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Inspection Summary


Overall summary & rating

Outstanding

Updated 9 August 2017

Silverleigh is registered to provide accommodation and nursing and personal care for up to 65 people. The service is intended for older people, who may also have a physical disability, mental health needs or a dementia type illness.

This inspection took place on 15 and 22 March 2017 and was unannounced. There were 59 people living at the service at the time of the inspection. The majority of people were living with dementia.

We undertook a focussed inspection on 10 July 2016 in response to concerns about staffing levels and the possible impact this had on people’s care. We found the number of staff and deployment of staff did not always ensure people’s needs were met in a timely way. We found a breach of regulation and made a requirement. The registered manager had developed an action plan to ensure improvements were made and sustained and had kept the Care quality Commission (CQC) informed of the progress made. We found that improvements had been made at this inspection.

The service had a comprehensive inspection in July 2015 when it was rated as good overall. Responsive was rated as outstanding.

Following the site visit, Devon County Council implemented a safeguarding process in relation to one person and the police were undertaking lines of enquiry. The registered manager and other senior staff were co-operating with the investigation.

A registered manager was 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.

The environment had been creatively adapted to help meet people’s needs, in particular people living with dementia. It provided clear dementia friendly pictorial signage and points of interest. The layout and design helped to maintain people’s independence and to reduce restrictions on their movements. Comments from relatives and professionals included, “The facilities are great and well used”; “The place is beautifully kept” and “The environment is very good for people; stimulated at the right level…” People were cared for in a clean, hygienic and safe environment.

The service continued to provide outstanding responsive care. People received a personalised service which was responsive to their individual needs. The registered manager, provider and staff continually looked at innovative ways to improve the service by exploring and implementing new ideas to improve people’s experience and wellbeing. Activities provided were varied and enabled people to live fulfilled and meaningful lives. For example two people with dementia were supported to volunteer at a local charity shop. People had regular opportunities to enjoy activities outside of the service, for example swimming sessions and frequent trips were organised to places of interest.

People experienced positive outcomes regarding their health care as the service had developed excellent working relations with a number of health care professionals. Relatives spoke about the improvements to their family health. One said, “I have noticed a tremendous difference. He is so calm and settled.” Health professionals consistently described the service as professional, effective and caring. A professional said, “Silverleigh is our ‘go to service’ for people with complex needs. They manage very well.”

People’s dietary needs and preferences were well met. The service offered an extremely wide and varied daily choice of freshly prepared food made from good quality ingredients. People’s dining experience was sociable and support was at hand where needed. The service had been the first care home to gain membership of the ‘Taste of the West’.

The service was exceptionally caring. People were supported by very kind and empathetic staff who knew them well and positive relatio

Inspection areas

Safe

Good

Updated 9 August 2017

The service was safe.

There were enough staff to keep people safe and meet their needs.

People were protected from the risk of harm because systems were in place to manage risks. There were suitable procedures for protecting people from the risk of abuse.

People received their medicines as prescribed and in a safe way.

Recruitment procedures ensured people were protected from unsuitable staff.

Effective

Outstanding

Updated 9 August 2017

The service was extremely effective.

The environment had been creatively adapted to help to meet people’s needs, in particular people living with dementia, and promote their independence.

The staff worked exceptionally well with other healthcare professionals to ensure people’s healthcare needs were met.

People were cared for by staff who were well trained and supported.

People’s rights were protected as their consent to care and support was sought in line with the principles of Mental Capacity Act 2005. Appropriate action had been taken where people lacked capacity to ensure care was delivered in their best interest.

People had a wide choice varied and nutritious meals. They were able to make choices about the freshly prepared food and had unlimited access to food and drink.

Caring

Outstanding

Updated 9 August 2017

The service was exceptionally caring.

Care and support were personalised and focused on the needs and wishes of each person. Staff were very kind, gentle and thoughtful in their approach.

People receiving end of life care were cared for with great compassion by staff who were well trained and committed to providing the best possible care.

Staff promoted people’s independence and encouraged them to do as much for themselves as they were able to. They respected their privacy and dignity.

Responsive

Outstanding

Updated 9 August 2017

The service remained outstanding.

People received personalised care which met their needs and reflected their preferences. A varied and meaningful activity programme took into account people’s personal hobbies and interests and introduced them to new activities.

People’s concerns and complaints were listened to and acted upon.

Well-led

Good

Updated 9 August 2017

The service was well-led.

The service was led by a qualified and experienced manager and there were clear management structures in place

People, relatives and staff were all involved in the running of the service.

There were systems in place to monitor and assess the quality of the service people received.