Castlethorpe Nursing Home

Updated 4 November 2022

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

This was a targeted inspection to check on concerns about staffing and recruitment.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Castlethorpe Nursing Home is a ‘care home’ and a domiciliary care service.

People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Castlethorpe Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided.

The domiciliary care agency provides personal care to people living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a new registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with 6 people and 4 relatives about their experience of the care provided from the services. We spoke with 10 members of staff including the provider, registered manager, clinical lead, care coordinator, senior carer, chef, housekeeping, care staff and nurses. We reviewed records relating to staff recruitment, rota systems and a variety of records in relation to the management of staff, including policies.

Updated 4 November 2022

About the service

Castlethorpe Nursing Home is a residential care home providing nursing and personal care for up to 59 older people, some of whom are living with dementia. There were 39 people using the service when we inspected. Accommodation is provided over two floors.

People’s experience of using this service and what we found

Systems were not in place to calculate safe staffing levels and there were not always sufficient staff to meet people’s needs. Risks to people were not consistently assessed and managed. Systems and processes were not fully established to learn from safety-related incidents.

There were shortfalls with some recording systems including medicines. Aspects of the renewal programme required prioritising and an effective programme of social support was not in place, which we have made recommendations about to the provider. The quality monitoring system had not identified this range of issues.

Staff were recruited safely and knew how to protect people from the risk of abuse and harm. Overall, safe infection prevention and control procedures were followed; the management addressed minor issues with standards of cleaning during the inspection.

There was a warm atmosphere in the home and staff worked closely with other healthcare professionals to meet people’s needs. People were happy with the choice and quality of the food.

People and relatives were happy with the care provided and were involved in planning and reviewing care. People and relatives knew how to raise concerns.

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 policies and systems in the service supported this practice.

Staff completed a range of training and had supervision and support to enable them to feel confident when completing care tasks.

People and relatives praised the staff for their kindness and compassion. We saw staff treated people with respect and maintained their privacy and dignity. People were supported to keep in touch with family and friends through video, phone calls and indoor visits.

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

Rating at last inspection

We carried out a targeted infection prevention and control inspection on 1 March 2021; the service was not rated. The last rating for the service under the previous provider was good, published on 1 August 2018.

Why we inspected

This was a planned inspection based on the date of the provider’s registration.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to staffing, governance and the management of risk at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.