CQC report explained · a nursing home
What the CQC found at Castle Keep
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that medicines, safeguarding, risk assessments, staffing, recruitment and infection control were managed safely.
- Effective?
- Good
- This question was not inspected during this visit.
- Caring?
- Good
- This question was not inspected during this visit, although inspectors recorded positive comments about the home's person-centred culture.
- Responsive?
- Good
- This question was not inspected during this visit.
- Well-led?
- Good
- Inspectors found effective audits, action plans, open communication and meaningful involvement of people, relatives and staff.
What inspectors found, August 2022
Castle Keep rated Good; inspectors found safe, well-managed care, with no registered manager in post at the time of the visit.
The inspection was unannounced. One inspector and an Expert by Experience visited on 5 July 2022, spoke with people, relatives and staff, and reviewed care, medicine, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found medicines were given as prescribed, risks were assessed, staffing was sufficient, safeguarding systems worked and infection control was managed well.
The home had a positive, person-centred culture. People and relatives were involved in decisions and their feedback was used to make improvements. The home had no registered manager, but a newly appointed manager was progressing with their registration application.
The previous rating was Requires Improvement, published on 30 March 2020. The home had acted on the earlier recommendation about medicines, and the overall rating changed to Good.
Medicines
Medicines were stored correctly, given as prescribed and supported by accurate records and staff training.
“Medicines are stored correctly; staff keep accurate medicines records and manage medicines consistently and safely.” from the report
Person-centred culture
The home promoted a positive culture focused on people's individual needs, equality and diversity.
“The service had a positive culture that is person centred.” from the report
Learning and improvement
The manager used audits, incident reviews and feedback from people and relatives to plan and monitor improvements.
“The manager has developed action plans from resident and relatives' feedback, these are signed and dated when completed.” from the report
No registered manager
needs fixingThere was no registered manager in post. A new manager had been appointed and their application to register was still progressing.
“The service had been without a registered manager since May 2022.” from the report
- 01What is the current progress of the manager's application to become registered with the CQC?
- 02How are medicine records and staff medicine competencies checked now?
- 03How often are staffing levels reviewed against people's changing needs?
- 04What improvements have been made in response to recent accidents, incidents and relatives' feedback?
- 05How does the home assess the quality of Effective, Caring and Responsive care, which was not inspected in this visit?
This was a focused inspection of Safe and Well-led; the other question areas were not inspected during this visit and the overall rating was calculated using previous ratings for those areas. This explanation was written from the published report of 10 August 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, April 2020
Rated Requires Improvement; inspectors found kind and effective care, but medicines, the environment and leadership needed improvement.
This was an unannounced inspection on 18 and 19 February 2020. Inspectors spoke with people, a relative, staff and health professionals. They observed care and reviewed care, medicines, staff and management records.
The home was rated Good for Effective, Caring and Responsive. People were treated with kindness, their health and food needs were supported, and staff provided personalised care and activities.
Safe and Well-led were rated Requires Improvement. Two people had not received medicines as prescribed because they were asleep, and guidance for some medicines was unclear. Inspectors also found unsafe furniture, cleaning shortfalls and no registered manager.
The overall rating fell from Good at the previous inspection to Requires Improvement. Some environmental issues were fixed during the inspection, and the provider said it would strengthen checks and adjust its refurbishment plan.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors found that staff supported privacy, dignity, independence and everyday choices.
“People were well looked after and treated with kindness in line with their diverse needs.” from the report
Health and nutrition
People's health needs were assessed and they could access health professionals. Meals included choices, alternatives and snacks, with extra monitoring for people at nutritional risk.
“People were provided with a well-balanced diet, which included choices, alternatives and snacks in between meals.” from the report
Staffing and recruitment
The provider completed employment checks and had enough staff on duty to meet assessed needs. Staff generally responded quickly to call bells.
“There were enough staff employed to meet people's needs safely.” from the report
Personalised activities
The home offered in-house activities, entertainers, trips and opportunities linked to individual interests. Staff supported people to maintain relationships and avoid isolation.
“There were two activity coordinators who provided a range of social stimulation for people.” from the report
Staff training
Staff received induction, training, supervision and appraisal. Training included specialist support for people's health and care needs.
“Staff received induction, training, supervision and appraisal.” from the report
Medicines were not always given as prescribed
seriousAt least two people missed important daily medicines because they were asleep when nurses gave them. Guidance and recording for some 'as and when needed' medicines was also unclear.
“Not everyone had received their medicines as prescribed.” from the report
Environmental safety and cleaning checks
needs fixingInspectors found exposed screw tips, a leaking sink, an evacuation ski pad stored in a locked room and food debris on equipment. These issues were addressed during the inspection, but the checking system needed strengthening.
“Risk issues had not always been identified and monitored in the environment.” from the report
No registered manager
needs fixingThe home had been without a manager registered with CQC since August 2019. Temporary management arrangements were in place while a new manager was being recruited.
“The service had been without a registered manager since August 2019.” from the report
Some care plans needed more detail
minorSome plans for people with complex health needs could have been improved. End of life information was spread across different sections rather than being in one separate plan.
“Some people had complex health care needs and their care plans could be enhanced further.” from the report
- 01Have the medicines arrangements changed so people do not miss prescribed doses when they are asleep?
- 02How are 'as and when needed' medicines now authorised, given and recorded?
- 03Who is currently managing the home, and has an application been made for CQC registration?
- 04Have all the environmental repairs and cleaning improvements identified during the inspection been completed?
- 05How have the care plans for people with complex health needs and end of life care been improved?
This was an unannounced inspection covering all five CQC questions, including the premises and care provided. This explanation was written from the published report of 1 April 2020 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 Keep
4 rated inspections over 7 years: the service has held its Good rating throughout.
- August 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- July 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Inspected but not ratedSafe: Requires improvementEffective: Good
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
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
13 live-in carers within about an hour of Kingston upon Hull, City of
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 £1,020 to £1,350 a week. 12 can care for a couple. 8 years' experience on average.
“What truly stands out is how mindful and attentive she is to all of my medical needs, always going above and beyond to ensure I’m comfortable and well cared for.”
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.