About the service:

Castelayn is a care home that provides personal care and accommodation for up to 42 people. At the time of this inspection there were 39 people using the service.

What life is like for people using this service:

• People told us they were consistently treated with kindness, dignity and respect. Without exception, people told us they felt safe and well cared for. One person said, “I have no doubt that the care here is first class, bearing in mind I have used other homes in the area.” People’s relatives praised the standards of care provided by staff and they told us they were always welcomed into the home when they visited;

• People received personalised support from staff who knew them well. Staff had built positive relationships with people living in the service. Staff supported people to retain their independence and to remain involved in planning and reviewing their care to ensure it was provided in accordance with their own preferences;

• Staff worked closely with a range of community health professionals to promote good outcomes for people. Various community health professionals had provided positive feedback about the service in a recent satisfaction questionnaire, commenting they thought the home was well-led and staff were very caring. A visiting health professional told us staff were proactive in seeking advice about people’s health and acted upon any advice given. The service maintained a close relationship with health professionals when providing care to people at the end of their life. This enabled the service to support people to have a dignified, pain free death;

• The service was consistently well-led. People felt able to raise any concerns with the registered manager and were confident they would be addressed. Staff felt well supported by the registered manager and we observed the staff team work well together;

• The registered manager and provider coordinated a wide range of quality checks and audits of the service to make sure the care and support provided was of high quality. This supported the continuous improvement of the service;

• The service met the characteristics of good in all key questions, however we have made a recommendation about staffing levels;

• More information is in the full report.

Rating at last inspection:

Good (published 12 May 2016)

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection. The service remains good.

Follow up:

We will continue to monitor this service. We plan to compete a further inspection in line with our re-inspection schedule for those services rated good.

Castelayn is registered to provide accommodation and personal care for up to forty two older people. The home is purpose built over three floors. The top floor of the home is dedicated to supporting people living with dementia. The home is situated in the S14 area of Sheffield, close to local amenities and bus routes.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

Our last inspection at Castelayn took place on 19 May 2014. The home was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 5 April 2016 and was unannounced. This meant the people who lived at Castelayn and the staff who worked there did not know we were coming. On the day of our inspection there were 38 people living at Castelayn.

People spoken with were positive about their experience of living at Castelayn. They told us they felt safe and they liked the staff.

Relatives spoken with had no concerns regarding their relative’s care. They told us they knew staff well and they were always kept up to date with any news.

Healthcare professionals spoken with told us they had no concerns about Castelayn.

We found systems were in place to make sure people received their medicines safely.

Staff recruitment procedures were thorough and ensured people’s safety was promoted.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. They told us they liked their jobs, worked well as a team and were well supported by the registered manager. The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences so their health was promoted and choices could be respected.

People living at the home, and their relatives said they could speak with staff if they had any worries or concerns and they would be listened to.

We saw people participated in a range of daily activities both in and outside of the home which were meaningful and promoted independence.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. People using the service and their relatives had been asked their opinion via questionnaires, the results of these had been audited to identify any areas for improvement.

An adult social care inspector carried out this inspection.

At the time of this inspection thirty six people were living at Castelayn. We spoke with ten people living at the home, three of their relatives and one professional visitor to obtain their views of the support provided. In addition, we spoke with the registered manager, the deputy manager, the administrator, three care staff, the cook and two domestic staff about their roles and responsibilities.

We gathered evidence against the outcomes we inspected to help answer our five key questions; 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.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People supported by the service, or their representatives told us they felt safe.

People told us they felt their rights and dignity were respected.

Systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We found risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant people would be safeguarded as required.

The service was safe, clean and hygienic.

Is the service effective?

People’s health and care needs were assessed with them and their representatives, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Staff were provided with training to ensure they had the skills to meet people’s needs. Some staff required updates to aspects of their training to ensure their knowledge and skills were up to date. Staff were provided with formal individual supervision and appraisals at an appropriate frequency to ensure they were adequately supported and their performance was appraised. Managers’ were accessible to staff for advice and support.

Visitors confirmed they were able to see people in private and that visiting times were flexible.

Is the service caring?

We asked people using the service and relatives for their opinions about the support provided. Feedback from people was positive, for example; “they (staff) are all right, every one of them. Very good”, “they (staff) give me the help I need, they know what I like. I can have a laugh with them” and “they (staff) seem very patient. They always keep me up to date about (my relative), what they’ve been like. (My relative) is always clean and well dressed. They seem content here. I have no worries at all. It is very good here”.

When speaking with staff it was clear they genuinely cared for the people they supported and had a detailed knowledge of the person’s interests, personality and support needs.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People’s preferences and interests had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People regularly completed a range of activities in and outside the service. The home had access to an adapted minibus, which helped to keep people involved with their local community.

Some people required specialised diets for health or personal reasons. We found the service provided food and drinks specifically requested by people. People told us, “they (staff) feed us up, you never want for anything” and “the food is good, three meals a day and snacks in between. We’ve no complaints at all”.

People spoken with said they had never had to make a complaint but knew how to make a complaint if they were unhappy. We found appropriate procedures were in place to respond to and record any complaints received. People could be assured that systems were in place to investigate complaints and take action as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure people received a good quality service at all times.

In this report the name of the previous registered manager, Diana Oak, appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

People living at the home told us that they were happy and that they were satisfied with the care they received. They told us, "it’s smashing here, the staff are lovely" and "I can’t praise this home enough. The staff are very kind. They are wonderful people.”

A relative spoken with said that they were happy with the care their loved one received. They told us, “(my relative) is happy here, so I am happy.”

We found that care and support was offered appropriately to people.

We found that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

We found that people's care and welfare needs were assessed and each person had a written plan of care that set out their identified needs and the actions required of staff to meet these.

We found that medicines were being obtained, recorded, handled, dispensed and disposed of in a safe way.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

The provider had an effective complaints system available.

We spoke to six people who lived at Castelayn. They told us that they liked living at the home, and the staff knew them well and supported them in the way they needed. Comments included; “The staff are lovely.” “They (the care staff) give me the help I need, the way I want.” “I am all right; (the staff) are always asking me if I need anything.” “I haven’t got anything to worry about, but I can talk to staff.” People told us that they felt safe living at Castelayn. They said that staff gave them the support they needed in the way that they preferred. All of the people spoken with said that they could speak to staff, and staff listened to them.

We spoke with one professional visitor, who told us, “This is a lovely home. I visit once a week and have no concerns at all. The staff are very helpful.”

We spoke with Sheffield Local Authority, Contracting, Commissioning and Safeguarding and they told us that they had not identified any concerns at the home.