Castle House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. We looked at 5 of the priority quality statements that included for this assessment, safe and effective staffing, medicines optimisation, safe systems and governance and assurance. This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Castle House those occupational health related services provided to customers under arrangements made by their employer or a government department are exempt by law from CQC regulation. Therefore they did not fall into the scope of our inspection. We found no breaches of regulation.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at feedback from partners during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service conducted thorough risk assessment the safe handling of medicines. People were given information about medicines available to them for either occupational health or travel abroad and could make an informed decision about what treatments they wanted. Staff were knowledgeable and worked to ensure the best outcome for people using the service. Vaccines were administered in line with best practice and national guidance. There were comprehensive risk assessments in relation to safety issues, for example, prevent accidents and cases of work-related ill health by managing the health and safety risks in the workplace. The practice conducted thorough environmental risk assessments and reviewed annually or upon significant change to the environment. We saw that the last health and safety risk assessment was dated 5 February 2024. The service monitored and reviewed activity. This helped it to understand risks and gave a clear, accurate and current picture that led to safety improvements. A fire risk assessment has been undertaken on 23 March 2023 and actions identified were for example, evacuation maps in the building showed out of date room names and there were no directions of where the fire assembly point was situation in the car park. We saw that there was an updated map wall mounted in the reception area. There were 3 fire marshals who had all received relevant training for their roles.

The service had a culture of high-quality sustainable care. Staff told us that they felt respected and supported. Openness, honesty and transparency were demonstrated when responding to incidents and complaints. The provider was aware of and had systems to ensure compliance with the requirements of the duty of candour. Staff we spoke with told us they were able to raise concerns and were encouraged to do so. They had confidence that these would be addressed. All staff received regular annual appraisals in the last year. Staff were supported to meet the requirements of professional revalidation where necessary. Clinical staff, including nurses, were considered valued members of the clinic team. They were given protected time for professional development and evaluation of their clinical work.

The clinic involved client and staff to support high-quality sustainable services. Client and staff views and concerns were encouraged. The service encouraged and valued feedback from clients and staff. It proactively sought feedback from clients through their website, social media and also locally at the clinic by filling out feedback forms. All the comments we reviewed were positive and included, for example, "my treatment was excellent" and "the staff are all helpful and explain everything".

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service had reliable systems for appropriate and safe handling of medicines. People were given information about medicines available to them for either occupational health or travel abroad and could make an informed decision about what treatments they wanted. Staff were knowledgeable and worked to ensure the best outcome for people using the service. Vaccines were administered in line with best practice and national guidance. There were comprehensive risk assessments in relation to safety issues, for example, prevent accidents and cases of work-related ill health by managing the health and safety risks in the workplace. Conducted thorough risk assessment and review annually or upon significant change to the environment. We saw that the last health and safety risk assessment was dated 5 February 2024. The service monitored and reviewed activity. This helped it to understand risks and gave a clear, accurate and current picture that led to safety improvements. A fire risk assessment has been undertaken on 23 March 2023 and actions identified were for example, evacuation maps in the building showed out of date room names and there were no directions of where the fire assembly point was situation in the car park. We saw that there was an updated map wall mounted in the reception area. There were 3 fire marshals who had all received relevant training for their roles.

Staff told us teamwork was good and without exception, they enjoyed working in Castle House. They said the nurses and their colleagues were supportive. They told us they had good training opportunities and they attended training sessions regularly. Staff told us the culture was open and friendly and the manager had an open-door policy. Staff were confident and comfortable approaching the management team for any reason. Staff told us how they would process safeguarding referrals and were all suitable trained to an appropriate level for their role.

The service had safe systems for appropriate and safe handling of medicines. People were given information about medicines available to them for either occupational health or travel abroad and could make an informed decision about what treatments they wanted. Staff were knowledgeable and worked to ensure the best outcome for people using the service. Vaccines were administered in line with best practice and national guidance.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service proactively sought feedback from clients through their website and also locally at the clinic by filling out feedback forms and through social media. We saw comments for example, "great service super helpful and friendly and I have only positive feedback to give, there was always great communication". People were supported to make informed decisions about what medicines would be needed either for occupational health or travel. The service ensured that a person’s medical history was taken and a person-centred plan for treatment was made for each patient. People were told if treatments were available on the NHS and were signposted to these services where appropriate.

There were policies in place to cover the safe and effective use of medicines. These were reviewed regularly. There was a process in place for managing safety alerts and recording outcomes from these. Each practitioner was signed up to safety alerts from NaTHNaC. There were clear responsibilities, roles and systems of accountability to support good governance and management. Structures, processes and systems to support good governance and management were clearly set out, understood and effective. The service conducted thorough environmental risk assessment safety issues, for example, prevent accidents and cases of work-related ill health by managing the health and safety risks in the workplace. Conducted thorough risk assessment and review annually or upon significant change to the environment. We saw that the last health and safety risk assessment was dated 5 February 2024. The service monitored and reviewed activity. This helped it to understand risks and gave a clear, accurate and current picture that led to safety improvements. A fire risk assessment has been undertaken on 23 March 2023 and actions identified were for example, evacuation maps in the building showed out of date room names and there were no directions of where the fire assembly point was situation in the car park. We saw that there was an updated map wall mounted in the reception area. There were 3 fire marshals who had all received relevant training for their roles.

Staff told us they had good training opportunities and they attended training sessions regularly. Staff told us the culture was open and friendly and the manager had an open-door approach. Staff told us the management team were approachable and supportive. They had regular supervision sessions where they were encouraged to make suggestions for their personal and professional development. Staff told us teamwork was good and without exception, they enjoyed working in Castle House. They said the nurses and their colleagues were supportive. Staff were confident and comfortable approaching the management team for any reason.

We saw that medicines were stored safely, and temperatures were monitored appropriately. Staff were aware of what to do if a fridge temperature was out of range and investigated any anomalies. Staff had access to an emergency medicines kit including oxygen if needed. They were checked regularly and recorded.