Archived: Castlethorpe Nursing Home

Castlethorpe Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The CQC regulates both the premises and the care provided, and both were looked at during this inspection. Castlethorpe Nursing Home supports up to 59 people, some of whom may be living with dementia, have a physical disability or a sensory impairment. At the time of the inspection, there were 34 people who used the service and 18 people were funded to receive nursing care.

The service had a registered manager in post. 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.

People, their relatives and visiting professionals provided only positive feedback about the service.

We found aspects of the quality monitoring and management recording systems were limited and outdated. The registered manager acknowledged the need to improve and develop these systems and programmes. We have made a recommendation about obtaining a more up-to-date comprehensive recording system and audit programme to support continued service development.

The building was adapted to meet people’s individual needs. The registered manager had ensured some redecoration and refurbishment had taken place and acknowledged further renewal was required, which was to be discussed with the provider. Equipment used in the service was maintained and any repairs were completed in a timely way. There were effective infection control training and procedures in place. People told us they were happy with the cleanliness of the service. Accidents and incidents were recorded and investigated.

Staff were recruited safely and checks were carried out before they started work in the service. There were sufficient care staff on duty to meet people’s needs. There were ancillary staff, which enabled care staff to concentrate on caring for people.

People received their medicines safely from trained staff. The registered manager made sure that people at the end of their lives had the medicines they required to maintain their comfort and dignity. People who were being cared for in bed were regularly seen by staff to make sure they remained comfortable.

Staff had received training and had procedures to guide them in safeguarding people from the risk of harm and abuse. In discussions, staff were clear about how they would escalate concerns and which agencies they would contact for advice. Staff had completed assessments with people to identify risk areas and the steps required to minimise risk.

People’s health and nutritional needs were met. Records showed people had access to a range of community healthcare professionals for advice and treatment. These included dieticians when people lost weight and required additional support. The menus provided varied meals with choices and alternatives. People told us they liked the meals provided to them.

The staff supported people to make their own decisions and choices when they were able. When people were assessed as lacking capacity, staff consulted with relevant people when decisions were made on their behalf. We found some gaps in the records when restrictions were in place which the registered manager addressed following the inspection.

Staff received training, supervision and appraisal to ensure they were skilled and confident in meeting people’s needs. There were staff meetings which enabled them to receive information and express their views. Staff told us they felt supported by management.

People were treated with respect, kindness and understanding. Staff demonstrated a good knowledge of the people they cared for, their preferences and abilities. People told us staff were friendly, caring and had time to sit and talk to them. We observed staff had developed good relationships with people who used the service and their relatives. People’s privacy and dignity was respected by staff who encouraged people to be independent and make choices and decisions in their daily lives.

People's needs were assessed and planned. People and their relatives were involved in this process which helped staff to deliver support tailored to their needs and preferences, although we found some care plan records could be more person-centred. People were happy with the standards of care and support provided. The service had developed strong links with the community palliative care team and received a lot of referrals for end of life support.

People who used the service and relatives were positive about the activity programme, which included one-to-one sessions, group activities, entertainers and community trips. Relatives told us they could visit at any time and we saw staff supported people who used the service to maintain relationships with their friends and family.

The provider had a complaints procedure and people told us they felt able to raise concerns and these would be addressed by management. Staff described the culture of the organisation as open and management as supportive and approachable.