Silverbirch House Care Home

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 newly 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 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Pre-assessments were carried out with people prior to moving into the service to help ensure Silverbirch House Care Home was the most suitable place for them to live. Within the first 7 days of a person moving in, their care plan was updated to include the most important information about the person which staff would need to know. Following that the care plan would be added to and reviewed to ensure it reflected the person’s needs fully.

We saw that pre-assessments had a lot of person-centred information included and a professional had commented, following their recent visit, ‘You (registered manager) have a very good oversight of your residents needs and are careful in terms of who you admit and when/where to ensure the placement is successful’.

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.

The registered manager explained that they complete a nationally recognised assessment, telling us, “We complete a nationally recognised assessment. If for example, a person came in with a skin tear, we would complete a Waterlow assessment for them to assess their skin integrity. All staff are competent in carrying out assessments and triangulating information to ensure people’s care plans are robust.”

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 worked with external professionals and agencies for the benefit of people. The registered manager told us, “We run events and talks covering common areas, such as falls. This helps both people and staff to understand how to reduce risks.” These events also helped prevent people having to move between services as they increased awareness of risks, and enabled people to remain safely in the service.

We observed staff working well together throughout the day. Senior staff were leading the floors well, constantly checking that staff were okay, allocating duties where needed and co-ordinating lunch for people.

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.

The registered manager undertook case studies on people by looking at those at higher risk and considering what could be done in addition to the normal day to day care, to reduce these risks. This included helping people to put on weight or reducing a person’s risk of falls. We saw people had their hydration and nutrition needs clearly set out in their care plans. Each person had a MUST (malnutrition universal screen tool) which was reviewed every 3 months or earlier if needed.

People were provided with a choice of foods and drink. One person told us, “The food is okay. We have choices. I’ve said though that at teatime it should be soup and a selection of sandwiches. Everyone is elderly and we don’t need another big meal.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. A relative told us, “I would say she has improved slightly since being at the home.”
Staff supported people’s routines to help ensure they had positive experiences. This included a situation where someone had been bereaved, which had negatively affected their wellbeing. They deteriorated rapidly and were placed on end-of-life medication. Knowing that they had an interest in babies, staff arranged for a new infant to visit, providing comfort and helping to boost their mood and outlook. Together with the support of Silverbirch House staff, and the involvement of external professionals, the person made an almost full recovery with staff describing them as, ‘back on their feet’.
Another person suffered with anxiety, and they had been prescribed an ‘as and when’ PRN medication for this, together with a written personalised distress care plan. The care plan was linked with the PRN protocol to help ensure this person only received medication when they needed it.

The provider did not always tell people about their rights around consent and respected these when delivering person-centred care and treatment.

Although we saw mental capacity assessments had been conducted with people to help identify whether they could understand living in a care home and the associated elements of doing so, it was not always clear that decisions were being made in a person’s best interests. This included 1 person who had equipment in their room to monitor their movements. The documentation completed stated this person did not consent to this equipment but staff had made a decision on this person’s behalf to install the equipment in their room. The person told us, “Sometimes I feel jailed, I can’t get to the door as they (staff) come running. I just come back (into my room).” This showed that staff may not always understand the principles of the Mental Capacity Act 2005 as there was no evidence of involving the person or family members to make a best interests decision, ensuring that the least restrictive options had been considered first. We discussed this with the registered manager on the day who agreed to review this person’s requirements.

However, we did read that where other people were being restricted, Deprivation of Liberty Safeguards (DoLS) applications had been made and where people had capacity, staff understood there was no need to carry out a capacity assessment with them as they were able to make their own decisions. A staff member told us, “We assume capacity, but would do an initial assessment and make decisions in a person’s best interest.” Another said, “Always assume capacity unless it’s proved otherwise. People have a right to make an unwise decision. We just make sure we give them all the information.”