Castle View House

Updated 5 February 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 was planned to check 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 18 December 2018 and was unannounced. The inspection team consisted of one inspector and an expert by experience. The expert by experience was a person who has personal experience of using similar services or caring for people with mental illness.

We used information we held about the service and the provider to assist us to plan the inspection. This included notifications the provider had sent to us about significant events at the service. We also used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we spoke with four people about what it was like to live at the service. We spoke with three staff members which included the registered manager, the director of care and one support worker. We asked for feedback about the service from five external organisations involved in contracting and monitoring the service.

We looked at risk and quality audit records, policies and procedures, complaint and incident and accident monitoring systems. We looked at three people’s care files, three staff recruitment files, the staff training programme and medicine records.

The service had been registered with us since 28 February 2018. This was the first inspection carried out on the service to check that it was safe, effective, caring, responsive and well led.

Updated 5 February 2019

This inspection took place on 18 December 2018. The inspection was unannounced.

Castle View House is a ‘care home'. People in care home services receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Staff provided residential care for up to eight people living with a mental illness. There were seven people living at the service when we inspected.

A registered manager was employed at the service and they were present during the inspection. The registered manager was also the provider of 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.

Staff assessed and treated people as individuals so that they understood how they planned people’s care to maintain their safety, health and wellbeing and choices. Risks were assessed within the service, both to individual people and for the wider risk from the environment people lived in.

Actions to minimise risks were recorded. Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. Staff understood the steps they should take to minimise risks when they were identified. The provider’s health and safety policies and management plans were implemented by staff to protect people from harm.

Staff were encouraged and supported to raise any concerns they may have. Incidents and accidents were recorded and checked by the provider to see what steps could be taken to prevent these happening again. Staff were trained about the safe management of people with behaviours that may harm themselves or others.

We observed safe care. Staff had received training about mental health and protecting people from abuse. The management and staff showed a good understanding of what their roles and responsibilities were in preventing abuse.

The registered manager and other senior staff held professional mental health qualifications and were registered to practice with the Nursing and Midwifery Council (NMC). They worked alongside their staff to deliver care. Therefore, the management had an in depth knowledge of how the service was running and got to know people and staff very well.

The registered manager involved people in planning their care by assessing their needs in partnership with the person and the community mental health team. Staff practice was based on recognised Mental Health person centred approaches. We observed and people described a service that was welcoming and friendly. Staff provided friendly compassionate care and support.

People were encouraged to get involved in regular reviews of their care and how their care was planned and delivered. All of the people had the support of a community psychiatric nurse (CPN) and an in house key worker. People were given maximum control over their lives based on positive risk taking practice. People could involve relatives or others who were important to them when they chose the care they wanted.

Care plans were kept updated to assist staff to meet people’s needs. Care plans recorded people’s life story, recorded who the important relatives and friends were in people’s lives and explained what lifestyle choices people had made. Care planning told staff what people could do independently, what skills people wanted to develop and what staff needed to help people to do.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People are 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.

People and staff felt that the service was well led. They told us that staff and the registered manager were experienced, understood people’s needs, were approachable and listened to their views. The registered manager continued to develop business plans to improve the service.

People were asked if they were happy with the care they received. The provider offered an inclusive service. They had policies about Equality, Diversity and Human Rights. People, their relatives and health care professionals had the opportunity to share their views about the service either face-to-face, or by using formal feedback forms.

Safe recruitment policies were in place. Safe recruitment practices had been followed before staff started working at the service. The provider recruited staff with relevant experience and the right attitude to work with people who had mental health illness.

New staff and existing staff were given an induction and on-going training which included information specific to the people’s needs in the service. Staff were deployed in a planned way, with the correct training, skills and experience to meet people’s needs.

Staff received supervision and attended meetings that assisted them in maintaining their skills and knowledge of social care and people’s needs.

Staff understood the challenges people faced and supported people to maintain their health by ensuring people had enough to eat and drink. Pictures of healthy food were displayed for people and dietary support had been provided through healthy eating plans put in place by dieticians. Staff supported people to maintain a balanced diet and monitor their nutritional health.

There were policies and procedures in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.

People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell. Good quality records were kept to assist people to monitor and maintain their health.

The quality outcomes promoted in the providers policies and procedures were monitored by the management in the service. Audits undertaken were based on cause and effect learning analysis, to improve quality. All staff understood their roles in meeting the expected quality levels and staff were empowered to challenge poor practice.

Management systems were in use to minimise the risks from the spread of infection, staff received training about controlling infection and carried personal protective equipment like disposable gloves and apron’s.

The registered manager had demonstrated a desire to improve the quality of the service for people by listening to feedback, asking people their views and improving how the service was delivered.