We carried out a review of the data available to us about Castle Dene on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Castle Dene, you can give feedback on this service.
Castle Dene specialises in the care and support of people with learning disabilities and/or autism, as well as additional health care needs.
Castle Dene offers two different types of service. A respite service accommodates up to eight people on short breaks or emergency placements in a care home within a residential area of South Gosforth in Newcastle. At the time of our visit, five people were staying at the respite service.
This care home was a single-floor adapted building, which also housed the offices from which the other part of the service was managed. This is a shared lives scheme which provides people with long-term placements, short breaks and respite care, within shared lives carers (SLC) own homes.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People’s experience of using the service and relatives’ feedback was overall positive. We took a balance of what people, relatives, staff and shared lives carers told us about the different parts of the service.
We found that some training needed to be updated and made a recommendation regarding the service’s awareness of current best practice guidance. Although the service had not been aware of Registering the Right Support, they applied the principles and values of this guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People using the shared lives service told us they felt safe living with their carers. People told us about their individual achievements, as well as activities they had enjoyed together with shared lives carers. One person said, “They look after me when I am not well. I am part of the family and call them mum and dad.“ Staff support to people in the respite service was respectful, dignified and person-centred. People appeared calm and relaxed in the presence of staff and feedback from relatives confirmed this. One relative summarised, “It is a nice place to go to, they know [name] well and they get on well. If I have any problems, I speak to the staff they will sort it out. I would recommend it to anyone.”
The empowering and inclusive culture of the service was led by a well-respected registered manager. The respite service setting required some updating, refreshment and refurbishment, which the registered manager had highlighted to the provider. They were looking to develop the service’s offer of things to provide sensory stimulation and seeking accreditation from the National Autistic Society.
Regular meetings took place for staff and shared lives carer and the registered manager was continuously looking to develop how they engaged and involved everyone with the service. Monitoring visits and other checks were in place to help ensure a safe, quality service. We considered with managers some improvements to ensure the consistency of reviews.
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 www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 23 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
In February 2016 a change in registration was made for the provider’s shared lives scheme to be managed from Castle Dene. This scheme arranges paid carers to support adults with disabilities, on a short or longer term basis, where the person lives with the carer in their home as part of the family. At the time of our inspection there were 22 people using the scheme and 26 approved carers, including support carers.
Castle Dene was last inspected in November 2015 when we had followed up on a breach of legal requirements relating to record-keeping. Prior to this we had carried out a comprehensive inspection in November 2014 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’ and met each of the fundamental standards we inspected.
We found that people using the service received safe and consistent care from staff and carers who had been robustly recruited. People’s vulnerabilities were recognised and measures were taken to reduce risks to their personal safety. There were established processes to protect people from harm and act on any safeguarding allegations.
Staff and carers were trained and given support in their roles to make sure they were equipped in effectively meeting people’s needs. People were appropriately assisted in maintaining their health, good nutrition, and, where required, in taking their prescribed medicines.
People were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible; the policies and systems of the service supported this practice.
Supportive relationships had been formed and people were involved, wherever possible, in making choices and decisions about their care. People took part in activities they enjoyed, accessed the community, and were encouraged to develop their independent skills.
A personalised approach was taken to planning support that was tailored to the individual’s needs and preferences. Feedback about the service was sought from people and their representatives, and any concerns were responded to.
The service was well managed and staff took pride in their work. Various methods were used to monitor people’s care experiences and assess the quality of the service.
Further information is in the detailed findings below.
We carried out an unannounced comprehensive inspection of this service on 19 and 21 November 2014. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach concerning record keeping.
We undertook this focused inspection on 13 November 2015 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to this requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Castle Dene on our website at www.cqc.org.uk.
Castle Dene provides respite care for people with physical and learning disabilities. The centre has seven beds, three of which are used to accommodate people who needed emergency placements in times of crisis. At the time of our inspection there were six people using the service.
A registered manager was in post at the time of the inspection. 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.
We found improved measures were now in place to ensure people using the service had appropriate care plans for meeting their needs and upholding their rights.
The inspection took place on 19 and 21 November 2014 and was unannounced. This means the provider did not know we were coming on the first day. We last inspected Castle Dene in December 2013. At that inspection we found the service was meeting all the regulations we inspected.
Castle Dene provides respite care for people with physical and learning disabilities. Services were being provided to 35 people. The centre had seven beds, three of which were used to accommodate people who needed emergency placements in times of crisis. At the time of our inspection there were seven people staying at the centre.
The service had a registered manager. 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.
We found that care was provided in a safe and clean environment that was well equipped to meet people’s needs. Potential risks were assessed and managed to ensure people were kept safe during their care delivery. People were assisted in maintaining their health and taking their medicines safely. A range of food and drinks was offered and people were given appropriate support in meeting their eating and drinking needs.
Thorough recruitment checks were undertaken before new staff started working with vulnerable people. There were enough staff on duty at all times to provide people with safe and consistent support. The staff were well supported in their roles and given training that enabled them to meet people’s diverse needs. All staff were aware of their responsibilities to protect people from being harmed or abused and understood how to report any safeguarding concerns.
People and their families were happy with the care and support provided and had good relationships with the staff team. The staff knew people very well and treated them as individuals. People were supported to take part in activities they enjoyed and to access the community to meet their social needs.
Staff were caring and sensitive in their approach and encouraged people to make every day choices about their care. Where people did not have the capacity to make important decisions about their care, the service worked with families and other professionals to uphold their rights under the Mental Capacity Act 2005.
The service had clear aims and objectives and was well managed. The registered manager provided leadership to staff and was accessible and supportive. There was an open culture and people and their families were able to be involved in developing the service. Suitable arrangements were in place to monitor and assure the quality of the service that people received.
Most care records reflected the person centred care provided, but there were omissions in the care planning for people who were staying at the centre longer term. This meant that the personal records for people using the service did not always protect them against the risks of receiving unsafe or inappropriate care. This was a breach of Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds to Regulation 17 of the revised Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
We saw people were treated with respect and they were involved in all decisions with regard to their daily living needs.
Relatives we contacted about Castle Dene were very positive about the service and the support of staff. Comments included; "Castle Dene staff go the extra mile in the care and support of my son." And; "It's streets ahead of other similar service provision." "I am very, very happy with the service provided by Castle Dene and the staff."
Staff we spoke with were enthusiastic and dynamic and all said they enjoyed working at the service and they had opportunities for personal development and career progression.
Records showed before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes and legal requirements.
We saw the premises were well-decorated and furnished for the comfort of people who used the service.
There were enough qualified, skilled and experienced staff to meet people's needs.
We saw the provider had systems in place to gather feedback from people, who used the service, and to regularly assess and monitor the quality of service people received.
People who used the service were given appropriate information and support regarding their care. People who could tell us about their experiences said staff had involved them in the preparation of their support plans.
Peoples' privacy and dignity had been promoted, helping to increase their confidence and self-esteem. People's independence had been encouraged, enabling them to do as much as they could for themselves. One person told us, 'I've been here a few weeks. I've made some soup and biscuits. I look after myself.'
Peoples' needs had been assessed and care and support was planned and delivered in line with their individual care plan. One person told us, 'They look after me ok. I feel ok with everything.'
There was an effective complaints system available. People said they would feel comfortable about raising concerns with staff.