Silverbirch House Care Home

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 newly registered service. This key question has been rated Good.

This meant people were safe and protected from avoidable harm.

This service scored 69 (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 proactive and 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.

The registered manager carried out a monthly audit and analysis of all accidents and incidents occurring at the service to look for themes, trends and learning. Where learning was identified, this was shared with the staff team through group supervisions and reflections. A staff member told us, “We raised it (incident) with the senior member of the team first. We have our (computer) system where we record behaviours and distress, then we have evidence so they have something to look back on.”

Recent learning identified included staff responding to people’s call bells as the registered manager had identified that some people had waited up to 20 minutes for assistance which placed people at risk of unnecessary anxiety or trying to do things for themselves. A group supervision was held with staff to remind them of the importance of answering call bells promptly

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.

To help ensure a smooth transition into Silverbirch House Care Home, the registered manager told us they would organise everything in advance for the person through liaison with other professionals and agencies. This included where 1 person could display anxiety and the service got the mental health team involved as well as the GP. Additionally, the registered manager stayed with the person over their first weekend to help settle them in.

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.

Staff received safeguarding training and knew how to recognise signs of abuse and report appropriately. One staff member was recognised as the ‘speak up’ champion for the service and they told us, “I encourage other people to come to me. So, then it would be up to me to take it to the manager as the first point of contact. If the problem was the manager, then I would take it to the regional director, CQC or police.” A staff member told us if they found an unexplained bruise on someone, “I would have a look and let the deputy manager know who would record it. It would be a possible safeguarding. I would record on the skin integrity chart and let the family know.”

The service had no current safeguarding concerns open and an adult social care professional told us, “Any safeguarding concerns are generally closed straight away.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. A relative told us, “Safety and risks are very well managed.”

Staff supported people to feel safe and free from harm. Where people were at risk of their skin breaking down, air flow mattresses were provided. One person told us, “I have a special mattress as I spend a lot of time in bed and they don’t want me to get bed sores.” A relative said, “They (staff) come and see her every 2 hours to check on her, but particularly to turn her.”

People’s care plans included good detail and information for staff in how to support people. This included what equipment people required to mobilise and where people had health conditions, such as Parkinson’s, a falls risk assessment. People and relatives told us they felt safe. They said, “I certainly feel safe and looked after” and “She’s in very safe hands day and night.”

Where people had food intolerances, there was a clear connection through the sections of their care plan in diet, health, medication and risks. A staff member told us, “We have specific people that are at nutritional risk. We have a lady who is a risk of this at the moment and we have established she can’t chew her food, so we give her soft stuff like ice cream.

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

Although the service was checked for its safety, we observed a concern during lunchtime. Staff had placed several people’s Zimmer frames and walking aids together in a cluster in the corridor whilst people were in the dining room. As a result, we saw 1 person attempting to walk using 2 frames that had become joined together. In addition, we also observed some people in their rooms and their walking aids were not within their reach. This presented a potential risk to people. We fed this back to the registered manager on the day for their attention and action.

Fire safety information was made available as each person had a personal emergency evacuation plan in their care plan, in the event the building had to be evacuated. This included information around what support they would need either with staff or equipment to ensure they could be moved quickly and safely.

The service was checked for its safety. Comprehensive checks were being carried out to include checks of equipment such as the hoists and slings, a lift check, annual electrical checks and regular fire equipment checks. In addition, the water was assessed for the risk of Legionella and to ensure it was set at the correct temperature.

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

Although we did see staff around throughout the day, there were occasions when staff presence was not seen. For example, for a period of almost 20 minutes observed 1 person alone in one area of the building and we did not see staff come and check on them.

We also received some mixed feedback from people in relation to how long they may wait for assistance. Some people told us, “Nothing could be better. All I have to do is press my bell and they come. It’s the same at night.” However, others said, “Sometimes it can take a little bit of a while to answer the call bell” and “It’s usually quite quickly but not always.”

Relatives also gave mixed views, telling us, “Absolutely enough staff”, “Always staff available and management very visible. People have call buttons and staff are responsive” and “There is no doubt about it, the staff here are really lovely, but there just aren’t enough of them.”

We received contradictory information on staffing levels on each floor. The registered manager had told us there were 5 care staff on duty across the 2 floors. However, staff we spoke with throughout the day said there were 7. This made it difficult for us to accurately assess whether staffing arrangements were sufficient to meet people’s needs, and we raised this with the registered manager at the end of our visit.

Despite the mixed information we received, staff felt there were a sufficient number of them, telling us, “There are definitely enough staff and the seniors help us if we need it”, “There is (enough) with the needs of the residents currently” and “I feel we are able to do everything that we are supposed to do and residents are getting a good level of care”

There was a robust induction and training process in place for new staff. Prior to a staff member commencing at the service, they were booked on training. This included 2 days of on-line training, followed by 2 days face to face. All training needed to be completed before working on the floor. This was followed by an induction period which was reviewed at 1, 6 and 12 weeks with the induction period being extended if staff required further support. Staff said, “The training was lovely. It was more than helpful. We have supervision with our line manager”, “The training has been amazing. We have supervision every 3 months and 10 to 10 meetings daily to share information” and “We do face to face dementia training and e-learning. I think it’s very rewarding caring for people with dementia.”

Prospective staff were recruited through robust processes which included providing their full employment history, right to work in the UK and references from previous employers. All new staff underwent a Disclosure and Barring Service (DBS) check to help ensure they were suitable to work in this type of service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was extremely clean and well-presented and we observed housekeeping staff working throughout the day. We observed staff washing their hands regularly and wearing gloves for care tasks.

The registered manager told us, “For any outbreaks we have gloves, aprons and masks if needed. We would put signage on a person’s door and ensure there was hand sanitiser available outside. I run regular quizzes for staff to check their understanding of good infection control practices.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. One relative told us, “Staff are very good with medication.” Another 1 said, “Her meds are all dealt with now. She’s so much better in herself.”

Only trained and competent staff undertook medicines administration, with these staff having their competency checked regularly. All medicines trained staff also completed blood glucose training and Boots pharmacy training to help ensure they were competent. Staff confirmed the training they’d received. One told us, “I’ve had Boots training, shadowed and medicine competency completed.”

People’s medicines were stored safely and in line with good practice. Clinical rooms were air conditioned and they were clean, well-organised and well maintained. We checked the stock levels for some people and found these to be correct and liquid medicines had opening dates written on them.

Where people were on time-critical medicines (medicines needing to be given within a certain timeframe), we read that staff ensured these were administered as required.

Each person had a medicine administration record (MAR). This included the person’s photograph, a list of any allergies, how people liked to take their medicine and protocols for any ‘as and when (PRN)’ medicines they were on. We checked the MARs for some people and found no gaps which indicated people were being given the medicines they had been prescribed.