Frequently Asked Questions

1. What Does Castlebeck Do?

We provide unique high quality healthcare and rehabilitation services for people with learning disabilities and complex needs, including those who challenge services. Castlebeck also provides treatment centres for people on the autistic spectrum and who challenge services. We have a reputation for success working with very complex individuals who have experienced repeated placement breakdown.

Who do our services work best for?

  • For people who have experienced multiple placement breakdowns in the past (the so-called revolving door syndrome)
  • For people who have often been in receipt of the wrong sort of service due to misdiagnosis or because of lack of service availability or quality
  • For people who perceive that our service may be one which is most likely to meet their needs
  • For people with the above needs and difficulties who wish to be as near to home as possible

2. What do we do differently?

"The Castlebeck Approach" - Through an emphasis on team work across the Company; on a positive attitude and on consistency and persistence, we continue to support people in making positive progress when, in many cases, this has not been possible for them before. Castlebeck offers commitment and stability to people for as long as their needs demand this. Our ethos is one of reward and encouragement rather than criticism and containment.

3. What is the Goal?

The aim is to make each person’s care pathway appropriately graduated in order to facilitate their successful transition through different levels of care.

At Castlebeck, we seek to free those who come into our care from that which often limits their freedom most - their challenging behaviour.

The combination of a person-centred approach, open environments, committed staff, a unique evidence-based clinical model and progressive care pathways assists people to reach their individual potential with a level of support consistent with their needs at any particular point in time.

4. What is The SHARED approach?

Our unique model of care is a systematic way of providing Supportive Help Achieving Realistic Effective Development.

It is an holistic approach based on non-aversive behavioural interventions, person-centred planning, CPA, and the broad range of skills and experience of Castlebeck staff, and is a tool to help the person and those who aim to support them to make sense of their world and their historical responses to this; and to help them develop in ways consistent with positive progress for that individual.

It involves a sequential process of understanding and discovering the person, maintaining an optimistic approach, and sharing challenges and achievements. Ultimately it is a positive way to unlock the person’s potential and seek to improve their quality of life.

The process is person-centred and encapsulated within the Care Programme Approach.

5. What is the “24.7 System”?

'24.7' is Castlebeck's system of support enabling people to structure their time; build relationships and strike a balance between work and productive time, self care and leisure. Individual plans are developed with each person and include structured evening and weekend activity as well as less structured time.

Active work takes place within these programmes to enhance local contacts and a sense of belonging in the community. Where possible and appropriate, local community services are accessed for activities to support development and independence. The Create Project is an excellent example of our innovative use of community resources to enhance therapeutic opportunities.

6. What do purchasers get for their money?

This can be summarised by the 3 P's - People, Places, and Programmes.

Those who require services such as ours need high levels of care provision in environments, which are as homely as possible; and which can facilitate the progressive development of each individual and allow them to settle, progress and move on towards more community orientated provision.

Castlebeck seeks to provide care to the highest standard, in the most cost-effective way, with all-inclusive fees, and no hidden extras. Castlebeck fully accepts people as they are, and works to support them all positively. Castlebeck creates individualised treatment plans with life-changing outcomes - many of the people supported by Castlebeck have complex requirements as well as care & support needs.

We have always placed an emphasis on high quality physical environments because we value those we support. The environment created within these excellent physical settings are central to care provision. Attention is paid to balancing issues such as observation, homeliness, and safety, in creating positive therapeutic places to live.

7. What happens during the assessment period?

There are three key stages to each individual assessment:-

  1. On receipt of referral information we undertake a desktop assessment to establish whether we think we can meet that person’s needs.
  2. A full and thorough assessment will be undertaken where the person currently lives; by a multi professional, experienced team. This can be done very quickly, especially if the person’s current placement is in crisis. The aim of this assessment is to confirm our initial view of our ability to help, and to identify exactly which Castlebeck service is best placed to meet the individual's requirements. We aim to report as quickly as possible.
  3. If a person comes into our service following their initial assessment, a 12 week full multi-disciplinary holistic assessment is undertaken. This involves psychiatry, psychology, occupational therapy, speech & language therapy and observation by experienced nursing and care staff. This is followed by a full review involving the person, their referrer, family and a full staff team towards the end of the 12 week period.

Individual care plans are regularly reviewed and re-assessed as people progress through our service.

8. What is the Cost and Value of the service to the purchaser?

    We aim to provide top quality care for second quartile fees.

  • We aim to provide stability for those in our care; and through a long history of providing resourceful and reliable services, the assurance to those who purchase from us, that record of placements of us not breaking down in crisis. We have not, in almost 20 years, sought an emergency placement out of our services; though we have often responded to the emergency needs of those requiring services from us.
  • We seek to manage risk on behalf of the referrer through active care treatment and rehabilitation of those referred to us; rather than aiming for containment and deferment of risk. We believe this is the approach that works best not only for the referrer, but of course for the person in our care.
  • We aim to work with those in our care to facilitate their development as far as possible in a direction as consistent as possible with their needs, wishes, hopes, aspirations and difficulties.
  • We aim, as far as possible and appropriate, to "consume all our own smoke", by providing comprehensive specialist healthcare, as well as appropriate access to primary care for those we support. We employ a full team of consultant psychiatrists, psychologists, occupational therapists and speech and language therapists.
  • We continue to listen to those who we support; and to other customers, and seek to work in partnership with all appropriate individuals and agencies to understand and respond to the needs of those we support; and through flexibility and a “through flow” model of care to help people move to live in the least restrictive environment possible while addressing the challenging behaviour and complex needs that originally brought them into contact with our services.

9. What happens next?

The process of planning for the future starts before a person enters our service.

We aim for a progressive care pathway for each person through our service, which includes an ongoing process of planning assessment and regular review of progress and outcomes. The continuum of care extends through to and beyond a person leaving our services, as we work actively with the service user and appropriate others to plan positively into the future.

10. General questions regarding the use and method of physical interventions.

Castlebeck practices a non-aversive, ‘light-touch’ approach to physical intervention with an emphasis on a balance between good clinical governance and our ability to manage some very difficult people.

We use MAYBO, the BILD-approved (British Institute of Learning Disability) approach to physical intervention. We employ our own BILD-approved trainers and all staff are fully trained, and receive regular refresher training.

The potential use of physical intervention is discussed with each service user, their family and other key parties. The aim is for physical intervention, if it is required, to be the end point of a full de-escalation process.

11. Do we support people detained under Mental Health Legislation?

Yes, both Civil and Criminal, as well as those who are not subject to any such legislation.

12. Why do people refer to us?

Feedback from those who live with us tells us that people enjoy living in our services and find them homely and supportive and places in which they can establish relationships with people with similar needs and difficulties; and also with staff and where it has not been possible for them before.

We do not always get it right. We do pride ourselves, however, on listening to those we support; as well as to families, referrers, regulatory agencies and those representing other involved agencies.

We have a long track history of providing stable and progressive placements within which outcomes are evidenced and value for money for referrers can be demonstrated.

We have an ISO 9001:2000 and robust systems of Quality Assurances as well as Clinical and Care Governance.

Castlebeck has a broad range of skilled clinicians working in support of committed, trained and experienced front line nursing and care staff, with a well established team approach, which we believe is unrivalled by other independent sector operators. We have the Investors in People accreditation and have been placed in the top half of the Nursing Times 'Top 100 Employers' list for the last two years.

This nursing care and clinical infrastructure, itself supported by strong operational management allows us to place an emphasis on relational rather than physical security. We offer a service that provides the least restrictive option available, in our view, for people who present with significant levels of challenging behaviour and complex needs which have tested other providers to the point that they have no longer been able to support those we continue to care for.