Archived: Castelayn

Castelayn is registered to provide accommodation and personal care for up to 42 older people. The home is purpose built over three floors. The top floor of the home is dedicated to supporting people living with dementia. At the time of this inspection there were 28 people living at the home.

We found the following examples of good practice

• The provider went into early lockdown and preparations around infection prevention and control were made in advance of and escalation in the spread of COVID– 19. People and staff had been regularly tested for COVID-19. The service held regular staff safety huddle meetings. The topics discussed included infection prevention control, social distancing and shielding.

• All visitors were asked to complete a visitor’s form and their temperature was checked. Hand sanitiser was provided in the entrance area and visitors were required to wear a mask. Visitors were provided with an apron and gloves where appropriate. Visitors had no contact with other people living at the home and had minimal contact with the Care staff.

• Visits from relatives took place in the garden area. There was a booking in system to stagger visitors and visiting times to minimise visitor numbers. A heated lodge was due to be installed in the garden area. The lodge had been specially designed to allow people and relatives to socially distance.

• Dedicated staff were deployed in specific units in the home to reduce the risk of cross contamination and infection across units. Enhanced cleaning was in place. Staff wore appropriate PPE and followed the current guidance. The home was not reliant on agency staff to cover staff absences as they had a good supply of bank staff.

• Staff had provided additional social care support to people to help them maintain their mental wellbeing. The innovative use of technology had enabled relatives to stay in touch with their family members. People had been supported to learn about and use new technology.

• New admissions were tested for COVID-19 and the results were known before they are admitted to the home. All new admissions were isolated in their rooms. Staff dedicate time to spend with new admissions to support them through their isolation period and adjusting to their new home.

Castelayn is registered to provide accommodation and personal care for up to 42 older people. The home is purpose built over three floors. The top floor of the home is dedicated to supporting people living with dementia. At the time of this inspection there were 38 people using the service.

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

People told us they felt safe whilst being cared for at Castelayn. Systems were in place to safeguard people from abuse and staff knew their responsibilities in keeping people safe from harm. There were enough staff to meet people's needs. Risks to people were assessed and managed. Systems were in place to make sure people received their medicines, which included staff receiving medicine training and regular audits of the system. People told us they always received their medicines at the right times.

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 received help and support from a kind and compassionate staff team with whom they had developed positive relationships. People were supported by staff members who were aware of their individual protected characteristics like age, gender, disability and religion. People were provided with information in a way they could understand.

People gave us positive feedback about the service and staff. Health professionals feedback demonstrated a responsive service. Staff were attentive to people's needs and knew individuals well. Staff spoke passionately about the people they supported and worked to uphold their rights. The service achieved positive outcomes for people through attentive care, understanding and responsiveness to the needs people communicated to them.

People were supported by a team of staff who were happy in their jobs and well-supported by their

managers. An experienced registered manager and senior staff completed a range of regular checks on the quality and safety of the service. The provider, registered manager and staff all demonstrated a desire to provide a high-quality service. People, relatives, staff and visiting professionals had regular opportunities to express their views about 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 12 May 2016). There was also an inspection on 26 November 2018 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.

Why we inspected

This is a planned re-inspection because of the issue highlighted above.

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.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

Our last inspection at Castelayn took place on 19 May 2014. The home was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 5 April 2016 and was unannounced. This meant the people who lived at Castelayn and the staff who worked there did not know we were coming. On the day of our inspection there were 38 people living at Castelayn.

People spoken with were positive about their experience of living at Castelayn. They told us they felt safe and they liked the staff.

Relatives spoken with had no concerns regarding their relative’s care. They told us they knew staff well and they were always kept up to date with any news.

Healthcare professionals spoken with told us they had no concerns about Castelayn.

We found systems were in place to make sure people received their medicines safely.

Staff recruitment procedures were thorough and ensured people’s safety was promoted.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. They told us they liked their jobs, worked well as a team and were well supported by the registered manager. The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences so their health was promoted and choices could be respected.

People living at the home, and their relatives said they could speak with staff if they had any worries or concerns and they would be listened to.

We saw people participated in a range of daily activities both in and outside of the home which were meaningful and promoted independence.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. People using the service and their relatives had been asked their opinion via questionnaires, the results of these had been audited to identify any areas for improvement.

At the time of this inspection thirty six people were living at Castelayn. We spoke with ten people living at the home, three of their relatives and one professional visitor to obtain their views of the support provided. In addition, we spoke with the registered manager, the deputy manager, the administrator, three care staff, the cook and two domestic staff about their roles and responsibilities.

We gathered evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People supported by the service, or their representatives told us they felt safe.

People told us they felt their rights and dignity were respected.

Systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We found risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant people would be safeguarded as required.

The service was safe, clean and hygienic.

Is the service effective?

People’s health and care needs were assessed with them and their representatives, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Staff were provided with training to ensure they had the skills to meet people’s needs. Some staff required updates to aspects of their training to ensure their knowledge and skills were up to date. Staff were provided with formal individual supervision and appraisals at an appropriate frequency to ensure they were adequately supported and their performance was appraised. Managers’ were accessible to staff for advice and support.

Visitors confirmed they were able to see people in private and that visiting times were flexible.

Is the service caring?

We asked people using the service and relatives for their opinions about the support provided. Feedback from people was positive, for example; “they (staff) are all right, every one of them. Very good”, “they (staff) give me the help I need, they know what I like. I can have a laugh with them” and “they (staff) seem very patient. They always keep me up to date about (my relative), what they’ve been like. (My relative) is always clean and well dressed. They seem content here. I have no worries at all. It is very good here”.

When speaking with staff it was clear they genuinely cared for the people they supported and had a detailed knowledge of the person’s interests, personality and support needs.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People’s preferences and interests had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People regularly completed a range of activities in and outside the service. The home had access to an adapted minibus, which helped to keep people involved with their local community.

Some people required specialised diets for health or personal reasons. We found the service provided food and drinks specifically requested by people. People told us, “they (staff) feed us up, you never want for anything” and “the food is good, three meals a day and snacks in between. We’ve no complaints at all”.

People spoken with said they had never had to make a complaint but knew how to make a complaint if they were unhappy. We found appropriate procedures were in place to respond to and record any complaints received. People could be assured that systems were in place to investigate complaints and take action as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure people received a good quality service at all times.

People living at the home told us that they were happy and that they were satisfied with the care they received. They told us, "it’s smashing here, the staff are lovely" and "I can’t praise this home enough. The staff are very kind. They are wonderful people.”

A relative spoken with said that they were happy with the care their loved one received. They told us, “(my relative) is happy here, so I am happy.”

We found that care and support was offered appropriately to people.

We found that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

We found that people's care and welfare needs were assessed and each person had a written plan of care that set out their identified needs and the actions required of staff to meet these.

We found that medicines were being obtained, recorded, handled, dispensed and disposed of in a safe way.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

The provider had an effective complaints system available.