Silverjen Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff completed assessments prior to providing care to a new person. Assessments included information on people’s needs, preferences and communication methods. People and their relatives told us they were involved in the assessment process, and the provider worked with other health and social care providers to ensure they had the information required prior to visiting the person for the first time. One relative told us, “We agreed the support when Silverjen started his care.” A member of staff described how they worked with stakeholders to find the information they needed about a person who was unable to take part in the pre-admission process, “If there’s no capacity, the pre-admission assessment is done with the family or the next of kin, GP and social services, we refer to everyone.”

The provider planned and delivered care and treatment to people, taking into account what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff completed assessments in line with national guidance, such as those related to skin integrity and the principles of Right Support, Right Care, Right Culture. Staff had received training to support people with a learning disability and/or autistic people in line with national guidance and understood how to support people effectively. One member of staff said, “They do involve the family and the staff. The care plan is done with the consideration with the patient. It’s person-centred. We make sure that the care plan is centred on the client.” A relative told us, “The carers are competent and show empathy to [person]. They know how to communicate with her. She can moan when she is being washed, but they are very careful with her.”

People told us that staff supported them in choosing their diet and encouraged them to follow a nutritionally balanced one. One person told us, “The carers make my food. I try and vary what I have. Quite a few of them know how to use the air fryer, if they don’t, usually the carer with them can show them.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People had individual hospital passports which detailed, using a traffic light system, what was important to them. This included important information in the event of an emergency or when the person attended appointments, such as healthcare conditions, a list of medicines, communication needs, and likes and dislikes, which could present as triggers for their anxiety.

Staff told us they worked well together and with healthcare professionals. One member of staff said, “Since I’ve worked for them, I’ve never had a hiccup. If you mention something to the office, they straightaway act on it.”

A professional who regularly worked with the service told us staff worked well together with them to achieve positive outcomes for people, “They (staff) contributed meaningfully to assessments, even in cases where it was difficult to establish baseline needs, and their input helped shape appropriate care planning.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

There was clear information recorded on the healthcare professionals involved in people’s care and care records included information on how to effectively support people’s health and wellbeing. One relative told us, “The carers put moisturising cream on [person’s] body. The GP surgery complimented the carers on [person’s] skin care.” Staff told us they understood the importance of ensuring people were supported with their health and psychological wellbeing. One member of staff told us, “I try to be with [person] most of the time and I try to do activities with [person]. I try to cook and we eat together. I give [person] personal care. I try to do most of the things [person] loves to do.”

Care records included information on how to support people with their mouth hygiene and when to refer to the dentist. A member of staff described the information contained in care plans and the steps they would take in relation to mouth hygiene, “[The care plan] says whether they are wearing dentures or their own teeth and if there’s a particular client we should mention what to do with the teeth or if they have dental pain or they need particular cleaners, natural teeth, tongue, gums, lips. All mentioned in the care plans and risk assessments.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. One person told us, “The carers can see that I am in pain and are aware of what I can and can’t do. When I use the stairlift, they make sure I have my seatbelt on.” A relative told us, “I think [manager] from Silverjen keeps in touch with the GP. She orders any creams for [person]. I think the carer would get in touch with [manager] if there was a problem, and then [manager] would let us know.”

Staff understood how to monitor and improve people’s outcomes and care records included information such as the signs to look out for in relation to physical and emotional changes, and what staff should do to monitor and escalate this appropriately. They were supported by the management team whom they could call if they had any questions relating to long-term monitoring and they knew how to escalate urgent concerns. One member of staff told us in relation to monitoring a person’s blood sugar before they leave the person’s home, “You check this before you go. We talk to the managers in the office and document it. 999 if it’s more serious or 111.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People and their relatives told us that staff sought consent prior to supporting them and were respectful of their choices. One person told us, “I would say that they are very good at asking my consent before doing something.” We saw there was evidence recorded in relation to people’s lasting power of attorney arrangements and of who was involved in decisions about their care.

Staff had received training to apply the Mental Capacity Act 2005 (MCA) and understood their responsibilities. One member of staff told us, “[MCA is] designed to protect and empower people who may lack capacity about their own decisions about their care treatment. We are always encouraged by the office to ask for consent from the person. You have to ask for everything, from personal care, food choices, everything else.” Another member of staff described the legislation, “Do not assume that someone doesn’t have capacity unless if it’s known. It has to be less restrictive and work in their best interest. Best interest decision [involves] the family, the doctors.”

The registered manager understood their responsibility in ensuring up to date information was available in relation to people’s decision-making. The registered manager told us, “[Previously] we would just ask them in an assessment. We were not asking for the evidence. Now we understand it’s important that we have the documents.”