Castle Farm Care Home

Castle Farm Care Home 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.

Castle Farm Care Home is registered to accommodate 22 older people. The home is split over two floors with the first floor having access via stairs or a lift. On the ground floor there is a large lounge, known as the parlour, conservatory and a separate dining room. There was level access to the outside patio area at the rear. There were 14 people living at the home at the time of inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff had received an induction and continual learning that enabled them to carry out their role effectively. Staff received regular supervision and felt supported, appreciated and confident in their work. People and their relatives had been involved in assessments of care needs and had their choices and wishes respected including access to healthcare when required. The service worked well with professionals such as doctors, nurses and social workers. However, the home did not always meet the requirements of the MCA. We have made a recommendation about the assessment of capacity and recording of best interest decisions.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse. Staff told us who they would report this to both internally and externally. Staffing levels were sufficient to provide safe care and recruitment checks had ensured staff were suitable to work with vulnerable adults. When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm. Medicines were administered and managed safely by trained and competent staff.

Staff were clear on their responsibilities with regards to infection prevention and control and this contributed to keeping people safe. Accident and incidents were recorded and analysed. Lessons learnt were shared with staff by the electronic care planning handset, handovers or during monthly meetings.

People had their eating and drinking needs understood and were being met. People told us they enjoyed the food and thought the variety and quantity was good.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People, their relatives and professionals described the staff as caring, kind and approachable. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs. Their life histories were detailed and relatives had been consulted. The home had an effective complaints process and people were aware of it and knew how to make a complaint. The home actively encouraged feedback from people, their relatives and professionals. People’s end of life needs were included in their care and support plans. Feedback received by the service showed that end of life care provided was of a good standard. Activities were provided and these included staff, people and their relatives. Individual activities were provided for those that preferred them.

Relatives and professionals had confidence in the service. The home had an open and positive culture that encouraged the involvement of everyone. Leadership was visible within the home. Staff spoke positively about the management team and felt supported. There were effective quality assurance and auditing processes in place and they contributed to service improvements. Action plans were carried out and lessons learnt. The registered manager actively sought to work in partnership with other organisations to improve outcomes for people using the service. The service understood their legal responsibilities for reporting and sharing information with other services.

Further information is in the detailed findings below.

Castle Farm Care Home provides residential care for up to 20 older people. There were 15 people living in the home at the time of our visit, some of whom were living with dementia.

There was a registered manager who had worked in the home for 16 years. 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.

There were sufficient trained and competent staff to meet people’s needs. The registered manager was able to demonstrate that additional staff could be booked to support people if their needs changed or extra support was required. Staff were unhurried and demonstrated a caring approach to people living in the home. The atmosphere in the home was relaxed and people living there interacted with each other and staff in an informal manner.

There were a variety of activities organised within the home. People were asked for their suggestions and ideas which were built into the activity programme which was on display. During our inspection there was craft work and a singer. We saw there were regular trips out and access to community activities was supported, including local theatres and garden centres. There were activities aimed at stimulating people’s memories such as memory boxes which were changed fortnightly.

People were offered choices at mealtimes such as where they would like to sit and what to eat. People told us the food was good and that it was served hot. Peoples preferred routines were identified in their care plan and staff were able to confirm with us that they were familiar with what people liked One member of staff told us they always checked with people as they were aware people could change their mind.

Information about the staff and the service and other useful information including community resources and support networks was clearly on display and available for people, visitors and staff. The registered manager told us their intention was to be transparent, they were visible within the home and people, staff and visitors told us the home was well managed. There were systems in place for monitoring the quality of the service. This meant the care and support people received was regularly audited and areas for improvements identified and actioned.

The home was accredited at beacon status with the Gold Standard Framework (GSF) which is a nationally recognised model to ensure people receive excellent end of life care. One relative who had been recently bereaved spoke highly of the care their loved one had received.

People were treated with dignity and respect and their privacy was maintained. There was a dignity champion who was a member of staff who had received additional training and had responsibility for updating staff to ensure that people were supported with dignity.

There were adaptations in the environment to ensure that people living with dementia or who had short term memory problems were supported to remain orientated such as signage. Activities such as memory boxes were provided to stimulate people’s memories.

We were able to observe and speak to people during lunchtime and saw that food was presented in an appetising manner. People who needed assistance were treated with respect and dignity. One person told us " the food here is really lovely and we can have anything we ask for".

The home was clean and tidy and promoted an obvious culture of infection control awareness. This was demonstrated by a variety of hand hygiene units around the home, hand washing procedure charts and infection control advice leaflets and notices displayed in prominent positions. Staff had received infection control training and there was an infection control lead person and champion in place.

We saw there was a caring and experienced staff team and that staff were well supported and trained to undertake their roles.

We spoke with members of staff who told us they " were very happy here, I love coming to work" and another member of staff told us that working in this home " had restored my faith in the care service, this is how it should be done".

People living at the home were positive about the manager and staff team and said that they were kind and supportive.

We reviewed the complaints procedures and found there to have been only three complaints of a minor nature during the past fourteen years.

People told us that they were happy. One person said "I have just come out of hospital. I am just so glad to be back home'.

We spoke with two members of staff and confirmed that they had received appropriate induction training and had the skills necessary to carry out their duties. Staff had received safeguarding training and were able to say what action they would take if concerns were raised or observed.

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. The service has been accredited by the 'Gold Standards Framework (GSF), this is a system to promote a gold standard of care for all patients at the end of life.