Guinness Care Castleham Lodge

Updated 1 June 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Service and service type: This inspection took place on 15,16 and 22 May 2019. We gave the service 24 hours’ notice of the inspection visit which is part of our methodology to ensure staff are available to assist with the inspection. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. It provides a service to older adults and younger disabled adults,

The CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Inspection team: The inspection was carried out by one inspector and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Notice of inspection: Our inspection was announced. We gave the provider 24 hours' notice as we needed to be sure someone would be available to support us with the inspection.

What we did: Before the inspection, we reviewed relevant information that we had about the service including any notifications of safeguarding or incidents affecting the safety and wellbeing of people. A notification is information about important events, which the provider is required to tell us about by law. We checked the last inspection report and contacted the local authority for information.

The service completed a Provider Information Return (PIR). A PIR is a form that asks the provider to give some key information about the service, what it does well and any improvements they plan to make.

During the inspection, we chose a selection of people to contact who used the service. Twenty-four people agreed to speak with us on a day of their choice. However, not everyone was available when we rang and some people changed their minds. Over two days, we spoke with 17 people and relatives. We also spent two days at the service’s office. On the second day, we focussed on speaking with range of eleven staff, including care staff, senior staff, care co-ordinators, managers of an extra care service, the registered manager and the assistant director of Care at Home. We reviewed three people’s care records, including assessments, staff files, records of accidents, incidents and complaints, audits and quality assurance reports.

Updated 1 June 2019

About the service:

Guinness Care at Home (Devon) is registered with the Care Quality Commission (CQC) to provide personal care to people within their own homes. At the time of our inspection, the service was providing personal care and support to 184 people. When we visited 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’s experience of using this service:

The feedback from people who used the services was consistently positive about their experiences. People and their relatives were equally positive about the approach of the care workers. For example, they said care workers, “…treat you with respect, they don’t talk down to you. They don’t say ‘we have to do this’ they ask you what you need.”

People said they felt safe because the staff group were caring and reliable. People continued to be supported by staff who respected their privacy and dignity. Staff relationships with the people they supported continued to be caring and supportive. There was a stable staff group which helped ensure a consistent approach. Staffing arrangements were flexible to meet people’s individual needs and to respond to changes. People's nutritional needs were met; staff supported some people with meal preparation. Care plans for each person held information about their dietary needs.

Risk assessments identified when people could be at risk and covered people's physical and mental health needs and the environment they lived in. Feedback from people and staff confirmed the provider recruited staff who suited the caring values of the service and recognised the importance of team work to provide consistent and safe care. People were protected from abuse because staff understood their safeguarding responsibilities.

People were supported by staff who were skilled and understood their needs. Since the last inspection, recruitment practice had improved. Staff spoke confidently about the care they delivered and understood how they contributed to people’s health and wellbeing.

Referrals were appropriately made to health care services when people’s needs changed. People were supported to maintain good health and had access to appropriate services, which ensured they received on-going healthcare support. Medicine administration, recording and auditing was safe.

There was a consistent approach to gain people's consent to care and treatment in line with requirements of the legislation and guidance. Information was in place to ensure people’s legal rights were protected.

There were systems in place to gain people's views and to address concerns and complaints. The service was well run by the registered manager and the provider. Senior staff assisted the management team with reviews and spot checks to ensure people received a good quality service. Feedback from people using the service and quality assurance records showed this had been achieved.

Rating at last inspection: This service was last inspected in 2018, when it was rated as requires improvement in two areas with requires improvement as an overall rating. The provider completed an action plan, which we reviewed, and used as part of the inspection planning.

Why we inspected: This inspection was scheduled for follow up based on the last report rating.

Follow up: We will continue to monitor the intelligence we receive about the service. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk