Archived: Castle View House

Castle View provides care and accommodation to up to eight adults with enduring mental illness. It has been run as a family business for more than 20 years, with the owners in day-to-day charge of the service. The premises looks and feels like a normal home, is well decorated and tastefully furnished. People were enabled to manage their mental health and recovery if they became unwell by the support provided by staff in the service. There were seven people using the service at the time of our inspection.

The service had a registered manager. 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. A senior member of staff was in day-to-day charge of the service whilst the provider was actively recruiting a new manager.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

There were enough staff with the skills required to meet people’s needs. Staff were recruited using procedures designed to protect people from the employment of unsuitable staff.

Staff had been trained to recognise and respond to the signs of abuse. Discussions with them confirmed that they knew the action to take in the event of any suspicion of abuse. Staff understood the whistle blowing policy and how to use it. They were confident they could raise any concerns with the registered provider or outside agencies if this was needed.

Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal to support them to carry out their roles.

Staff respected people in the way they addressed them and helped them to move around the service.

Staff were long serving, friendly and very knowledgeable about mental health matters and the needs and requirements of people using the service. Staff involved people in planning their own care. Staff supported people in making arrangements to meet their health needs. People had access to health services and referrals for additional support were made when people needed it.

Medicines were managed, stored, disposed of and administered safely. People received their medicines in a safe way when they needed them and as prescribed.

People received the support they needed to eat and drink. They had a choice of meals from a varied menu. Mealtimes were a relaxed and pleasant experience for people.

People’s care was planned and delivered in a personalised way. The service had been organised in a way that promoted a personalised approach to people’s activities. People were involved in making decisions about their care and treatment and had been supported to decide how they would like to be occupied, for example social activities and going out. People were given individual support to take part in their preferred hobbies and interests.

There were risk assessments in place for the environment, and for each individual person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. The risks to individuals, for example in moving safely around the service, had been assessed and action taken to reduce them. Staff understood how to keep people safe. The registered provider had taken action to ensure the premises were safe and met people’s needs.

There were systems in place to review accidents and incidents and make any relevant improvements as a result.

People knew how to make a complaint if they needed to. Complaints were responded to quickly and appropriately and people were given feedback in a way they could understand.

One of the owners is also the registered manager. They have maintained their skills and personal development through their membership of a nationally recognised and high profile mental health charity. There were systems in place to obtain people’s views about the quality of the service and the care they received. People were listened to and their views were taken into account in the way the service was run.

There were five people using the service at the time of our inspection. We considered our inspection findings to answer the questions we ask:

' 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. The summary describes what people who used the service and the staff told us, what we observed and the records we looked at.

Is the service safe?

The service was safe. People had been protected from abuse and avoidable harm. People who used the service had benefited from safe care and support, due to good decision making and effective management of risks to their health, welfare and safety. People lived in a clean environment where the risk of infections/cross infection was reduced. The provider had ensured that people who used the service were in safe, accessible surroundings that promoted their wellbeing.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. No applications had been submitted. The manager had awareness of and made reference to current guidance in relation to DoLS applications.

Is the service effective?

The service was effective. We saw that the manager and staff understood people's care and support needs. They knew the people who used the service very well. We were told by one person we spoke with that, "Staff are very good. They help me get on and look after myself". The service had quickly identified occasions when people's health had declined. Timely action had been taken to ensure medical needs were assessed and treated.

Is the service caring?

The service was caring. We saw staff show understanding, patience and attention when supporting people. The staff and manager spoke with compassion and care about people who used the service. We saw people getting on well with staff and each other. One person we spoke with told us that they felt treated, 'Like family'. Staff described how, 'Trust, understanding and choice' had informed their relationships with people that used the service.

Is the service responsive?

The service was responsive. People's needs had been assessed before they moved into the home and kept under review. We saw that people had been supported and had been helped in areas that were important to them. Care and support had been provided which met people's needs and preferences. People who used the service told us that the provider and staff had been interested in their views about the service and other matters they liked to discuss. They told us that they felt listened to and taken notice of.

Is the service well led?

The service was well led. The registered providers both worked in the home on a day to day basis. One of the providers was also the registered manager. The providers both maintained a high level of involvement and provided clear direction and leadership to the staff team. Staff were clear about their roles, responsibilities and the ethos of the home. Staff told us that the providers had been very supportive and receptive to their contributions. We found the provider had sought the views and opinions of people who used the service and where possible those of their relatives and/or representatives.

People who lived in the house spoke positively about their experiences. Comments included: "Staff are very nice here.' 'Staff are around to help me if I need them to.' 'I can choose what I want to do.'

We found that people or their representatives had been involved in decision making and giving their consent for care and treatment.

People were provided with appropriate care and support that met their needs.

People received the medication they needed at the time they needed it.

There were robust recruitment and selection procedures in place to make sure people were cared for by staff who were suitable.

Overall we found that this service had achieved compliance but have made some comments that the provider may find useful to note.