CQC report explained · a residential care home
What the CQC found at Castlemaine Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Inspectors found safer risk management, enough staff, safe medicines systems, suitable recruitment checks and effective infection-control arrangements.
- Effective?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- Management systems had improved and were being used, but leadership and care delivery were not yet fully consistent. Inspectors found gaps in some staff training, vital-sign records and monitoring of oral care.
What inspectors found, June 2023
Rated Good overall; inspectors found safe care and clear improvement, but the home still needs to strengthen its leadership and records.
This was an unannounced focused inspection on 25 and 27 April 2023. One inspector reviewed records, premises and communal areas, and spoke with people, staff, visitors and health professionals.
The home was rated Good for Safe. Inspectors found enough staff, safe medicines practice, suitable recruitment checks and better management of risks such as poor nutrition, dehydration and unsafe building maintenance.
The home was rated Requires Improvement for Well-led. Management systems had improved and the home was no longer in breach of Regulation 17, but training, vital-sign records and oral care still needed more consistent attention.
The overall rating changed from Requires Improvement to Good. This inspection only checked Safe and Well-led. Ratings for the other key questions were carried forward from the previous inspection.
Safe care
People told inspectors they felt safe. Staff knew how to recognise and report abuse, and risk assessments and care plans were in place.
“People were protected from abuse and avoidable harm.” from the report
Medicines
Medicines were stored, given and disposed of safely. Staff had the required training and competence, and audits were used to identify shortfalls.
“Medicines were stored, administered, and disposed of safely.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs and saw appropriate checks in staff files before people were employed.
“All staff files included key documents such as an application form, interview notes, full employment history, at least two references and a Disclosure and Barring Service check.” from the report
Listening to feedback
People, relatives and staff were encouraged to give their views. The home recorded actions in response to feedback and held meetings.
“People and their relatives were encouraged to give their views about the care they received, and these were listened to.” from the report
Staff training
needs fixingSome staff supporting people whose behaviour may distress others, or people with mental health problems, needed further training.
“For example, provision of training for staff who were supporting people with behaviours that may distress and for those that live with mental health problems.” from the report
Incomplete health records
needs fixingRecords of people's vital signs were not always consistent. In one case, a high blood sugar result had no recorded reason or follow-up action.
“Inconsistencies were found in the recording of peoples' vital signs.” from the report
Oral care monitoring
needs fixingOral health had received more attention since the previous inspection, but inspectors said it still needed monitoring to make sure care was consistent.
“Oral health had been prioritised since the last inspection, but still needed to be monitored to ensure people received consistent oral care.” from the report
Staff deployment
minorAt one point, an activities staff member had to leave one person to deal with another situation because they were the only staff member in the communal area.
“At times the activity person had to leave the interaction with one person to attend to a situation as she was the only staff member in the communal area.” from the report
- 01What training have staff received for supporting people whose behaviour may distress others or who have mental health problems?
- 02How do you check that vital-sign readings are recorded with the reason for taking them and any follow-up action?
- 03How do you monitor and record people's oral care now?
- 04How do you make sure there is enough staff cover in communal areas when activities or other situations need attention?
- 05Which ratings from the previous inspection were carried forward because they were not checked during this visit?
This was a focused inspection of Safe and Well-led only; the other key-question ratings were carried forward from the previous inspection. This explanation was written from the published report of 6 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, June 2022
Requires Improvement; inspectors found risks from premises, records and oversight, although medicines and recruitment were handled safely.
This was an unannounced focused inspection on 28 and 29 April 2022. The inspection followed concerns about safety and staffing. One inspector spoke with people, relatives, staff and health professionals, observed care, and checked care, medicine, staffing and safety records.
The home was not always safe. Inspectors found exposed hot pipes, rucked carpets, unsafe floors, poor cleanliness and gaps in food and fluid records. Some people at risk of dehydration had no recorded drinks for up to 14 hours. Staff deployment also needed review because some people had little positive interaction at busy times.
The home was rated Requires Improvement overall, with Safe rated Requires Improvement and Well-led rated Requires Improvement. The overall rating changed from Good at the previous inspection in November 2019. The other three key questions were not inspected during this visit, so their previous ratings were used in the overall rating.
Medicines
Medicines were stored, given and disposed of safely. Staff who administered them had training and competency checks.
“Medicines were stored, administered and disposed of safely. Medicines were ordered in a timely way.” from the report
Recruitment and training
Staff recruitment records included the required checks, including references and DBS checks. Staff had essential training to support people's needs.
“All staff files included key documents such as an application form, interview notes, full employment history, at least two references and a Disclosure and Barring Service (DBS) check.” from the report
Choice and consent
Inspectors found that the home was working within the principles of the Mental Capacity Act. People were involved in everyday choices.
“People were asked for their consent and were involved in day to day choices and decisions.” from the report
Kind staff
People, relatives and professionals gave positive comments about staff and management. Relatives described staff as kind and cheerful.
“The staff are very good, It's been a long journey but staff are all kind and very cheerful which makes it easier.” from the report
Building safety
seriousExposed hot pipes could cause scalding. Rucked carpets, unsafe floors and some unrecorded building risks had not been dealt with promptly.
“There were exposed hot water pipes which could cause scalding to peoples' skin.” from the report
Food and fluid records
seriousFluid charts did not consistently show whether people at risk of dehydration had received enough to drink. Food records did not reliably show how much some people had eaten or what action was needed.
“Some fluid charts had gaps of up to 14 hours where drinks were not offered or given.” from the report
Cleanliness
needs fixingSome communal bathrooms, corridors and other areas were not clean or hygienic. Some damaged furniture could not be cleaned properly.
“The overall cleanliness of the home needed to be improved to ensure that people lived in a clean and hygienic environment” from the report
Staff deployment
needs fixingThere were enough staff overall, but staffing at key times needed review. Inspectors saw brief interaction and people being directed away while staff were busy.
“Engagement was brief and resulted in people getting up to seek out staff and being directed away as staff were busy assisting other people.” from the report
Quality oversight
seriousThe provider's checks had not consistently identified, recorded or acted on risks. Care records, incident reviews and feedback actions were incomplete or delayed.
“The provider had failed to assess, monitor and improve the service.” from the report
- 01Have the exposed hot pipes, rucked carpets and unsafe floors now been repaired, and how are these risks checked?
- 02How do you record and review drinks for people at risk of dehydration, including overnight?
- 03What changes have you made to food records and weight-loss care plans?
- 04What has been done to improve cleaning, damaged furniture and the condition of communal areas?
- 05How do you make sure enough staff are available for positive interaction and support at busy times?
This was a focused inspection of Safe and Well-led only; the other key-question ratings were carried over from the previous inspection when calculating the overall rating. This explanation was written from the published report of 1 June 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 Castlemaine Care Home
9 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- November 2019Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- November 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2017Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2016Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- February 2016Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 2 December 2010.
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.
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19 live-in carers within about an hour of East Sussex
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 £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful 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.