Maiden Castle House

Updated 11 June 2021

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 Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors carried out the inspection.

Service and service type

Maiden Castle House 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 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.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection, this included notifications made by the service and concerns raised with the Care Quality Commission. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

During the inspection

We spoke with nine people who used the service about their experience of the care provided. We spoke with eleven members of staff including the operations manager, registered manager, assistant manager, senior care workers and care workers. As most people were living with dementia, we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included elements of four people’s care plan and care records and Deprivation of Liberty Safeguards authorisations. We looked at a variety of records relating to the management of the service.

After the inspection visit

We continued to seek clarification from the provider to validate evidence found. We looked at further records related to seven people, and documentation and policies related to eating and hydration. We received feedback from two health professional teams who regularly visit the service. We also received feedback from 12 relatives of people living in the home and six staff who wanted to contribute their experiences to the inspection. We received feedback until 11 May 2021.

Updated 11 June 2021

About the service

Maiden Castle House is a residential care home providing personal care to 56 people aged 65 and over at the time of the inspection. The service can support up to 66 people.

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

Staff were following good infection prevention and control measures to minimise risks to people and enable them to see visitors safely.

People enjoyed the food and there was a relaxed atmosphere at mealtimes. Staff supported most people to eat and drink well during the inspection. The registered manager was robust in their response to a person not receiving food and drink as described in their care plan. Where people were at risk of not eating and drinking enough staff maintained records that were used to ensure they received appropriate support.

People and relatives told us that health needs were well managed, and professionals were generally confident that referrals were made appropriately. A delay was identified in accessing appropriate healthcare; the registered manager ensured appropriate training was provided.

People told us their needs had been assessed before they moved into the home. They were happy with the way their care and support was provided. Staff were confident in their understanding of people’s needs.

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 can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes this is through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). There was a robust system in place to ensure the oversight of DoLS and any conditions attached to them.

The environment had been adapted to meet the needs of people. This included adaptations designed to enable people with dementia to retain independence.

The quality assurance and oversight systems had been effective in identifying areas for improvement. A new recording system was being implemented. The registered manager assured us there would be ongoing training and coaching to ensure this system was used accurately and effectively.

People, relatives and staff spoke highly of the registered manager and management team. There was a positive person centred culture at the service and everyone fed back that they felt listened to and supported.

The management team was responsive to the feedback and arranged for additional staff training in relation to record keeping.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 December 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced focused inspection of this service on 1 November 2019 breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the management of risks, the oversight of DoLS, recording and governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Effective and Well-led which contain those requirements.

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.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Maiden Castle House on our website at www.cqc.org.uk.

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.