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Inspection carried out on 24 February 2021

During an inspection looking at part of the service

Silver Court is a care home without nursing which is registered to provide a service for up to 42 people aged 65 and over who require assistance with personal care. At the time of the inspection 33 people were living at the home. People living at the home had a variety of care and support needs, such as dementia and physical disabilities. The service is provided from a single purpose built residence offering single occupancy en-suite rooms.

We found the following examples of good practice.

People were well supported by staff to have telephone and internet contact with their family and friends. There were technology champions amongst the staff who promoted and supported residents with technology solutions. The service facilitated in person visits in a manner which minimised the risk of infection spread, including outside visits.

Plans were in place to isolate people with COVID-19 to minimise transmission. The service had good supplies of personal protective equipment (PPE) that were readily available in stations throughout the service.

Visitors were asked screening questions and to sanitise their hands when they arrived. Visitors were also provided with appropriate PPE prior to entering the home.

Staff had received training on how to keep people safe during the COVID-19 pandemic and staff and residents were regularly tested for COVID-19. The building was clean and free from clutter. Internal gates within the gardens had been removed to reduce the number of high touch areas.

Staff ensured people’s welfare had been maintained and they had sufficient stimulation, such as themed crafts, quizzes and music sessions. Activities were often repeated to enable smaller groups to participate.

Smaller themed seating areas had been created in different areas of the home, for example one small seating area was decorated like a library and had a selection of books available for residents.

Inspection carried out on 23 July 2019

During an inspection looking at part of the service

About the service

Silver Court is a residential care home providing accommodation and personal care to 41 people aged 65 and over. People living at the home had a variety of care and support needs, such as dementia and physical disabilities. The service can support up to 42 people in one adapted building.

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

Risks associated with people's care and support had been appropriately assessed and managed. People felt safe living at the service and with the staff team who supported them. One relative said, “They support [person] well to the best of their ability and make her has comfortable as possible. Overall, they understand her and her risks and put measures in place to keep her safe.” Staff told us they knew how to manage risks effectively and identify signs and symptoms of abuse and who to report concerns to.

The home was clean, and people were protected from the risk of infection. Lessons were learned when things went wrong, and the registered manager had oversight of accidents and incidents. People’s medicines were managed safely. One relative told us, “They are pretty good with medicines, there have been several changes, but we have been notified and everything is recorded.”

People and their relatives thought the home was well led. One relative told us the home was, “Very well managed, always clean. Meals are on time, there is a good boss, everyone does their best for my wife.” Quality assurance systems were in place to drive improvement to the care people received. People their relatives and staff were engaged in the running of the service and staff worked well with other professionals. People were supported in a person-centred way and we observed friendly interactions between them and staff.

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 10 February 2018).

Why we inspected

The inspection was prompted in part due to concerns received about moving and handling practices and potential safeguarding concerns. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

The inspection was also prompted in part by notification of a specific incident. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident.

The provider and registered manager had taken action to reduce risks to people by working openly with the local authority safeguarding team and by welcoming support from external agencies such as local authority moving and handling assessors.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained the same, good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 12 December 2017

During a routine inspection

We carried out an unannounced comprehensive inspection on 12 and 13 December 2017.

Silver Court provides care and accommodation for up to 42 people. On the day of our inspection there were 40 people living at the home. The home provides residential care for the elderly and frail and people living with dementia.

Prior to this inspection we received some information of concern about the management of people’s skin and the staffing levels, mainly at weekends.

There was a registered manager in post. 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. At the last inspection on the 26 August 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated good:

People told us they felt safe. One person said; “Safest place for me (living here not at home). Another said; “Security at the door makes me feel safe.” Staff said; “People are safe because we know them and what they like.” A relative said; “Want to express deepest gratitude for making mums quality of life in past few years something she could cope with and enjoy.”

People remained safe at the service. People were protected by safe recruitment procedures to help ensure staff were suitable to work with vulnerable people. People, relatives and staff mostly said there were sufficient staff to keep people safe. However a few relatives and staff commented that weekend staffing levels were not always as good. Other staff said they were able to meet people’s needs and support them with activities and trips out.

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments were completed to enable people to retain as much independence as possible. People who required additional input to protect their skin integrity had input from the district nurse team. Professionals stated people were safer now as all staff had received training and worked with them to keep people’s skin integrity safe. People received their medicines safely by suitably trained staff.

People continued to receive care from staff who had the skills and knowledge required to effectively support them. Staff had completed safeguarding training. Staff without formal care qualifications completed the Care Certificate (a nationally recognised training course for staff new to care). Staff said the Care Certificate training looked at and discussed the Equality and Diversity policy of the company.

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. People’s end of life wishes were documented. People's healthcare needs were monitored by the staff and people had access to a variety of healthcare professionals.

People’s care and support was based on legislation and best practice guidelines, helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought. Care plans were person centred and held full details on how people’s needs were to be met, taking into account people preferences and wishes. Information held included people’s previous history and any cultural, religious and spiritual needs.

People were treated with kindness and compassion by the staff who valued them. The staff had built strong relationships with people. People's privacy was mostly respected. However we did note that on occasions not all staff knocked on people’s door before entering. People or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personal

Inspection carried out on 26 August 2015

During a routine inspection

The inspection took place on the 26 August 2015 and was unannounced.

Silver Court provides care and accommodation for up to 42 people. On the day of our inspection there were 40 people living at the home. The home provides residential care for the elderly and frail and people living with dementia. The home is a purpose built home all on one floor with communal lounges with dining areas.

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.

People felt safe living at the home. There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. One person told us “I have always felt safe, staff really look after me”. The registered manager made sure there was enough staff on duty at all times to meet people’s needs. When the provider employed new staff they followed safe recruitment practices.

People’s individual needs were assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people they were happy for them to undertake care tasks before they proceeded.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get the medicine they needed when they needed it. People were supported to maintain good health and had access to health care services when needed.

Staff supported people to eat and they were given the time to eat at their own pace. People’s nutritional needs were met and people reported that they had a good choice of food and drink. Staff were patient and polite, supported people to maintain their dignity and were respectful of their right to privacy.

The activities co-ordinator organised a weekly (seven day) programme of different activities on a two week rota. This included arts and crafts, baking, exercise and a visiting PAT (pet as therapy) dog Some activities were organised around assisting the kitchen, for example we observed three people enjoying peeling potatoes and carrots and other people making cakes.

Staff felt fully supported by management to undertake their roles. Staff were given regular training updates, supervision and development opportunities. For example staff were offered to undertake additional training and development courses to increase their understanding of needs if people living at the home. A member of staff told us “We get lots of good training, If I felt I wanted anymore I can just ask and they will arrange it”.

There was a positive and open atmosphere at the home. The registered manager was visible and active within the home. Staff and people told us they liked having regular meetings and felt them to be beneficial, the provider took action in response to feedback received. One person told us “The manager is nice, I can go and see her anytime”.

Inspection carried out on 20 November 2013

During a routine inspection

This was a targeted inspection to follow-up on concerns that we raised about record keeping when we inspected the home on 12 June 2013. We did not seek specific feedback from people who used the service on this occasion.

We looked at a range of records including accident, incident and safeguarding reports, health and safety checklists and the care plans for five people. We found that the standard of record keeping had improved since our last inspection. We met with the registered manager and one of the home's team leaders. We found that staff had maintained documentation to evidence that people had received appropriate care and treatment.

Inspection carried out on 9 October 2013

During a routine inspection

This was a targeted inspection to follow-up on specific concerns that we raised about infection control when we last inspected the home on 12 June 2013. We did not seek specific feedback from people who used the service on this occasion.

We found that the home was clean and tidy and the provider had taken appropriate action to improve infection control standards within the home. We saw that sluices were now suitably maintained and that there were systems in place to ensure that these areas were regularly checked. This meant that people were now better protected because the home had taken steps to reduce the risk of the spread of infection.

Inspection carried out on 12 June 2013

During a routine inspection

We spoke with seven people who lived at the home, two visiting relatives and five members of staff during our visit. People told us they liked living at the home. One person said "Everyone is very nice" and another commented it was "Beautiful" and that they were "Happy here". Visiting relatives told us that they were able to visit unannounced at any time.

We found that people received care which met their needs. However there was a lack of information on managing challenging behaviour which meant that staff could not ensure that support in this area was given confidently and consistently.

Staff told us they were aware of safeguarding procedures and were confident in identifying possible abuse. They told us that they had training in safeguarding and understood the procedures to follow and who to contact.

We found that people's rooms and the communal environment were clean and free from unpleasant odours. However, sluice areas were poorly maintained and did not protect people from the risk of infection.

Staff were supported through a wide range of training and regular supervision. Comments received from staff included "I really enjoy it here", "It has changed for the better" and "The manager is understanding".

We identified that there were gaps in care plans and other records which meant that the provider could not be certain that people were receiving appropriate care. Records were kept securely and were accessible to those that needed to see them.

Inspection carried out on 17 June 2012

During an inspection in response to concerns

People told us that they liked living at the home. They said that they were �happy here and had no complaints�. People stated that staff �treat me well� and they had nice rooms. People informed us that they received �good food� which they described as �lovely�, �plentiful� and �I�m never hungry�.

Inspection carried out on 20 June 2011

During an inspection in response to concerns

People living at Silver Court told us that they liked being there. One person described it as being a �home form home� and another person told us it was �marvellous� and �I can�t fault it at all�.

Relatives of people using the service said that they are always made to feel welcome and can call in at any time. They described the home as clean and staff as �friendly� and �approachable�. One relative informed us that �we are really happy and pleased that mum is living at Silver Court� and another stated �our relative is safe here and that gives us peace of mind�.

The only recurring theme where people expressed that they we not so happy was in relation to the food. We joined residents in their dining areas for their breakfast and lunchtime meals. Whilst people told us that they enjoyed their breakfasts, they were less positive about the food served at lunch. One resident described the quality of lunch as �very poor and insufficient� whilst another said �I don�t like the food, I could cook better myself�. A relative also told us they had raised concerns about the food at the home.

Reports under our old system of regulation (including those from before CQC was created)