Silverways Nursing Home

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 good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’ care needs were assessed and routinely reviewed.

Relatives confirmed they and their family members were involved in discussions about care plans. One relative said, “They took time to ask [person] about interests and history, important events in their life etc.” Another relative told us, “I have recently reviewed [person’s] care plan and was invited to comment.”

Permanent staff knew people well and the registered manager was in the process of recruiting more staff. A staff member said, “Residents are involved in decisions about their care, including their daily routines, preferences, and how they wish to be supported. They are encouraged to make choices and are supported to access the community where appropriate, promoting independence and wellbeing.”

People’s communication needs were assessed and explained in their care plans.

The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We received mixed feedback regarding the quality of the food at the service. One relative said, “I am aware that […] the older you become the less of an appetite you have, however the presentation and quality of [person’s] food look quite poor and bland. Example the other day [person] was served a plate which consisted of half a sausage roll, a small square of pizza, six dry looking chips and a shabby looking lettuce leaf.” Another relative told us, “The food is well presented, freshly prepared and looks and smells good. There are always several fresh vegetables with the lunchtime meal.” People mostly liked food at the service. Comments included, “Food is hit and miss, but it was very nice today” and “Food is alright. They ask every day what you would like to eat.”

We observed people were given choices of food.

People were referred to the speech and language therapist (SALT). SALT is the Speech and Language Therapy who provide assessment of swallowing or communication difficulties for people with medical, neurological and surgical conditions.

We found 1 person’s SALT requirements were incorrectly recorded in the kitchen. This put the person at risk of avoidable harm. Some people were assessed as needing fortified diet to prevent further weight loss. This information was recorded in their care plans, however it was not passed on to the kitchen staff or care staff. This meant people did not receive care in accordance with their assessed needs. The registered manager responded to our feedback and amended all information in the kitchen to ensure everyone got their meals in accordance with their assessed need.

People were assessed as needing to be weighed weekly, however this was not implemented or recorded in their daily notes. This placed people at risk of avoidable harm

The service 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.

Relatives confirmed they were kept informed and involved in their family member’s care.

Staff had access to the electronic system used by the service.

Health and social care professionals did not raise any concerns in relation to communication with the service and maintaining continuity of care.

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

The GP visited the service weekly. This meant the risks to people’s health and wellbeing could be identified early.

Health and social care professionalswere often involved in people’s care and the information about their visits and recommendations could be found on the electronic care planning system used by staff. This meant the relevant information was easily accessible by all staff which supported effective cooperation between different services.

Record keeping to monitor people’s ongoing health needed to improve.

When people required their catheter bags to be changed weekly, this was not recorded in their daily notes and there was no task to remind staff to complete this every week. We found that people’s catheter bags were changed, however the lack of reliable system, meant people were at risk of this task being missed, especially when supported by non-permanent staff.

We found people’s emotional support and mental wellbeing was not always recorded in their daily notes, even when this was assessed as a need in their care plan. This meant the provider could not be assured the right support was provided to people who needed it.

Some people were assessed as needing to be repositioned regularly or required support with regular exercises. However, this was not recorded in their daily notes and there were no reminders or prompts on the electronic care planning system to remind staff to complete tasks. This meant the provider could not monitor if the mitigation strategies put in place were effective in improving people’s outcomes. We did not find people had developed pressure sores as a result of this shortfall. The registered manager responded to our feedback and assured us the necessary changes to the system would be implemented without a delay.

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

Staff told us they understood the Mental Capacity Act (MCA) and the importance of consent. One staff member said,“I have completed MCA training. It helps me support residents in making decisions and ensures I act in their best interests when they lack capacity, always following legal and ethical guidelines.” Another staff member told us, “I have completed MCA training. It helps me understand how to support residents in making their own decisions and act in their best interests when they lack capacity. When a person lacks capacity, care is provided in their best interests, ensuring dignity and respect. We try to follow care plans and involve senior staff where necessary.”

Records showed MCA assessments and best interest decisions had been completed for individual decisions.

People told us they were treated with respect and were offered choices.