Castle Dene

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

People were protected from avoidable harm; through assessment and management of the risks they faced day to day. Staff knew how to recognise concerns and reported them both within the home and to external organisations. Staff had the necessary experience and skills to provide care, and there were enough staff planned on duty. Medicines management was safe. Infection control procedures adhered to good practice guidelines. Utility checks and maintenance processes were in place to ensure people were safe. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met.

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.

People and their relatives told us they were assured by the home learning from experiences and making improvements.

Incidents that occurred within the home, were recorded, and discussed to prevent reoccurrence. Staff told us the actions they took in real life recent events which included reflection. All steps for safety were maintained and records reflected the actions taken.

Accidents, incidents and events were recorded on the provider’s electronic governance systems. The registered manager was informed of each incident and undertook regular reviews to identify trends. In addition to this, learning was shared across the provider’s locations through managers meetings and reviews of the governance system at provider level.

People felt confident their needs would be met by staff and information would be shared to promote joined up care. This had included information for medical professionals.

Staff told us information was available to them if they needed to speak with external professionals for people. This included, if a person had gone to hospital or moved to a new care service.

Healthcare professionals were confident in the care delivered at Castle Dene and told us, “We find the Management very approachable and feel at ease to ask any questions relating to the care and support needs of clients. They are also aware of how we work and achieving best value.”

People’s needs, and care requirements were detailed within their care plans and risk assessments on the electronic system. A summary sheet was available if the person went into hospital or moved to another care home, this encouraged continuity of care for people.

People and their relative’s told us Castle Dene was a safe place to be. People told us a variety of reasons why they felt safe, but mainly having the staff team around when they needed them. Some comments we received were, “Staff give you a hug if you need it. They all work so hard, it's safe here”, “Castle Dean is a good care home with staff who are willing to help” and, “I feel the residents are safe at Castle Dene.”

Staff knew how to ensure people were protected from harm and abuse. They told us how they would raise concerns both internally and externally. Staff were confident the registered manager would follow up any concerns. Staff understood how to ensure people’s rights were fully respected and had received training in DoLS. The registered manager and deputy manager showed a good understanding of DoLS which ensured any restrictions were the minimum needed to promote safety.

We observed safe interactions throughout our inspection. Staff worked in safe ways, for example, when supporting people to move and transfer from place to place.

Safeguarding procedures were in place to ensure people were protected. Potential risks and dangers had been identified, assessed and mitigated. Safeguarding was a topic for discussion, not only during annual training but within all staff meetings. Records showed safeguarding referrals had been made as necessary and this included notifying CQC of certain events as required. All legal applications had been made in accordance with DoLS, this meant people’s rights were fully respected. The registered manager had oversight of DoLS applications, authorisations, and conditions and used a tracker process to ensure all documentation was in date.

People and their relatives told us they felt safe, and risks to their wellbeing were considered and managed.

Staff told us they understood people’s risks and how to keep them safe. Staff told us how they would support people who had significant risks to their wellbeing. This included, where a person was at risk of weight loss and malnutrition.

We observed staff working in safe ways with people. Where people were supported to eat and drink, this had been carried out by staff in a respectful, dignified and safe way. Processes: Risks to people were assessed prior to, and when they moved into the home. People had individual risk assessments, for example, supporting their mobility and risks of falls. Risk assessments were updated as people’s needs changed. The provider’s electronic care planning system ensured changes were made immediately as required. The records we reviewed were up to date.

Risks to people were assessed prior to, and when they moved into the home. People had individual risk assessments, for example, supporting their mobility and risks of falls. Risk assessments were updated as people’s needs changed. The provider’s electronic care planning system ensured changes were made immediately as required. The records we reviewed were up to date.

People and their relatives told us they were happy with the home environment and told us it was, ‘homely.’ People were encouraged to furnish their bedrooms and bring along their personal belongings.

The registered manager told us ensuring a safe environment was important to them. Many updates and improvements had been made and there was an ongoing maintenance, redecoration, and refurbishment plan. Staff told us they had fire safety training, including fire drills, records confirmed this had taken place.

Castle Dene had received extensive refurbishment and decoration; the home was clean and well maintained. Equipment and décor were effectively maintained. Fire safety procedures were in place, this included equipment and instructions for emergency services, about the assistance people required to safely evacuate the building.

Equipment and utility checks were up to date and closely monitored to promote safety. A dedicated staff member was responsible for maintenance within the home, this included provider oversight. There was a programme of works and reminders of expiry dates. The home used external specialists and contractors to undertake some checks.

People told us staff were there when they needed them. People and their relatives told us they believed there was enough staff on duty. They told us they thought staff were skilled and had received sufficient training to support them with their needs.

Staff received the training and support to ensure they could carry out their role. Staff told us they felt supported fully by the registered manager and deputy manager. Formal supervisions were carried out and staff told us they could access support at any time. A member of staff told us, “I am happy with the training, we get a lot.”

We observed the home to be calm and relaxed. Staff were busy and the number of staff were in accordance with the plan for the day.

Staffing numbers had been calculated to meet people’s needs; this helped the registered manager understand how many staff were needed to provide safe care. Each person had their dependency assessed to calculate the safe number of staff, this was reviewed regularly or as things changed. Staff were recruited safely, and recruitment records reflected this. Procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. Staff learning and development was in place to ensure staff were properly inducted into the home and their knowledge maintained. The registered manager and provider had oversight of training within the home.

People and their relatives told us the home was clean and tidy, this included people’s own bedrooms.

Staff received training in creating and maintaining a clean environment. Dedicated staff ensured the home was clean.

We observed the home to be clean and hygienic. People were supported to maintain their own environment, and this included their bedrooms. Personal protective equipment (PPE) was worn appropriately by staff.

Safe infection prevention and control procedures were in place and were supported by a clear policy. Infection control procedures and audits were in line with good practice guidance. Staff had plentiful supplies of cleaning materials, products, and PPE.

People told us they received their medicines when they needed them. We observed medicines being given safely, with staff explaining to people what the medicine was for.

Staff told us they were confident with medicines management. Staff who were responsible for giving people medicines were trained and had their competency assessed. Staff told us they worked well as a team to ensure medicines were safe.

Safe procedures were in place for the ordering, storage and administration of medicines. The home worked well with the pharmacy and GP surgery to ensure people were receiving the correct medicines at the correct time. Robust checks were in place, and the providers electronic medicines system contained accurate recordings. The registered manager had oversight of the system. Medicines were stored at safe temperatures and checks were in place to ensure this continued. Guidance was in place to ensure medicines taken occasionally were given in a consistent way. Medicines which required stricter controls were monitored and correct control measures were in place. Medicines were reviewed regularly and discussed to ensure people only received the medicines they needed.