Two inspectors visited Castel Froma on 30 May 2014. At the time of our visit there were 55 people living in the home. Most of the people who lived at the home had highly complex medical conditions requiring a lot of care and support or highly specialised nursing. During our visit we spoke with the clinical manager and eight care and nursing staff. We spoke with three people who lived at Castel Froma and six visiting relatives. We also had the opportunity to speak to a GP who attended the home on the afternoon of our visit. We spent time in the communal areas of the home and observed the care and support provided to people. We looked at care records, staff records and quality assurance records. We used all the information we gathered during our visit to answer 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 would like to see the evidence supporting our summary please read the full report.
Is the service safe?
We looked at the care records for three people living at Castel Froma. Care plans provided staff with the information required to meet people’s individual care and nursing needs.
The service was safe, clean and hygienic. Housekeeping staff demonstrated a good understanding of their responsibilities in providing a clean environment for people receiving support. Staff understood the importance of infection control although training in that area was not up to date.
There were appropriate emergency evacuation plans in place and an up to date critical incident plan to ensure the needs of people could continue to be met during or following an emergency.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLS) which applies to care homes and hospitals. Whilst nobody had a DOLS in place, the clinical manager was aware of their responsibilities under the legislation to ensure people’s rights were protected.
Is the service effective?
People’s health and care needs were assessed before people moved to the home. Relatives confirmed they were involved in planning the care their loved one received. We saw people’s care needs were regularly reviewed and discussed with them or their relatives.
One relative told us they had an annual review with the nurse, physiotherapy and occupational therapy. They told us, “They listen intently to what I say because I am very proactive and they like my feedback as much as I like theirs. We cover everything.”
A visiting healthcare professional told us, "For the level of care and nursing support people need here, the staff do a really good job as there is a high level of need for some patients."
One person told us, “They have done me well. They have got me back on my feet.”
We found there were areas of record keeping that needed improvement to evidence care was being delivered as set out in people’s care plans.
Is the service caring?
People were supported by kind and attentive staff. People who used the service and their relatives spoke positively about the staff who provided care and support.
Comments included:
“They are all friendly and they all speak.”
“They are very good. I have a good laugh with them. They try and make it as homely as possible. When I need somebody they will always come to me.”
Interactions between staff and the people living at the home appeared relaxed and not rushed. We found staff were compassionate and caring when supporting people.
Is the service responsive?
Care records we looked at confirmed people were referred to other healthcare professionals when a need was identified.
Most people told us they would feel confident in raising any concerns about the service provided. One person said, “If I’m not happy, I will say. I find the powers to be here are very approachable.”
Is the service well-led?
We found staff employed at the home did not have regular supervision with members of the management team. We saw where staff had raised concerns about their workloads these had not been addressed and staff had not received the support they required to carry out their role. A lack of supervision and support was impacting negatively on staff morale.
There was a system of audits both internally and by the provider to identify areas of concern and actions the manager and staff needed to take to address concerns.
People and their relatives were asked their views of the home through regular quality assurance questionnaires.