About the service:

Castlewellan House is a residential care home registered to provide personal care and support for up to 18 people aged 65 and over. At the time of the inspection there were 16 people living in the home.

People’s experience of using this service:

People who lived in the home continued to be supported to remain safe. Management and staff knew people well and supported them with kindness and consideration. Staff knew how to keep people safe and had received training in safeguarding and how to reduce the risks of harm from occurring.

People received medications safely and risks to people had been assessed and managed to identify and reduce or address the impact of any known risks. People were supported to access healthcare services as needed and staff responded promptly to changes in people’s health. Other aspects of safety, including fire safety and issues of personal safety, were well managed in the home.

People were supported by a team of consistent staff who provided kind and personalised care. Safe recruitment processes ensured people were supported by staff of good character. People were cared for by staff who were well trained.

People’s preferences and experiences were known, and staff provided encouragement and enabled people to do as much as possible for themselves. People’s rights were upheld and protected, and people received kind support and assistance to have choice and control over their day to day lives.

People were supported to maintain their health through a good diet that provided them with choice and addressed their nutritional needs. Drinks were readily available at all times. People continued to be supported in a comfortable home with access to all communal areas and private space as they wished.

People and staff were encouraged to provide feedback about the home. There was a range of effective monitoring systems in place to check the home was well managed and delivered care that enabled people to have a good quality of life. The registered manager and deputy manager were aware of their responsibility to report events that occurred within the home to the CQC and other external agencies.

Rating at last inspection: Good (report was published March 2016)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This was an announced inspection which took place on 27 January 2016. Castlewellan House provides accommodation with personal care for 18 people. Some people lived with conditions that related to old age whilst other people had dementia. At the time of this inspection 16 people were living at the home. When we last inspected the home in July 2013 the provider was compliant with the regulations we assessed.

There was a registered manager at the home. 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.

We received a high level of praise from people and their relatives in relation to this home. They were very complimentary about the quality of the care they received. We found the registered manager and staff were motivated and committed to providing a high standard of care to people.

People had no concerns about their safety, risks to their safety had been identified and staff had training in how to recognise abuse.

Staff were recruited in a safe way and had relevant training and support to enhance their skills in providing people with quality care. There were enough trained and experienced staff to support people and meet their needs in a personalised manner.

People had their medicines when they needed them but staff did not always follow safe procedures and there was a lack of written guidance for staff.

Care was focused on people’s individual needs and we saw this was effective in managing risks to their health such as falling or developing pressure sores.

Staff were aware of how to support people’s rights, seek their consent and respect their choices. We saw staff worked within the principles of The Mental Capacity Act 2005 (MCA) to ensure that the human rights of people who may lack capacity to make decisions are protected. We saw staff understood the Deprivation of Liberty Safeguards (DoLS) to deprive someone of their liberty to ensure their safety.

People were happy with the meals offered and were supported to have the meals that they enjoyed. Drinks were offered throughout the day to prevent the risk of dehydration. People’s health was supported by access to appropriate health professionals.

We saw that staff were attentive and caring towards people. People described the staff as being friendly and kind. Relatives told us the staff were polite, patient and respectful towards people. People told us that they were happy living at the home. They knew how to raise any concerns if they needed to and we saw arrangements were in place to listen and act upon any concerns.

People enjoyed a range of activities which were tailored to meet their individual interests and encourage their independence.

People described the management of the home as very friendly and approachable.  Staff felt supported by the provider who was also the registered manager and worked in the home daily. We found quality monitoring systems were in place to ensure people received a good standard of care. Some adjustments were needed to the medicines checks. The registered manager had kept their own knowledge and learning up to date which ensured they were aware of new initiatives to enhance the quality of care provided.

We spoke with nine of the 15 people who used the service, the manager, two senior staff members, one care staff and the cook. We also spoke with a visiting relative. A relative said, "The standards are excellent, people are really cared for properly”.

We found that staff understood the importance of getting consent from people before they delivered care. We saw arrangements were in place to protect people who were unable to give their consent.

We saw people's needs had been assessed and planned for. People had a care plan that reflected their needs, personal routines and preferences.

People were happy with their meals, one person said, "The food is marvellous, we always have a choice”. Appropriate arrangements were in place to support people to eat and drink sufficient amounts. This meant the risks of dehydration or poor nutrition were reduced.

We found that people had their medication when they needed it and staff were trained to do this safely. The lunch time arrangements for administering medication needed to improve and we were advised that this would.

Staff members said they received support to do their job. People who lived there were complimentary about the staff. One person who lived there told us, "The staff are kind, thoughtful and patient”.

There were 15 people living at the home at the time of our inspection, another person was in hospital. We spoke with six people, four relatives and three staff. One person told us, "The staff are very obliging, I am very happy here”.

People who use the service are supported to make choices about the care and support that they receive.

People had care plans in place which reflected both their care and their specific health needs. Plans detailed risks to people, and how these are met. For example we saw people who had specific health needs such as diabetes had the support they needed to keep healthy.

We found that arrangements are in place to ensure people are protected from the risk of harm or abuse. A relative told us, “My mom kept falling at home; when she came here she refused to use the buzzer and had a fall. I was so pleased when they got her an alarmed mat, now she doesn’t fall because the staff know when she’s moving out of bed”.

We found there is enough skilled staff to look after people’s needs. One person said, “The staff are marvellous you couldn’t get better”.

People told us they knew how to complain if they had any concerns. One relative said, “I have never had any reason to complain, I always discuss mom’s care and I see her care plan. If there is anything I need to discuss, I do”.

Systems are in place to monitor the quality of service provided, and people who live there are involved in this process.

People receive good quality care care in a warm and homely environment. People and visiting professionals were complementary about the staff saying they were kind and dedicated. Quality assurance systems are in place to monitor the quality of service provided. The home will need to monitor the feasibility of it's current management systems to ensure these standards are maintained