Silverberry Care Kenilworth

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this registered service. This key question has been rated Good.This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 aimed to make sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed before they started to use the service to ensure their needs could be met. The registered manager explained, “We would get the information from the social worker and what we need to know about that client. We take that information and do a client care needs assessment to ensure it is something we, as an organisation have the capacity to support.” A senior member of staff told us, “We do a client needs assessment. We go to the client’s house and have a chat with them. You need to know their expectations and then you come back and start doing the care plan for the carers.” However, we identified 1 person’s assessed needs fell outside of the service user bandings permitted for the service. This meant systems were not fully effective in ensuring assessments were aligned with registration conditions and service user bandings in place. We discussed this with the registered manager who told us prompt and appropriate action would be taken to address this.

Staff told us they were informed of any changes in people’s assessed needs. One staff member told us, “If their care plan was to change, it would be updated on the ‘App’ and if I need to undergo any more training because of the support I need to give that client, that would be stated clearly.” Another staff member explained, “If there has been a change, straightaway we are told about it.”

Relatives told us how the service had been accommodating where their family members had struggled to adjust to the new routines associated with regular care calls. The service had supported these people by working with them and their family members to reduce the calls. This had helped people to better adjust to receiving the care and support they needed.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People and their relatives told us they were happy with how the provider supported them. One relative told us, “They are very well trained, in fact they have been ahead of the game. They have suggested things [Name] could be using or doing, so very proactive, it's been a great help to us.” Another relative said, “They know what they are doing, sometimes I or [Name] want things done in a certain way and they are all good about that.”

Risk assessments reflected good practice standards to ensure people were supported with effective care and treatment. One person needed to have their food presented in a modified manner due to their risk of choking. A staff member described how they prepared the food and sat with the person to mitigate choking risks. Staff told us the training they received was relevant and kept their knowledge up to date. One staff member told us, “There are topics you expect, but more recently my last load of training, there were some much wider topics which are very good for our knowledge.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us communication between them was effective and how links had been developed with health and social care professionals to ensure that support was provided to people when required. For example, the registered manager engaged in multi-agency meetings to ensure care packages remained effective and promoted the best outcomes for people.

Staff completed electronic records of the support they had provided during each care call to show people received care in accordance with their assessed needs. Staff told us they supplemented written records by talking and communicating with each other about people’s needs. One staff member told us, “We speak quite a lot and we talk about things.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People’s care calls were completed by a group of staff who knew them well. This enabled staff to quickly identify if a person was unwell or not themselves. One relative told us how the service had supported their family member when their health had deteriorated. They said, “It’s been very good, [Name] has been in and out of hospital and they have been very accommodating with all the changes due to all the admissions and all the problems, it’s never an issue with them to change things, they are all very helpful.” This demonstrated the service had considered how to support the person to maintain their ongoing health and wellbeing.

Staff told us they assisted with healthcare arrangements when it was requested or a need was identified. One staff member told us they sometimes accompanied people to health screening tests, such as to the optician or the audiologist. Another staff member told us how they encouraged 1 person to socialise in the community to support their emotional wellbeing and mental health.

People had social care plans that detailed their interests, hobbies and preferred outings to help staff build relationships with people and support them with these where appropriate.

The provider’s systems were not always clear to show people’s care and treatment was routinely monitored to continuously improve it. They aimed to ensure that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff told us they monitored people’s health, but care records were not always sufficiently detailed to show people’s care was being effectively monitored. For example, 1 person was susceptible to developing sore skin due to lack of movement and mobility. Their care plan had not been updated for several months so it was not clear what their current skin condition was to ensure any required monitoring took place. However, 1 staff member told us how they increased their observations in response to any changes in people’s physical or emotional presentation. Staff told us they would escalate any concerns about people’s health and wellbeing so the right action could be taken in response. One staff member said, “They (managers) always say if you have any concerns you have to write it in your notes and call the office and let them know. Making sure that line of communication is not broken.”

When people’s needs were assessed, it was agreed how many care calls they would need to provide care and monitor their health conditions. The electronic care planning system meant care plans and care calls could be monitored and checks made that care calls were completed on time to support people’s needs. The registered manager explained how any concerns would be flagged on the system so these could be identified and addressed.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us staff sought their agreement before providing care. One person told us, “They (staff) are all very nice to me, very good. They ask me what I want to do, very good.” Relatives told us where people were reluctant to receive care and support, staff worked with their family member to encourage and seek their agreement. One relative told us, “The [registered manager] has been brilliant, she has a behavioural agreement with [Name] about what they are asked to do, which is lovely.”

Care plans provided information to staff where people had communication difficulties so that staff could ensure they sought people’s agreement before providing care. For example, 1 care plan advised staff to use “visual cues, gestures and reminders” to support the person’s understanding. Another care plan advised staff to give the person time to process information and observe their response though ‘facial expressions, sounds and body movement’ to help ensure their consent was confirmed before supporting them.

A staff member told us people had capacity to make their own decisions, but they would escalate concerns if, for example, a person was consistently declining to take their medication. They explained, “We need to first talk to the client and give them as much information to understand the importance of taking their medication. If that doesn’t work, then it is communicating the situation with other family members and definitely reporting the issue to the staff here in the office. For someone who keeps on forgetting there could be visuals to remind them to take their medication. That could be put in place quite easily.”