Silver Mews Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this newly registered service. This key question has been rated Requires Improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance at the service.

This service scored 54 (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 had a strategy and vision that was shared with people and staff. However, we received mixed feedback about how well this worked in practice. Some staff told us they felt the service could be improved in relation to food and activities, especially in relation to engagement for people with a dementia. While most staff felt the culture was positive, four staff commented that morale needed to improve, and others told us they did not feel there was a fair and equitable culture.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

People, relatives and staff told us the registered manager was kind and approachable. They were supported by a wider management team who regularly visited the home. We received mixed feedback about how effectively management listened and responded to issues raised, and how long it took for concerns to be resolved.

The management team undertook a range of quality checks on the service, but these had not identified and remedied all the issues we found at this assessment.

People did not always feel they could speak up and that their voice would be heard.

While most staff told us they felt able to speak up, a staff member expressed concern that they felt information was not kept confidential. Other staff raised concerns about practices in the home with us that they had not raised directly. We fed these back to the management anonymously so they could take any necessary action to address the concerns raised. This highlighted that some staff may not feel confident to report concerns or may be unfamiliar with the processes in place to do so.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Recruitment processes, training, and policy and procedures were in place to support equality, diversity and inclusion.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Quality assurance audits were not always effective and not all the areas of concern we identified had been picked up by the provider. Documentation audits had shown no overall improvement over the last 5 months. The registered manager explained that during this time some areas within the audit had improved whilst other areas had ‘slipped back’ resulting in the overall score remaining the same. IPC audits highlighted issues with peoples' bedrooms but timely action had not been taken to address this.

The home had an internal medicines audit programme which was identifying areas of concern. In addition, external medicines audits had also been completed which had identified similar concerns. Actions had been taken including speaking with staff at team meetings and changes to processes. However, the actions taken were not effective. Audits showed that similar areas of concerns continued to be identified each month.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

External professionals we spoke with told us the staff and management were proactive and worked effectively in partnership with them. A professional told us, “I always find the management to be knowledgeable about their residents and supportive when helping me complete my assessment. They take on board any suggestions I make to improve patient care and tell me they disseminate this to their staff.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

There were avenues to collect stakeholder feedback and learn from incidents, but these needed further improvement to ensure they effectively supported improvement and innovation.