CQC report explained · a nursing home
What the CQC found at Castlehill Specialist Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2023
Rated Good; inspectors found safe, effective care and good leadership, but the inspection followed safeguarding concerns and agency staff were still being used.
This was a focused inspection on 5 and 6 April 2023. It followed safeguarding concerns about falls, personal care, moving and transferring, unexplained bruising, nutrition and hydration, agency staff and staff shortages. Inspectors found no evidence that people were at risk of avoidable harm from these concerns.
Inspectors spoke with people, relatives, staff and a visiting healthcare professional. They observed care, reviewed care plans, staff files, medicines records, audits and other records. They found enough staff during the visits, safe medicines practice, suitable infection control and good support from health professionals.
The home was rated Good overall. Safe, Effective and Well-led were rated Good in this inspection. Caring and Responsive were not inspected, so their previous ratings were used when calculating the overall rating. The last overall rating was also Good, published in April 2022.
Enough staff during visits
Inspectors found enough staff on duty to meet people's needs, including the required one-to-one and two-to-one support.
“At the time of our visits, there were enough staff on duty to meet people's needs.” from the report
Safe medicines practice
Medicines were stored, administered and checked safely. Staff had training and regular competency checks.
“We saw staff administered medicines to people safely.” from the report
Good healthcare support
Staff worked with GPs, mental health teams, nursing services and other professionals to support people's health needs.
“Staff communicated effectively with health and social care services.” from the report
Effective management checks
Managers used audits, staff observations, meetings and surveys to monitor care and identify improvements.
“Audits were used effectively by the registered manager to monitor the care and support provided to people.” from the report
Kind and calm atmosphere
Inspectors saw staff supporting people kindly and found the atmosphere calm across the home.
“Overall, we saw staff supported people in a kind and friendly way.” from the report
Agency staff still used
needs fixingThe home continued to rely on agency staff. Managers were recruiting permanent staff and tried to block-book agency workers to improve consistency.
“The provider had used and continued to use agency staff.” from the report
One care plan was out of date
minorOne person's care plan did not reflect a medical condition. It was corrected on the first day and the person had not been harmed.
“Although we found one person's care plan had not been updated to reflect one medical condition.” from the report
Pharmacist advice was missing
minorThere was no evidence that a pharmacist had been consulted about the safe way to give covert medicines. Nursing staff contacted the pharmacist for advice immediately.
“There was no evidence a pharmacist had been consulted on the safe administration method.” from the report
More reassurance during transfers
minorManagers had identified that staff could be more interactive when moving and transferring people, including explaining what they were doing and offering reassurance.
“There had been occasions when staff could be more interactive with people.” from the report
- 01How much are you still relying on agency staff, and what progress has been made in recruiting permanent care and nursing staff?
- 02How do you make sure agency staff know each person's support needs and risks before working with them?
- 03What checks now make sure care plans are updated promptly when a person's medical condition changes?
- 04What pharmacist advice is now recorded for people who receive medicines covertly?
- 05How do staff explain moving and transferring to people and provide reassurance during this care?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 3 June 2023 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 2022
Rated Good; inspectors found safe, effective and well-managed care, but raised concerns about agency night staff, mask use and some records.
This was an unannounced focused inspection on 3 and 4 March 2022. Inspectors spoke with people, relatives, staff and visiting professionals. They reviewed care, medicines, staff and management records, including infection control arrangements.
The home was rated Good overall. Safe, Effective and Well-led were also rated Good. Inspectors found that people were protected from avoidable harm, received suitable support and had their needs monitored. Medicines were handled safely, staff received training and quality checks were carried out.
There were some areas to improve. Agency staff were being used, especially at night, and some relatives and staff felt this could affect care. Some staff wore masks incorrectly in reception areas and offices. Daily records did not always show oral care, and some staff needed a better understanding of deprivation of liberty safeguards.
People felt safe
People and relatives said care was safe. Staff had safeguarding training and knew how to report concerns.
“People and relatives told us safe care was provided.” from the report
Safe medicines practice
Staff were trained and assessed as competent to give medicines. Audits were used to identify and address shortfalls.
“Systems were in place for the safe handling and storage of medicines.” from the report
Good health support
The home worked with healthcare professionals and followed advice about people's health needs. Dietary needs and food preferences were also supported.
“Staff worked well with healthcare professionals to ensure people's needs were met.” from the report
Facilities and activities
Inspectors found useful facilities, including cinema rooms, outside spaces and a bar area where people could spend time with visitors.
“The home was purpose built and had some excellent facilities including cinema rooms on each floor.” from the report
Open management
People, relatives and staff could raise concerns with the manager. The home used surveys and meetings to gather views and plan improvements.
“People and relatives felt able to raise concerns and approach the home manager.” from the report
Agency staff at night
needs fixingA relative and a staff member were concerned that agency staff, particularly at night, might not know people's needs as well as permanent staff. The manager was taking steps to increase permanent staffing and carry out night checks.
“The problem with the night staff is its agency run, it's just not the same.” from the report
Incorrect mask use
needs fixingSome staff wore face masks below their nose or on their chin in reception areas and offices. Inspectors said this was not in line with government guidance.
“We observed some staff were wearing face masks under their nose or chin in the reception area and in offices.” from the report
Oral care records
minorPeople's oral hygiene needs were assessed and staff were trained, but daily records did not always show that support had been given. The provider agreed to change the electronic recording system.
“However, daily records were not always completed to evidence the support given.” from the report
Understanding legal safeguards
needs fixingSome staff were not clear about deprivation of liberty safeguards. The provider said refresher training would be provided.
“However, some staff were not clear on what DoLs meant.” from the report
Registered manager
needs fixingThere was no manager registered with the CQC at the time of inspection. The home manager applied to become registered during the inspection.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01How many permanent staff now work at night, and what has changed since inspectors raised concerns about agency night staff?
- 02How do you check that all staff wear face masks correctly in reception areas and offices?
- 03How is oral care recorded now that inspectors found daily records were not always completed?
- 04What refresher training have staff had about deprivation of liberty safeguards?
- 05Has the home manager's application to become the registered manager been completed?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 14 April 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.
Every inspection of Castlehill Specialist Care Centre
3 rated inspections over 2 years: the service has held its Good rating throughout.
- June 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Castlehill Specialist Care Centre →
- April 2022Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
Read what inspectors found at Castlehill Specialist Care Centre →
- April 2021GoodSafe: GoodEffective: GoodWell-led: Good
- March 2020
Registered with the Care Quality Commission on 30 March 2020.
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
At least 100 live-in carers within about an hour of Walsall
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 £950 to £1,200 a week. 85 can care for a couple. 9 years' experience on average.
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
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.