Castle Keep

Updated 10 August 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.

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

The inspection was carried out by one inspector and an Expert by Experience who made calls to people and relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Castle Keep is a ‘care home’. 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. Castle Keep is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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 not a registered manager in post, however a manager was employed, and they had started the process of registering with the Care Quality Commission.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 4 July 2022 and ended on 8 July 2022. We visited the location’s service on 5 July 2022.

What we did before the inspection

We reviewed information we received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service and 10 relatives about their experience of the care provided. We spoke with nine members of staff, including the current manager, the operations manager and seven care workers.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and supervision. We reviewed a variety of records relating to the management of the service. We also received information from two health care professionals who visit the service.

Updated 10 August 2022

About the service

Castle Keep is a residential care home providing personal and nursing care for up to 49 people across two designated wings; Nightingale for people living with dementia and Willow for people with complex health care needs. Each wing has a separate entrance and adapted facilities to suit the needs of the people living there. The service provides support to people living with dementia, older people, people with a physical disability and younger adults. At the time of our inspection there were 47 people using the service.

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

The service did not have a registered manager in place; however, a manager had been recruited and was waiting for their application to progress through the Care Quality Commission.

People received their medicines as prescribed. Medicines are stored correctly; staff keep accurate medicines records and manage medicines consistently and safely.

Effective safeguarding systems were in place. Safeguarding concerns were managed consistently and promptly. All staff had an awareness and understanding of abuse and felt comfortable raising concerns about their own or other people’s safety.

Risk assessments were person centred and contained enough information to guide staff in their practice. There was a culture of learning from accidents and incidents.

There was enough competent staff across the service to meet people’s needs. Recruitment processes were robust and appropriate recruitment checks were carried out. One relative told us “There is always enough staff around if you need them.”

Infection, prevention and control was managed well. Staff were trained and understood their responsibilities for maintaining high standards of cleanliness.

The service had a positive culture that is person centred. The provider, manager and staff had a good understanding of equality and diversity and this was promoted through the workforce. Relatives told us “The staff are brilliant; they go above and beyond” and “The staff are lovely and it is a lovely atmosphere.”

The manager had effective governance systems in place. Risks were identified through audits and action plans were produced that monitored the services performance and used the information to drive improvements through the service.

People and their families were involved in a meaningful way and their feedback used to drive improvements in the service.

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.

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

Rating at last inspection

The last rating for this service was requires improvement (published 30 March 2020). At our last inspection we recommended that the provider consider current guidance on administering and recording medicines and update their practice accordingly. At this inspection we found the provider had acted on the recommendations and had made improvements.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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 changed from requires improvement to good based on the findings of this inspection.

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

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