Castlehill Specialist Care Centre

Castlehill Specialist Care Centre is a residential care home providing personal and nursing care to up to 84 people. The service provides support to people who are living with dementia. At the time of our inspection there were 74 people using the service.

The care home is an adapted building across three floors comprising the separate units The Shires, Coppice, Brooklands, Sandhills and Beeches. The home had a number of communal lounges, a cinema room and access to an outside space on each floor.

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

People, relatives and staff told us they felt the care provided at the home was safe. Staff had received training on how to keep people safe and knew what to do if they had concerns. Risks to people were appropriately managed and reviewed regularly to reflect any changes in medical conditions.

At the time of our visits, there were enough staff members on duty to meet people’s needs. The provider had safe recruitment processes in place. Some people were assessed as needing 1 to 1 support from staff, we observed this was in place. Medicines were administered safely. We found there were effective infection control measures in place.

The provider had used and continued to use agency staff. The registered manager and nominated individual had been taking steps to reduce the use of agency staff with the recruitment of permanent care and nursing staff. Where agency staff were being used, the registered manager had tried to make sure they were block booked to maintain consistency. The agency staff we spoke with were knowledgeable about people’s support and care needs.

People’s care and support needs had been assessed and were reviewed. People and relatives told us they had been involved in those reviews. Staff had received training to support them in their roles. People’s dietary needs were being met alongside support from external healthcare professionals. People told us they were offered a choice of food to make sure their dietary needs were being met. People were supported by staff to access health and social care services with regular support from the community nursing and health teams. The home had facilities such as a bar area on the ground floor where visitors were able to spend time with their loved ones.

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.

People and relatives told us they felt able to raise concerns and approach the registered manager. Regular audits had been carried out to make sure ensure the quality and safety of the care was maintained. Surveys and meetings were held with people, relatives and staff to gather their views and make any improvements to the service.

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 good (published 14 April 2022).

Why we inspected

We had received a number of safeguarding concerns relating to people’s safety. These included high number of falls, poor personal care, unsafe moving and transferring practices, unexplained bruising, poor nutrition and hydration, high use of agency staff and staff shortages. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. We found no evidence during this inspection that people were at risk of avoidable harm from these concerns.

Please see the safe, effective and well-led sections of this full report. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same.

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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Castlehill Specialist Care Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Castlehill Specialist Care Centre is a residential care home providing personal and nursing care to up to 84 people. The service provides support to people who are living with dementia. At the time of our inspection there were 64 people using the service.

The care home is an adapted building across three floors with lounges, a cinema room and access to an outside space on each floor.

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

People and relatives told us safe care was provided. Staff received training on how to keep people safe and what to do if they had concerns. Medicines were administered safely. The provider had safe recruitment processes in place, some people were assessed as needing one to one support from staff and we observed this was in place.

Agency staff were used, and a relative and staff member raised concerns about the impact of this on the care at night. The home manager was taking action to address this. We observed good infection control measures in place although some improvement was required to ensure staff were wearing face masks correctly in the reception area and offices.

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 worked well with healthcare professionals to ensure people’s needs were met. People were offered a choice of food and people’s dietary needs were met. The home had some excellent facilities such as a bar area where visitors could spend time with people and cinema rooms. Staff received the necessary training to support people.

People and relatives felt able to raise concerns and approach the home manager. Audits were regularly carried out to ensure the quality and safety of the care was maintained. Surveys and meetings were held with people, relative and staff to gather their views and make any improvements to the service.

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 good (published 30 April 2021).

Why we inspected

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.

We received concerns in relation to an increase in safeguarding referrals and infection control. This included concerns about nutrition and falls. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Castlehill Specialist Care Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Castlehill Specialist Care Centre is a residential care home providing personal and nursing care to 34 people aged 65 and over at the time of the inspection. The service can support up to 84 people.

This purpose built care home accommodates 84 people across three floors of the home. Each floor has separate wings with adapted facilities. There is access to all floors via a lift.

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

People were supported by staff who understood actions to take to keep people safe. Staff had received training around safeguarding and understood how to recognise and escalate safeguarding concerns. Staff were safely recruited and systems had been developed to determine safe staffing levels.

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.

People were supported by staff who had the right skills and knowledge to support their needs. Staff were responsive to changes in people’s needs and liaised with healthcare professionals to support people’s health and well-being.

People were supported to receive meals of their choosing and to access the healthcare they needed.

People were supported with care that was kind and caring. Staff knew the people living at the home and what was important to them. People were treated with dignity and respect and were encouraged to retain their independence.

People received care that was responsive to their needs. People had access to meaningful activities based on their interests. There were systems in place that enabled concerns or complaints to be raised and responded to.

People received a service that was well-led. There were a number of monitoring systems in place that measured the quality and safety of the service.

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

Rating at last inspection This service was registered with us on 30 March 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about safe care practices and safeguarding concerns. A decision was made for us to inspect and examine those risks.

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 coronavirus and other infection outbreaks effectively.

Follow up

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.