Silverleigh Cedars

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. At our last assessment we rated this key question good. At this assessment the rating has remained good.This meant people’s outcomes were generally 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, well being and communication needs with them.People were assessed prior to moving to the service to ensure their needs and preferences could be met. Wherever possible, people and their families were actively involved in the assessment process.Some family members said they did not have much involvement in care planning. The director and registered manager explained relatives had been invited to care reviews and they would ensure this continued.

One relative spoke about staff visiting them at home to discuss their relative’s needs and preferences. They added, “The staff seemed very attentive and understanding”. They said the admission had gone smoothly and their relative had settled well. The staff completed a comprehensive assessment when people joined the service and care plans were reviewed and updated as 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’s needs were assessed with them and, where appropriate, their families or representatives were also involved. Staff used nationally recognised tools to assess risks and inform care planning. For example, the Waterlow assessment was used to assess the risk of skin tissue breakdown and Malnutrition Universal Screening Tools were completed to identify and act in response to people’s nutritional risks.

Staff made timely and appropriate referrals for specialist support, including GPs and other health professionals. Professional advice was documented and followed. Staff demonstrated a good understanding of how to support people. For example, with modified diets. Kitchen staff ensured modified meals were presented in a visually appealing manner.

Feedback from professionals was positive about the care and treatment people received at the service. One professional said, “The staff are very experienced and know when simple care and homely remedies are required, and when a medical opinion is necessary”. Another told us, “We have no concerns about Silverleigh. This is a lovely home. I would recommend it”.

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.

Good communication and joint working had been established between the service and professionals. We received positive feedback from people and professionals.One health professional said, “We receive appropriate and timely referrals from Silverleigh. I have always felt that the service is safe, and the clients are extremely well cared for”. A relative told us, “The staff were great, the care is good”.

Information-sharing systems ensured good communication with external services. Staff were well-informed and up to date about people’s individual needs. The provider held regular team meetings, daily handovers and briefings.

The provider supported people to manage their health and well being to maximise their independence, choice and control. The provider was making improvements to ensure people were supported to live healthier lives and where possible, reduce their future needs for care and support.Evidence in care plans and daily care records confirmed people had access to healthcare services andany advice was recorded and followed. Health professionals were confident their advice and recommendations were understood and followed.

People were offered a balanced diet, with a choice of food at each mealtime. Snacks and drinks were offered in between. Overall people were happy with the quality of the food. One person said, “The food is marvellous”; another commented, “The food is generally very good”. Where people had been identified as being at risk of malnutrition, staff ensured fortified foods and build up shakes were provided to promote weight gain.

People had a mixed dining experience on the first day of our visit, and we discussed this with the director and managing director. There was a lack of organisation at lunchtime, with people waiting for their meal for nearly an hour. No condiments were offered, and some staff did not recognise the support some people needed.

Some people were finishing a cooked breakfast at 11.30 and then offered a cooked lunch at 12.30. We saw people declined lunch at this time. We discussed the management of staggered mealtimes for people who had a late cooked breakfast. While it was noted that alternative options should be offered if a person declines lunch, there were concerns that this practice was inconsistent due to a lack of formal oversight to ensure meals are appropriately spaced. The deputy manager explained that people could request food at any time, but they acknowledged that individuals living with dementia may lack the capacity to communicate their hunger effectively.

The provider conducted several mealtime observations following our feedback and shared their findings with us along with the actions taken to improve the mealtime experience. Adjustments were made to promote inclusion within the dining experience at lunchtime (e.g. offering soup or smaller portions… for those that had a late breakfast). Dessert was delayed and offered in the afternoon. Any missed meals were compensated with snacks and fortified drinks in the afternoon. They found staff demonstrated a receptive and proactive approach towards the implementation of changes designed to improve nutritional awareness and mealtime coordination. On the second day of our visit, the mealtime was more organised with a better staff presence in the dining room to assist people when needed.

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.

People’s care and support needs were regularly reviewed, and action was taken promptly when any changes to their health needs were identified. We received positive feedback from health professionals. Comments included, “Staff work very well with us” and “All our recommendations are followed, and outcomes fed back to us at the weekly phone calls”.

Relatives confirmed they were kept well informed of any changes to their family member’s health or well being. We were told, “Staff genuinely seem to care about people” and “I am happy with the care. (Person) is safe and I can go home without worrying”.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.We saw people made their own choices and decisions about what they did, what they ate and how they spent their time.The provider had processes that ensured the Mental Capacity Act 2005 (MCA) was followed effectively, to support people who lacked capacity to make specific decisions about their care. Mental capacity assessments and best interest decisions were completed following the principles of the MCA, to ensure decisions made on behalf of people were made lawfully. Where people were deprived of their liberty, the provider had requested the appropriate authorisations.