CQC report explained · a nursing home
What the CQC found at Castle Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about testing, PPE, hygiene, admissions and managing infection outbreaks. They were only somewhat assured that visiting arrangements followed current guidance.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Requires improvement
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, January 2022
Castle Grange was inspected but not rated; inspectors found good infection-control practice but were only somewhat assured about visiting arrangements.
This was an announced, targeted inspection on 11 January 2022. Inspectors looked at infection prevention and control, visiting arrangements and staffing pressures linked to COVID-19. They gave the home 24 hours' notice.
Inspectors found good practice in the use of personal protective equipment, testing, vaccination, cleaning and infection-control training. Staff supported people with activities in their rooms, and relatives could use different ways to keep in touch.
Some residents and staff had tested positive for COVID-19. The home had agreed a two-week visiting ban with residents and families, but inspectors said they were only somewhat assured that visits were being facilitated in line with current guidance.
The home was inspected but not rated. This report does not provide an overall quality rating or ratings for the other four areas.
Infection control
The home had supplies of PPE, trained staff in infection control and used PPE correctly. Staff and residents had received COVID-19 vaccinations and boosters.
“Stocks of the right standard of personal protective equipment (PPE) were well-maintained and staff used and disposed of it correctly.” from the report
Testing and vaccination
Staff were tested twice a week and used a lateral flow test before each shift. The report says the service met the vaccination requirement for staff and visiting professionals.
“COVID-19 testing was undertaken twice weekly by all staff and lateral flow testing was required before each shift.” from the report
Keeping people connected
Staff carried out activities in people's rooms to reduce separation while maintaining communication. Relatives could see and speak with loved ones in different ways, including through an outside visitors' pod.
“We observed staff undertaking activities with people in their rooms to preserve separation as much as possible but maintain communication and activity at the same time.” from the report
Staff commitment
The provider told inspectors that staff had remained loyal and committed during the pandemic. Agency staff use was kept to a minimum.
“We were told that staff had been loyal and committed throughout the pandemic and the provider recognised the good care that was being provided by their staff, of whom they were very proud.” from the report
Visiting arrangements
needs fixingThe home had agreed a two-week visiting ban after some residents and staff tested positive. Inspectors signposted the latest government guidance and said the ban should be reviewed, because they were only somewhat assured that visits were being facilitated in line with guidance.
“We were somewhat assured the provider was facilitating visits for people living in the home in accordance with the current guidance.” from the report
- 01How are visits being facilitated now, including during an infection outbreak?
- 02How will you decide when a visiting restriction should be reviewed or lifted?
- 03What measures are in place if COVID-19 causes staff shortages?
- 04How often are staff tested, and what happens when a test is positive?
- 05How much agency staff is currently being used?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it was not a full inspection and the service was not rated. This explanation was written from the published report of 25 January 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2019
Rated Good overall; inspectors found safe, kind and responsive care, but the home needed to improve its leadership systems and records.
Inspectors visited without warning on 23 and 24 January 2019. They spoke with people living in the home, relatives and staff. They observed care and checked care plans, medicines, staff records, training and management information.
The home was rated Good for Safe, Effective, Caring and Responsive. People and relatives gave positive feedback. Inspectors saw kind interactions, enough staff, safe medicines practice, good cleanliness, support from health professionals and improved activities.
Well-led was rated Requires Improvement. The home’s leaders were respected and focused on care, but some checks, records, policies, feedback follow-up and action plans were not strong or clear enough.
The overall rating improved to Good from Requires Improvement at the previous inspection. Responsive also improved to Good. The well-led rating stayed at Requires Improvement.
Kind and personal care
Staff were warm, respectful and unrushed. Inspectors saw that they knew people well and used their preferred names.
“We observed kind, unrushed interactions between people who lived at the service and staff members.” from the report
People felt safe
People and relatives said they felt safe. Call bells were answered promptly and staff understood safeguarding responsibilities.
“People felt safe living at the service. Staff understood their responsibilities to keep people safe.” from the report
Food and drink support
The home offered a variety of food and drinks and adapted meals to people’s wishes. Staff paid particular attention to people at risk of malnutrition.
“The service had a particular focus on a model called "Good food, good mood.” from the report
Improved activities
Activities had improved since the previous inspection. People could join weekly outings, religious activities and activities brought to those who stayed in their rooms.
“Activities on offer for people had improved and there were weekly outings available for people who lived at the service.” from the report
Good health support
The home worked with a range of health professionals and made appropriate referrals to support people’s wellbeing.
“We found the service made appropriate referrals and worked frequently with professionals including a community matron, district nurses, GPs, speech and language therapists, physiotherapist, chiropodists and dieticians.” from the report
Management checks were not robust enough
needs fixingSome internal checks did not identify issues with a fire door or the display of information. Audits did not always produce clear action plans showing what had been done.
“The robustness of some governance systems and record-keeping needed to be improved.” from the report
Feedback was not followed up consistently
minorThe home gathered feedback through meetings and consultations, but learning and improvements were not always recorded consistently. Less positive feedback needed more consideration.
“We found that although there were some follow-up notes, learning and improvement from what people told the service needed to be recorded more consistently.” from the report
Some policies needed updating
minorInspectors found that some policies were out of date. They specifically noted that the safeguarding policy referred to guidance that had been replaced.
“The provider's Safeguarding policy had last been reviewed in 2016.” from the report
- 01How have you improved your governance checks and action plans since the January 2019 inspection?
- 02How do you make sure care plans fully record each person’s preferences, needs and decisions?
- 03How do you record and act on less positive feedback from residents and relatives?
- 04Have the policies identified by inspectors, including the safeguarding policy, been updated?
- 05How do you make sure the environment and equipment checks identify problems such as fire doors and privacy issues?
This was an unannounced inspection covering all five key questions, with care, records, medicines, staffing, training and management systems checked. This explanation was written from the published report of 8 February 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Castle Grange
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- January 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- February 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2018Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- July 2013
Registered with the Care Quality Commission on 18 July 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
91 live-in carers within about an hour of Liverpool
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 83 can care for a couple. 10 years' experience on average.
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
“All in all Kama b cared for the owner really well, every aspect of her care was of the highest standard.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.