Castleford Lodge

Updated 3 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.This was a targeted inspection to check on a concern we had about the management of medication.

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 two inspectors.

Service and service type

Castleford Lodge 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. Castleford Lodge 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 a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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. We reviewed information we received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with four staff, including the operations manager, registered manager, deputy manager and a nurse. We spoke with a relative and a visiting healthcare professional.

We spent time observing the care people received and how staff interacted with people. 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 saw a range of medicines records, care records, audits and incident records in relation to medicines. We requested and reviewed further records in relation to the management of the medicines, which were provided to us remotely.

Updated 3 August 2022

About the service

Castleford Lodge provides accommodation and nursing care for up to 61 older people, some of whom may be living with dementia and other mental health needs. The accommodation is arranged over two floors with units specialising in dementia care and nursing on the ground floor and residential and nursing care on the second floor. There were 48 people living at the home on the day of our inspection.

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

Systems in place to monitor the service were not always effective. Audits in place had not always identified the concerns we found on inspection. Although concerns raised were swiftly addressed, systems and approaches required improvement. The provider had identified this and was implementing a new auditing system from 1 May 2022. However, this needed embedding in to practice.

We observed staff interacting with people and found they were kind and friendly. The home had three activity co-ordinators who were available throughout the week. However, there were some areas where person centred care required improvements. This included making sure personal items, such as hairbrushes and toiletries were named and improving some aspects of people’s mealtime experience. The registered manager had commenced action to improve the mealtime experience and new menus were due to commence in May 2022.

We carried out a tour of the home and found some areas required cleaning. Other areas needed some maintenance work to ensure they could be cleaned effectively. The registered manager took immediate action to address these issues.

The provider had a tool which was used to identify the number of staff required each day, based on the needs of the people using the service. We found there were enough staff available to meet people’s needs in a timely way. The provider had a safe recruitment procedure to ensure suitable staff were employed.

Accidents and incidents were recorded and analysed to identify any trends or patterns. This helped to mitigate future risks and ensured lessons were learnt. Risks associated with people's care had been identified and plans were in place to mitigate risks.

Staff were knowledgeable about safeguarding and confirmed they had received training in this subject. They knew what actions to take if they suspected abuse.

The manager had been in post since January 2022, prior to this the home had several interim managers. Staff we spoke with said the new manager had begun to take action to address issues and shortfalls within the home.

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, with requires improvement in the responsive key question (published June 2018).

Why we inspected

The inspection was prompted in part due to concerns received. A decision was made for us to undertake a focussed inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 overall rating for the service has not changed. This is based on the findings at this inspection.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Castleford Lodge 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.