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Inspection Summary


Overall summary & rating

Good

Updated 19 October 2018

We carried out an inspection of Silverdale on 29 and 30 August 2018. The first day of the inspection was unannounced.

Silverdale is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is located in Bredbury, Stockport and can accommodate up to 47 older people, some of whom are living with dementia. At the time of our inspection there were 43 people living at the home.

The home was last inspected on 14, 15 and 16 March 2017 when we rated the service as ‘requires improvement’ overall and in the key questions safe, effective and well-led. We also identified four breaches in three of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to preventing and controlling the spread of infection,

staff competency, supervision and training and the effectiveness of governance systems in place. We also made a recommendation about the deployment of staff around the home.

Following the last inspection, the provider sent us an action plan detailing what they would do and by when to address the breaches identified. At this inspection we found the provider had made the necessary improvements and was meeting all the requirements of the regulations.

At the time of the inspection the home 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.

The home had a clear management structure in place, with the registered manager being supported by two deputy managers. The home was further assisted by an area support manager, who spent at least one day per week in the home. Staff told us the management team were a visible presence in the home, were approachable and happy to help out when needed.

During the inspection we found the home was clean throughout and had appropriate infection control processes in place. Hand hygiene guidance and equipment was located in bathrooms and toilets and personal protective equipment (PPE) such as gloves and aprons were available for staff to use to help prevent the spread of infections.

People living at the home told us they felt safe and well cared for. Relatives we spoke with also had no concerns about the safety of their family members and spoke positively about the standard of care provided. The home had appropriate safeguarding policies and procedures in place, with instructions on how to report safeguarding concerns to the local authority. Staff had received training in safeguarding vulnerable adults, which was refreshed and they demonstrated a good knowledge of how to identify and report any safeguarding or whistleblowing concerns.

People, their relatives and the staff we spoke with all told us enough staff were deployed to meet people’s needs. Staffing levels were determined by the registered manager based on peoples level of dependency and assessed needs. Our observations during inspection confirmed the home had

sufficient numbers of staff to meet people’s needs, with people’s request for assistance responded to promptly.

We found medicines were stored, handled and administered safely and effectively. Staff who administered medicines had received training and had their competency assessed. Medication Administration Record (MAR) charts had been completed correctly, as had topical medicine charts, which are used to record the administration of creams and lotions. We found guidance for ‘as required’ (PRN) medicines such as paracetamol were in place, to ensure people were given these medicines safely and when needed.

The home had a compre

Inspection areas

Safe

Good

Updated 19 October 2018

The service was safe.

People we spoke with told us they felt safe living at Silverdale. Staff were trained in safeguarding procedures and knew how to report concerns.

Staffing levels were appropriate to meet people’s needs.

Medicines were stored, handled and administered safely by trained staff who had their competency assessed regularly.

Effective

Good

Updated 19 October 2018

The service was effective.

Staff reported sufficient and regular training was provided to enable them to carry out their roles successfully.

All staff spoken to had knowledge of the Mental Capacity Act (MCA 20015) and Deprivation of Liberty Safeguards (DoLS) and the application of these was evidenced in the care plans.

People’s medical needs were supported and involvement of professionals clearly documented.

Caring

Good

Updated 19 October 2018

The service was caring.

People living at the home were positive about the care and support provided, telling us that staff were kind, respectful and treated them with dignity.

Staff had a good understanding of the people they cared for and were actively involved in promoting people’s independence.

People’s preferences were captured within care files and care was provided in line with their wishes.

Responsive

Good

Updated 19 October 2018

The service was responsive.

Care plans provided staff with the necessary information to help them support people in a person centred way.

A wide range of activities, events and outings were facilitated which catered for people’s needs and interests.

People and their relatives told us they knew how to complain but had not had cause to do so.

Well-led

Good

Updated 19 October 2018

The service was well-led.

People living at the home, their relatives and staff said the home was well-led and managed and that they felt supported by the registered manager and deputy managers.

Team meetings were held regularly to ensure that all the staff had input into the running of the home and were made aware of all necessary information.

Meetings were held with people living at the home and their relatives, to capture people’s views and update people with pertinent information.

Audits and monitoring tools were in place and used regularly to assess the quality of the service, with action points generated and completed.