs.
The home employs an activity coordinator and social companion who spend time with people and or their relatives to find out people's interests to help them plan suitable activities. They also arranged one to one time for people who did not like to be involved in group activities. During the inspection we saw activities of quizzes, exercises and one to one time.
We noticed throughout the home there were signs about treating people with dignity and respecting people's privacy.