• Care Home
  • Care home

Silverways Nursing Home

Overall: Good read more about inspection ratings

Silver Way, Highcliffe-on-Sea, Christchurch, Dorset, BH23 4LJ (01425) 272919

Provided and run by:
Christchurch Housing Society

All Inspections

19 October 2023

During an inspection looking at part of the service

About the service

Silverways Nursing Home is a residential care home providing personal and nursing care for up to 61 people. The service provides support to older people. At the time of our inspection there were 41 people using the service. Silverways is located in a residential area and accommodation is provided over two floors. Shared facilities include specialist bathrooms and lounge and dining areas.

People’s experience of using this service and what we found

People told us they felt safe. Risks to people were regularly assessed, monitored, and reviewed. Staff knew people well and the actions they needed to take to help keep them safe. People had their medicines managed safely and were protected from avoidable infection. There were enough staff with the right skills and experience to care for people safely. Recruitment processes were robust ensuring the right staff were employed to work with older people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The culture of the home was open, caring, and friendly. Staff felt supported and were happy in their roles, speaking positively about the home and the care provided. The management team were visible and worked alongside the care team in providing person centred care. People, their families and staff felt included in the development of the service and able to speak up. Quality assurance systems and processes were in place and used to ensure quality standards were being met.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 11 July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Silverways Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

17 February 2021

During an inspection looking at part of the service

Silverways is a residential nursing home providing care and accommodation to older people. At the time of our inspection there were 33 people living at the home. Accommodation is provided in single occupancy rooms, over two floors, with a varying range of en-suite facilities. Communal areas include specialist bathrooms, lounge and dining rooms, laundry, catering facilities and accessible outdoor space.

We found the following examples of good practice.

Policies and staff practices at Silverways were in line with the latest infection, prevention and control (IPC) government guidance. This included safe admissions, caring for a person with Covid-19 and how staff were deployed. Regular IPC audits were completed, ensuring standards were met, and when actions were identified they were completed in a timely way.

At the time of our inspection limited visiting was taking place due to a country wide national lockdown. Risk assessments to ensure safe visiting were completed for exceptional circumstances such as when a person was nearing end of life. Arrangements for visiting were by appointment only and accessed through a separate external door which avoided entering areas in the home were people lived. Visitor checks included a temperature check and rapid Covid-19 test, which indicated a positive or negative test result within 30 minutes.

Premises and equipment appeared clean and the correct cleaning products were being utilised. Changes to the environment had been carried out to enable more effective cleaning, including changes to flooring.

Staff were up to date with infection, prevention and control training which had included safely putting on and taking off personal protective equipment (PPE) and the correct use of self-testing kits. Competencies were regularly checked.

People and staff were participating in regular testing and the Covid-19 vaccination programme in line with government guidance. Legal requirements for obtaining consent for testing and vaccinating had been met. The registered manager told us they were reviewing resources supplied by Public Health England aimed at addressing staff anxieties about vaccination.

People’s wellbeing needs were understood, and staff assisted people to use technology to help keep in touch with family and friends. Friendships between people living at Silverways were able to continue with social distancing safeguards in place.

Further information is in the detailed findings below.

4 June 2018

During a routine inspection

Silverways is a residential care home registered for 61older people. At the time of our inspection 50 people were living at the service of which 48 were receiving nursing care. Accommodation is provided over two floors with lift access to the first floor. Both floors have a range of specialist bathing facilities.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People felt safe and spoke positively about care staff describing them as kind, caring and compassionate. People’s risks had been assessed and staff understood the actions they needed to take to ensure people were safe from avoidable harm. People and their families had been involved in reviewing risks and had their freedoms and choices respected. The service was responsive when things went wrong and reviewed practices in a timely manner. Staffing levels meant that people had their needs and choices met. Staff had been recruited safely including a disclosure and barring check to ensure they were suitable to work with vulnerable adults. An induction and on-going training and support enabled them to carry out their roles effectively. People had their medicines managed safely by trained staff.

Assessments of people’s care needs had been carried out in line with current legislation and recognised people’s diversity. This meant that people had care planned around their needs and life choices. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. A complaints process was in place and people felt if they raised concerns they would be listened to and actions taken.

The environment and design effectively met the needs of people and enabled them to live more independent lives. People felt involved in decisions about their day to day lives and had their dignity and privacy respected.

People had access to healthcare both for planned and emergency events. Working relationships with other health and social care professionals enabled effective care outcomes for people. Appropriate reporting and sharing of information with other health and social care agencies meant people received safe, consistent, appropriate care.

The culture of the home was open and transparent empowering people, their families and staff to share ideas, make suggestions and raise concerns. Leadership was visible and promoted teamwork. Systems were in place to encourage and promote communication and engagement with people. Feedback about the service had led to quality improvements. When things had gone wrong actions had been taken appropriately and used as an opportunity to reflect on practice.

Further information is in the detailed findings below.

15 & 19 October 2015

During a routine inspection


We undertook an unannounced inspection on 15 October 2015. The inspection continued on the 19 October and this was announced.

The service provides accommodation and nursing care for 61 people but we were told the maximum occupancy is 58 people. On the day of our visit there were 52 older people living in the service. People can have a long term placement or short respite stays at the service. Rooms are single occupancy and over two floors. Each room has a call bell fitted so that people can call for help when needed. Each floor has three groups of bedrooms that share a kitchenette, specialist bathrooms, a lounge and dining room. A room on the first floor is available for when people and their families and friends want some quiet time together. There is a commercial kitchen and laundry.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe living at the service. We found that staff had a good knowledge of safeguarding and received regular safeguarding training. Safeguarding information was displayed in the reception telling people how to contact the local authority safeguarding team.

We found that risks were not always properly managed. Two of the four people’s records contained risk assessments and plans to reduce the risk of them choking. However, we found these risks were not safely managed. People’s risk in relation to other aspects of care such as moving and handling, skin integrity and falls were assessed and regularly reviewed. Plans were in place to reduce risk and we saw staff following the plans.

Medicines were stored safely and administered by a qualified nurse. Nursing staff told us their medication administration competency is checked annually. One person told us, “I have 11 tablets a day. I always get the right ones. I have a list. They are meticulous about the tablets”.

People and staff told us that there were enough staff on duty. We observed staff were unrushed and call bells were answered promptly. We looked at four staff files. Each file contained evidence that staff were suitable to work with vulnerable people and were eligible to work in the UK.

An individual fire evacuation plan was in place for each person. Staff training records showed us that staff received regular fire drill and evacuation training. We saw maintenance records and certificates showing us equipment was regularly serviced.

People felt that they knew the people caring for them. We saw photographs in peoples’ bedrooms of their named nurse and the care worker who was their keyworker. A care worker told us “We work as a team with the nurses”. One relative said, “Always the same staff when I visit. We feel involved in decisions”.

Newly appointed staff completed the care certificate induction programme. The care certificate is a national induction for people working in health and social care who have not already had relevant training. The service employs a trainer who ensures staff are up to date with training requirements. Nursing staff have regular clinical updates and competencies checked.

We saw evidence on files of mental capacity assessments being completed which included a best interest’s decision being made with families. The Manager and staff were aware of the Deprivation of Liberty safeguards legislation and how to apply it to their practice.

Care records contained risk assessments for malnutrition which were reviewed monthly. When the risk was high the GP and dietician had been contacted and actions taken stabilised the persons weight. Actions included fortifying food with high calories such as extra butter and cream. The kitchen practice was to fortify food for all the people unless they specifically had a low fat diet. Two relatives told us they were concerned about the amount of weight their relative had gained since admission. We discussed with the head chef the potential risk to a person’s health and well-being when being given excessive calories when risk assessments are not indicating a risk of malnutrition. We were told that the menus were currently being reviewed and they would include a review of this practice. We observed lunch being served in the dining room. The food looked appetising, people were supported in a respectful way, assisting one person at a time and encouraging people to be independent. The meal experience was relaxed and people chatted together.

People told us that they could access healthcare whenever they needed. Records showed us that people regularly received visits from health professionals such as dentist, chiropodist and physiotherapists.

We found the home clean and odour free. We observed staff using aprons and gloves appropriately when providing person care. There was a cleaning schedule in place and an up to date clinical waste contract. We observed the correct processes in place to avoid cross contamination when a person had a suspected contagious condition.

After our visit we spoke with a health professional about the quality of end of life care. They told us that the home were proactive in ensuring that anticipatory pain medication was always in place to ensure a person remained comfortable. They said “Very homely, level of care exemplary”.

During our time at the service we observed staff talking and laughing with people, their relatives and friends. We spoke with a person who said “I know the staff by name. They are quite friendly. They always want to help”. We observed care being provided in an unhurried way. A person told us “We have choice here with food, bed times and are allowed our own possessions in our rooms”. Staff understood the importance of respecting people’s wishes. We observed staff respecting people’s privacy and discreetly offering support. Activities were varied, one person told us “There are lots of activities here; card making, christmas pudding making, church services and we made Chinese lanterns for the Chinese new year”. Extra staff hours were available for social care. This was to provide support on a one to one basis for people who chose to stay in their rooms. People told us they were supported to keep in touch with their families and their local communities.

We found that people and their representatives were involved in planning and reviewing care. A nurse told us “Handovers are person centred. People’s needs are constantly being assessed and handed over to each staff team at the start of shifts. A call bell audit showed times calls were taking longer to be answered. Shift patterns had been changed so that additional staff was available to support people during these busy times. This showed us that the service is flexible and responsive to peoples changing needs.

A complaints procedure was displayed on the reception window. It gave details of other agencies people could take their complaint to if not satisfied with the outcome. Some of the information was incorrect. More clarity was needed of the complaints escalation process so that people understand their rights. The manager kept a log of complaints and recorded details of investigations, actions taken and outcomes. People, their visitors and staff all were aware of the complaints process and felt able if needed to make a complaint. Regular resident and relative meetings take place and minutes were displayed in the lounge areas.

The service has achieved the ‘Gold Standard Framework’. It is a model of care that enables good practice to be available to people nearing the end of their lives. The service completes regular audits to see how they have performed against the framework standards. The audits showed us that the service provided responsive care at the end of a persons’ life.

People using the service, visitors, staff and visiting health professionals all told us the service was well managed. We observed nurses and senior care workers visible on the floor supporting care staff. We spoke with a health care professional before our inspection who told us, “The manager is positive, pro-active and keen on staff training”.

Staff received regular supervision. The service has signed up to the ‘Social Care Commitment’. This is a national initiative that employers and employees of the care sector sign up to pledging to improve the quality of care standards. The six key commitments had been used as part of staff personal development through supervision.

The manager carried out regular quality audits. Any identified actions were noted and the outcome recorded. We saw evidence in staff meetings that audit findings were shared with staff to improve quality and learning.

The last CQC report, the local authority contracts monitoring report and results from the services quality survey were on display in reception. This demonstrated that the service had a positive culture that is open and inclusive.

We recommended the service consider how risks to individuals are managed so that they are protected whilst ensuring their freedom and choices are respected.

29, 30 May 2014

During a routine inspection

A single inspector carried out this inspection.

During the inspection we considered five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led? Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them, and from looking at records. If you want to see the evidence that supports our summary please read the full report. This is a summary of what we found:

Is the service safe?

The provider had taken steps to provide care in an environment that was suitably designed and maintained. We saw that the home and grounds were well maintained. Fire safety equipment, window restrictors, boilers, electrics, and the lift had all been regularly checked and serviced.

We saw that care risk assessments and plans were in people's files and had been regularly updated. People living at the home told us that they felt safe at the home. One person said, 'I press the buzzer and they come within five minutes. I feel safe."

We saw that there were procedures in place in the event of a fire and emergency hospitalisation. The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. People were not detained under Deprivation of Liberty Safeguards. We saw evidence in people's files that consent was sought before care or treatment was provided. Relevant health professionals were involved with making decisions about mental capacity.

Is the service effective?

We saw that people had care plans to identify their needs. Staff told us that care records and conversations with other staff members gave them enough information about how to support people. The people that we spoke with and their relatives told us that the provider met the needs of people living at the home. One person living at the home said, 'My medicine is brought as needed, morning and night.' A relative said, 'The GP comes regularly. Staff arrange blood tests, and physiotherapy.'

Activities took place for people living at the home. One person living at the home said, 'The activities are good.' We saw activity timetables around the home and observed activities taking place. This showed that the service was effective in providing people with opportunities for leisure pursuits and interests.

People had access to enough food and drink and were offered a choice. Alternative food choices were offered on the day of the inspection and we saw that people were supported to eat their food where needed. One person living at the home said, "They top up my water. I get a choice of food and drink'. This meant that the service was effective in making sure that people received adequate nutrition and hydration.

Staff reported that they felt well supported and that they received adequate supervision, training, and appraisal. One staff member said, 'There is always help if needed." This meant that staff received sufficient guidance and training to enable them to meet people's needs.

Is the service caring?

We spoke with people living at the home and relatives and they said that staff were caring. One relative said, 'Their attitude is wonderful. I couldn't give a higher score.' A person living at the home said, 'Staff are kind, caring, and really nice. They never make me feel embarrassed. They help me with everything I need." This meant that staff at the home supported people in a caring way.

Is the service responsive?

We saw that care plans were updated regularly. The manager and staff members explained that this occurred every month and as needed. This meant that staff were provided with recent information to help them meet people's changing needs.

Systems were in place to make sure that managers and staff learnt from complaints, concerns, accidents, incidents, and audits. People who lived at the home and relatives said that they felt that they could discuss any concerns with staff members and have them resolved. One relative said, 'I attend relatives' meetings and can request changes. Matron is very good. They say if I have any problems go and see her, but I have no complaints or concerns." A person living at the home said, 'I can talk to staff and get problems changed.'

Is the service well led?

The provider had an effective system to regularly assess and monitor the quality of service that people receive. We saw that the home had completed audits for medication and care plans. This meant that the provider had taken steps to reduce the risk of inappropriate care and treatment through monitoring the quality of the service. Incidents, accidents, complaints, and concerns were monitored and this information was used to improve the service. This meant that the provider had taken steps to ensure that people living at the home received appropriate care that met the essential standards of quality and safety.

11 December 2013

During an inspection in response to concerns

We carried out an early morning inspection between 6am and 9.30am because of concerns we had received about the care of people living at the home regarding their waking and getting up routines and the levels of staffing in the home.

We spoke with four members of staff including the manager and three people who lived at the home. We looked at two people's care planning records, staff duty rosters, staff meeting minutes and other documents relating to people's care.

One person we spoke with who lived in the home told us, 'It's wonderful here, better than any hotel'.

At this inspection we found that people's care needs were being met.

There were sufficient numbers of staff on duty to meet the needs of the people living at the home.

29 May 2013

During a routine inspection

At this inspection we spoke with the acting manager, three care workers on duty, five people who lived in the home and three visiting relatives. On the day of our visit 48 people lived at Silverways Nursing Home.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We found that care plans accurately reflected people's needs and had been drawn up with their involvement. People expressed satisfaction with the care they received and told us the care workers were 'Friendly' and 'Very kind, caring and patient'.

Staff were recruited in a safe manner and had received the required training to enable them to carry out their role.

People who lived at Silverways Nursing Home benefit from safe quality care, treatment and support, due to effective decision making and the management of risks to their health, welfare and safety.

Records we looked at were accurate, up to date and were easily accessible to us during our visit.

18 June 2012

During a routine inspection

We carried out this inspection unannounced, during our visit we spoke with three members of staff, the registered provider, five people who live in the home and two of their relatives.

We observed that the atmosphere in the home was relaxed and calm. People received their personal care in a respectful and dignified way.

We observed signs on people's bedroom doors identifying when people were receiving personal care, this ensured these people were not disturbed during this time.

People who lived in the home were seen listening to music, reading newspapers of their choice and chatting to each other.

People told us they were able to choose how they spent their time during the day. They said the staff were very caring, kind and knew how to assist them with their particular needs.

We observed that staff and people living in the home were relaxed with each other laughing and chatting and enjoying each others company.

One relative said Silverways was 'wonderful' and the standard of care provided to the people who lived in the home was 'very good'.

People told us that they were consulted and involved in their own care. People who lived in the home said they were treated with dignity and respect by a staff that knew them well and fully understood their individual needs. People were confident that the staff knew how to meet their needs and were properly trained in order to carry out their role.

We found that care plans lead from the person's assessment of need and were person centred. We noted that people had been involved in the development of their care plans.

People were supported by staff who had been recruited in a safe manner. People said there were enough staff available to make sure they received the care they needed.

22 September 2011

During an inspection in response to concerns

People told us that they were given sufficient information and were able to visit, before moving into the home. A relative told us that staff were welcoming and friendly and they were able to visit freely and support their relative.

People were positive about meal provision and able to choose what and where they ate.

People are involved in the assessment and care planning process. However, documentation did not fully evidence care given and people's experiences.

Staff were aware of safeguarding procedures, but did not implement them consistently, which could place people at risk of harm.

People living in the home were supported by suitable numbers of staff, but their privacy and dignity was not always protected.

People were able to attend regular residents meetings, but there was limited auditing of the whole of the service provided to make sure that there were effective management systems in place.