Castle View

People living at Castle View receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is registered to accommodate 57 people and specialises in providing care, treatment and support for older people. The service was split over three floors which were all accessible by stairs or a lift. There were 55 people using the service at time of inspection.

There was a strong emphasis on eating and drinking well. Staff had a good knowledge of people's individual dietary needs. A 'night owl menu' was available to people for snacks and light meals during the evening and overnight. There was a smoothie menu to increase people's nutritional intake. There were systems in place to carefully monitor people's nutritional needs.

Care and support was provided by staff who had received an induction and continual learning that enabled them to carry out their role effectively including. Staff training was tailored to meet staff member's individual training styles and ensure they were able to meet people's needs. Nurses were provided with opportunities to maintain and develop their clinical skills. Staff felt supported by the management of the service and were confident in their work.

There were champions in dementia care, moving and handling, health and safety and end of life care to help improve outcomes for people.

Technology was used to support care delivery. The provider had introduced a tool which looked at patterns for falls, wounds, accidents/incidents, safeguarding alerts and infections. This information was used to help determine quickly whether any changes were required in the support people receive.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse and who to report this to both internally and externally if abuse was suspected.

Staffing levels were adequate to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults. Registered nurses had the necessary permissions to practice.

Risk assessments were individual and detailed which meant that staff understood safe practices which helped keep people safe.

Medicines were administered and managed safely by trained and competent staff. Medication stock checks

took place together with regular audits to ensure safety with medicines.

People knew their responsibilities about the prevention and control of infections within the service. Staff had received training and there was protective equipment readily available.

People had been involved in assessment of their care and support needs. They had their choices and wishes respected. The service worked well and in partnership with professionals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The registered manager actively sought to work in partnership with other organisations to improve outcomes for people using the service.

People, their relatives and professionals described the staff as kind and caring. People had their dignity and privacy respected and their independence promoted.

People had their care needs met by staff who were knowledgeable about their individual needs and how they communicated.

The service had a complaints procedure and people were aware of it. People knew how to make a complaint. The service actively encouraged feedback from people and this was used in making changes and improvements.

A variety of activities were available and people could decide what they wanted to do. The service actively encouraged people to be involved.

Relatives and professionals had confidence in the service. The home had an open, honest and positive culture that encouraged the involvement of everyone.

Leadership was visible within the home. Staff spoke positively about the management team and felt supported. The registered manager and clinical lead actively kept themselves updated.

There were effective quality assurance and auditing processes in place and they contributed to service improvements. Action plans were completed and those responsible kept things up to date.

The service understood their legal responsibilities for reporting and sharing information with other organisations.

Further information is in the detailed findings below.

The five questions we ask about services and what we found