Silver Mews Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated Requires Improvement. This meant people’s needs were not always met.

This service scored 61 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care plans were not always person-centred and did not always include enough information to meet people’s needs in a way that was in line with their preferences. Although people were offered some choice around activities and food, people and relatives told us these did not always meet their likes and dislikes.

Staff we spoke with were knowledgeable about people’s care needs but information about their preferences was not always documented as a guide for all staff.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff understood people’s health needs and worked collaboratively with external professionals to ensure continuity of care and to support informed choices around this.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

We observed people were not always given the appropriate support to make choices about their meals. Picture menus were not always available and printed menus were not always produced or displayed in an accessible way. A relative told us, “A few weeks when we visited there were picture menus and photos of the meals, there's none of that now, people need to know what they're having.” This is something the provider confirmed they were working on, and we saw some improvement on our second visit.

Assistive technology was available to support a person with their communication needs. However, we received feedback from them that staff were not always providing the appropriate support with this.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

The provider had introduced a variety of ways people, relatives and staff could give feedback about the service such as at meetings, or via a comments book or satisfaction questionnaires. They were acting to improve the service and feeding back on the actions they had taken at resident’s meetings. Despite this, we received mixed feedback from relatives and staff. Some told us they did not feel listened to or that nothing changed when they gave feedback. One relative told us, “We are raising the same issues over and over.” A staff member said, “Yes, we can make suggestions and raise issues however it feels like they aren't listened to, and we do not get feedback.” In contrast, other relatives and staff told us they felt involved in decisions about the service, and their views were valued.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People and their relatives told us they were supported to have equitable access to health and social care services in their local area. People’s care records confirmed this.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. We identified shortfalls within the care planning arrangements. Gaps in care planning can affect how people experience care and the quality of support they receive. This was discussed with the management team. The management team were receptive to our findings, and some amendments to people’s care plan information were made immediately.

Some people and relatives told us the lack of social engagement and activity impacted on their experiences; there were limited systems in the home to measure how successfully people’s social outcomes were met.

A staff member told us, “The difference in care between upstairs and downstairs continues to be clear. Residents upstairs consistently receive less attention and fewer choices, particularly at mealtimes, compared to resident’s downstairs. This creates an unfair divide within the home and leaves the most vulnerable residents overlooked.”

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Nobody was receiving end of life care at the time of the assessment. The registered manager told us, “We have death and dying care plans for people and as we get to know people we add more into them. Some people don’t want to share the information. If someone is really poorly and the GP is involved, then we work to get them end of life plans in place.” A professional told us the home was in process of having advance planning conversations with families.