Casterbridge Manor

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to Good. Good: This meant people were safe and protected from avoidable harm. People were safe and protected from harm. There was a safeguarding reporting system in place that staff expressed full confidence in using. Safeguarding referrals had been made as necessary. Accidents and incidents were logged, trends identified and risks had been identified and mitigated. Lessons were learnt from events within the home. People received medicines as prescribed. Infection prevention and control measures were robust. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether, and found the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met . Safe recruitment practices were followed, and staff had received training appropriate to their role that was up to date. Staff told us they were enabled to develop and fulfil their roles, and their performance was regularly reviewed and monitored. There were sufficient and appropriately trained and experienced staff in place to support people, retention of staff is very good, as is the consistency of staff.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. People and their relatives told us staff made changes when necessary, in order to keep them safe and well. Comments included, “The staff keep me informed and up to date, they are very good.”

People’s needs and care requirements were detailed within their care plans and risk assessments. A summary was available if the person went into hospital or moved to another care home. This supported continuity in care for people.

People told us what being safe meant to them and knew who to raise concerns to if they did not feel safe. Everyone we spoke with said they, or their loved one felt safe. Staff understood how to ensure people’s rights were fully respected and had received training in DoLS. The registered manager had oversight of DoLS applications, authorisations, and conditions and had implemented a tracker procedure to ensure all documentation was current.

Risks to people were managed and regularly reviewed so that people were protected and their wishes supported and respected. People had risk assessments covering all their care and support needs. Risk assessments were personalised, detailed and gave staff clear guidance on ensuring people were supported safely. Risks were managed using the least restrictive practices to ensure people were cared for safely whilst still maintaining their independence.

The home was secure, and we observed checks taking place to ensure only authorised people could enter the premises. We fedback during our onsite visit we had identified some areas that needed addressing , such as some doors that were marked as needed to be locked were unlocked. This was rectified immediately, and action taken to ensure checks are now in place. Checks of the environment and equipment were undertaken in line with the provider’s policy and legal requirements. The home is a listed building and there were limits to the amount of refurbishment that could take place, however carpet flooring was being replaced and an ongoing remedial service plan was in place.

The provider had effective processes in place to ensure staff had the necessary skills and competence to carry out their roles. Recruitment records showed staff were recruited safely. This included an enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

There was a robust infection prevention and control policy in place and staff had a good understanding of these. There were dedicated domestic staff who followed cleaning schedules, and audits carried out and any shortfalls were addressed. The provider told us the sluice room was being refurbished imminently and cleaning schedules had been updated to increase cleaning of shower heads to remove limescale build up.

Records showed that people received their medicines safely as prescribed. There were suitable arrangements for the storage, administration and disposal of medicines. We identified one person's photograph did not reflect their current image (which was rectified immediately) and a PRN protocol referred to a pain scale tool, [which can be used to assist in the assessment of pain in residents who are unable to clearly articulate their needs] was not in place, nor was there information of how the person would present if they were experiencing pain. This was rectified immediately and the registered manager explained an electronic medication management system was being introduced that would help with consistency and oversight of medicine management. Staff described in detail, how they would recognise if a person was in pain.