Silverberry Care Kenilworth

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this registered service. This key question has been rated Good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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 positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff recorded and reported any accidents and incidents. One staff member told us if a person sustained an injury, “I would report it straightaway, make a body map, assess the person and if need be, I would call the doctor or 999 if it was serious. I wouldn’t leave it.”

The registered manager told us if areas of improvement were noted during their audit processes, these were shared with staff and discussed at supervision meetings to ensure improvements were made and sustained. Audit processes included spot checks to ensure staff were working in accordance with best practice and to identify any areas for improvement. One staff member told us, “Working with Silverberry, I have come to understand feedback is not criticism, but it is about understanding you need to improve; there is always room for improvement. If you are good, then you get feedback you are doing okay. That standard is there.” A senior member of staff told us, “We always try and make staff understand that it is not about what you have done wrong, but about what you are doing to correct that.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

When people started to use the service, a care plan was devised with details of people’s care needs to help them transition to using the service safely and in a supportive way. A family member told us, “They came and saw us and did a care plan before they started.”

Staff knew people well and were able to support them should they need healthcare support. Staff told us if a person was unwell or sustained an injury, they stayed with them until family or medical support arrived to ensure a safe transition into their care.

The registered manager explained how they had supported 1 person by working with their family support worker to help ensure their appointments and care was managed effectively during the person’s change of address. The registered manager told us, “Continuity is important to ensure relationships are built.”

The provider used electronic systems that staff could access remotely to help ensure information was readily available to them should people be required to transfer to hospital due to their health.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People did not raise any concerns regarding their care and told us they felt safe with the staff supporting them. One person told us, “It’s all good, they come morning and evening to me, very good, they look after me, I am safe.”

Staff had access to safeguarding policies and procedures to remind them of their safeguarding responsibilities. Staff told us they would report any suspicions or concerns to the management team and escalate it further if they felt appropriate action had not been taken. One staff member described the different types of abuse and commented, “I always look out for money being spent wrongly or things going missing. I am always looking at everything. I would speak to my boss straightaway.” Another staff member told us, “If I have any concerns, I have to document it and make sure my words are legible. If it is an emergency or a safeguarding issue, then I report it to the safeguarding lead as soon as possible.”

The registered manager demonstrated a good understanding of their safeguarding responsibilities to both adults and children receiving a regulated service. They described, and were aware of, the specific safeguarding risks to children through the use of social media and cyber-bullying.

The provider worked with people to understand and manage risks, but staff did not always have detailed risk information available to them to ensure they met people’s needs in a safe and appropriate way.

People and their relatives spoke positively about how staff managed risks associated with people’s care. However, care records were not always sufficiently detailed to help make sure staff exercised a consistent and safe approach to managing risk. For example, 1 person had a health condition that could place them at risk of seizures. There was a lack of information about the signs and symptoms of a potential seizure, and how staff should manage any seizures should they occur when they were supporting the person.

Staff worked with people to help ensure any risks associated with their care were managed. Staff explained how people were at the centre of their care and how their views were important when managing risk. Staff balanced their responsibility to keep people safe with respecting their right to make their own decisions and choices. One staff member described how they supported a person with capacity who had risks associated with their care. They explained, “It is a bit of a balancing act, but you try and do your best. It is their life, sometimes they choose to do the wrong things, but it is their choice.”

There was a system in place to code people’s risks so if there was a disruption in the service, for example, because of adverse weather, visits to those people at highest risk could be prioritised.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Environmental risks were considered when visiting people’s homes to ensure both people and staff were kept safe. The registered manager told us those people with equipment had this checked by other agencies to ensure it was safe for people and staff to use.

Each person supported by the service had a care plan that set out expectations in regards to the person’s environment. For example, 1 person’s care plan stated they required a “safe, clean and well organised home” that supported their mobility limitations to reduce risk of injury. There were instructions for staff to complete safety checks, follow safe use of equipment, and make sure the environment was left clean and organised after each visit.

People told us staff respected their environment and completed the tasks expected of them to keep their home safe. A family member told us, “They are very respectful to [Name] and my house.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and their family members spoke positively of the staff team and the care and support they received. They told us staff usually arrived at the time they expected although there were mixed comments about the consistency of staff. Comments included, “It’s all different staff, we would like the same ones really. They are all on time and they do say if they are going to be late” and “It’s a group of 4 regular carers…they are on time.” One family member told us how they used an App to track staff, they said, “I have got the App on my phone and that gives me the carers and who is coming when, and they are here within 10 minutes or so. They are never really late, and they haven’t missed a call or anything like that.”

The provider understood the importance of people having consistent staff completing their care calls and aimed to ensure the same staff supported people regularly where this was possible. All staff completed training linked to people’s needs to ensure they could support people safely.

The registered manager told us there were enough staff to support people and the electronic system they used enabled them to check staff arrived to complete their care calls on time, stayed the allocated time, and were at the required location. The electronic care planning system calculated the distance between care calls to support the planning of these. Staff confirmed they were allocated enough time to travel between care calls which meant they arrived when people expected them. One staff member said, “There is plenty of travelling time.”

Staff told us they had enough time to provide the support outlined in people’s care plans. One staff member told us, “I don’t rush, I don’t feel under pressure.” Another staff member said, “There is no rush, there is always time to sit with clients and give them that bit of companionship before you leave.”

Staff knowledge and learning was monitored through supervision meetings with their manager and observations of their practice. Staff said this provided an opportunity for them to discuss personal development and any training requirements.

The provider has processes in place to assess and manage the risk of infection, but these were not always followed. They usually detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People told us staff usually wore personal protective equipment (PPE) such as gloves and aprons. However, comments received suggested some staff did not always do this. We were told some staff did not wear aprons when delivering personal care and when they were questioned about this had stated, “They (provider) haven’t got any.”

We saw care plans were specific about the use of PPE and what was expected by staff which confirmed the provider’s expectations. For example, 1 care plan stated, “Carers will follow infection prevention procedures, maintain good hand hygiene, use PPE appropriately, clean equipment after use, and follow family routines to minimise discomfort and infection risk.”

The provider had policies and procedures to guide staff on safe infection, prevention and control practices. Records confirmed staff also completed the necessary training to help ensure they understood their responsibilities and worked safely.

Staff spoken with told us they always had sufficient PPE to use during personal care.

The provider did not always make sure there were clear systems to manage medicines and treatments effectively. Staff involved people in planning, including when changes happened.

People were mostly supported by relatives with their medicines or were able to manage these independently themselves. Where people received support, relatives told us their medicines were managed appropriately. However, we found medicine records were not always sufficiently clear to show risks were managed. For example, 1 person was prescribed multiple medicines, but the service only supported the person with some of these. Records did not clearly show how the risks associated with the person not taking some of their medicines should be managed. Daily records completed by staff showed the person was not always taking their medicines. Staff were requested to monitor the person for side effects but there was no information stating what the side effects may be.

Staff received training and undertook competency assessments to ensure they had the skills and knowledge to manage medicines safely. Staff raised no concerns in regards to how they managed people’s medicines.

The provider completed medicine audits to ensure medicines were managed appropriately. The registered manager told us records would be further reviewed to ensure they were sufficiently clear.