Archived: Castle Mount

Updated 3 January 2019

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

This inspection took place on 14 November 2018 and was unannounced. The inspection was carried out by an adult social care inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using services or caring for a person who uses services. The team were experienced in the care of someone who is living with dementia or who is an older adult.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least annually to give some key information about the service, what the service does well and improvements they plan to make. This was received in a timely manner and in good detail. We also reviewed the information we held about the service, such as notifications we had received from the registered provider. A notification is information about important events which the service is required to send us by law. We also spoke with social workers, health care practitioners and commissioners of care during our regular contact with them. We planned the inspection using this information.

The team met all of the twenty two people in the home on the day and spoke in some depth with fourteen of them. The team spent time talking with people, the staff and with visitors. We also spent time in shared areas simply observing the life of the home. We spoke with three relatives and friends who were visiting the home. We met a visiting health care professional on the day of the inspection.

We read seven care plans in depth and looked at daily notes related to these care plans. We looked at charts and other records of things like food and fluids taken. We saw moving and handling plans and risk assessments for other interventions. We also looked at records of medicines and checked on the stored medicines kept in the home.

We met the registered manager, two supervisors, the administrator and seven care staff. We also met two kitchen staff and one of the housekeeping team. We talked with them in small groups or individually. We looked at six staff files which included recruitment, induction, training and development records. We checked on the details of the supervision and appraisal notes on these files. We saw rosters for the four weeks prior to our visit.

We had access to records relating to maintenance and to health and safety. We checked on food and fire safety records and we had discussions about some of the registered provider's policies and procedures. We saw records related to quality monitoring.

We walked around all areas of the home and checked on infection control measures, health and safety, catering and housekeeping arrangements.

We received information related to staffing issues and quality audits during and after the inspection. We also had contact with the operations manager some time before the inspection in relation to a staffing issue and to the plans for future activities.

Updated 3 January 2019

This was an unannounced inspection that took place on 14 November 2018. The service was last inspected in April 2016 where there were no breaches in regulation seen and the home was rated as Good. We found at this inspection that the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Castle Mount is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home can accommodate up to thirty four people across three units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with dementia. There were twenty two people in residence when we visited. People living in the service are older adults. The home does not provide nursing care.

The home had a suitably qualified and experienced registered manager who had a background in social care and in management. 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 staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and spoke to us about how they would identify any issues and report them appropriately. Risk assessments and risk management plans supported people well. Good arrangements were in place to ensure that new members of staff had been appropriately vetted and that they were the right kind of people to work with vulnerable adults. Accident and incident management was of a good standard.

The registered manager kept staffing rosters under review as people's needs changed. We judged that the service employed enough care staff by day and night to meet people's needs. There were suitable numbers of ancillary staff employed in the home.

Staff were appropriately inducted, trained and developed to give the best support possible. We met team members who understood people's needs and who had suitable training and experience in their roles.

Medicines were suitably managed in the service with people having reviews of their medicines on a regular basis.

People in the home saw their GP and health specialists whenever necessary. The staff team had good working relationships with local GP surgeries and with community nursing services.

Good assessments of need were in place, and the staff team reviewed the delivery of care for effectiveness. They worked with health and social care professionals to ensure that assessment and review of support needed was suitable and up to date.

People told us they were satisfied with the food provided and we saw suitably prepared meals being served. Simple nutritional planning was in place and special diets catered for appropriately.

Castle Mount is situated in a residential area of Egremont. The provider had updated and refurbished the building to a good standard. It had suitable adaptations and equipment in place. The house was warm, clean and comfortable on the day we visited.

People in the home were kept fully informed and helped to make their own decisions. People were aware of the plans to close the service in 2019 when the new residential home was ready to open. They were being involved in choosing furniture and fittings for the new home.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People who lived in the home told us that the staff were caring. We also observed kind and patient support being provided. Staff supported people in a respectful way. They made sure that confidentiality, privacy and dignity were maintained.

Risk assessments and care plans provided detailed guidance for staff in the home. People in the service were aware of their care plans and had influenced the content. The management team had ensured the plans reflected the person centred care that was being delivered.

Staff could access specialists if people needed communication tools like sign language or braille.

Staff encouraged people to follow their own interests and hobbies. We saw evidence of regular activities and entertainments in the home.

The service had a comprehensive quality monitoring system in place and people were asked their views in a number of different ways. Quality assurance was used to support future planning.

We had evidence to show that the registered manager and the operations manager were able to deal with concerns or complaints appropriately .

Records were well organised, easy to access and stored securely.