Archived: Silverlea Care Home Limited

People’s experience of using this service:

Systems to monitor and check the service were in place but some of these needed to be more thorough to ensure the service consistently met the required standards.

People’s care needs were assessed, and they received good quality person centred care from staff who knew them well. The registered manager was in the process of updating care plans. However, we found some care plans required more detail to ensure they reflected people's needs and involvement. We found there were limited opportunities for meaningful individualised activities. We have made a recommendation about improving the range of opportunities available to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests: the policies and systems supported this practise. Improvements were needed to documentation to fully evidence compliance with the Mental Capacity Act (MCA). We have made a recommendation about updating documentation to reflect people’s involvement.

People and their relatives praised the standard of the care at home. People said they felt safe and they were supported by a consistent and experienced team. People said staff were kind and caring. One person said, “It’s the best place you can stay. I’ll tell anyone. The ladies are all lovely here.”

Staff were knowledgeable and received training, supervision and support to carry out their roles effectively. Staff were committed to providing person centred care and promoting people’s independence.

Medicines were safely managed. There were very close links with health professionals and other agencies to ensure people’s health needs were met and changes responded to promptly.

The registered manager provided people with leadership and promoted an open and inclusive team culture. There was a warm and welcoming atmosphere throughout the home.

More information is in the full report.

Rating at last inspection and update:

The last rating for this service was requires improvement (published 19 June 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations. Please see the effective and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Why we inspected:

This was a planned inspection based on the previous rating.

Enforcement:

We have identified breaches in relation to safe governance and audit processes.

Follow up:

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report, which is on the CQC website, www.cqc.org.uk

Silverlea is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Silverlea accommodates up to 35 people in one adapted building spread over three floors. At the time of the inspection, 16 people were living in the home.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People, relatives and health professionals spoke positively about the way the service was managed. They said people received good care that met individual needs. People and relatives said staff were kind and caring and this was confirmed through our observations of care and support.

However, the service needed to better access and work to recognised guidance in a number of areas to develop the service. For example, some improvements were needed to medicines practices. Improvements were needed to documentation to fully evidence compliance with the requirements of the Mental Capacity Act (MCA). We made a recommendation in relation to ensure evidence of compliance with the Mental Capacity Act (MCA).

Overall, we found there were enough staff to meet people’s individual needs, although a review of staff deployment at mealtimes was required to ensure people received consistent support. Safe recruitment procedures were in place.

People were protected from abuse living in the home. Risks to people’s health and safety were assessed and plans put in place to help keep people safe. However we identified some safety concerns with the premises which needed addressing.

People’s nutritional needs were assessed and met. Some improvements were needed to the mealtime experience. People’s healthcare needs were assessed and plans put in place to meet their needs. The service worked effectively with a range of health professionals.

People’s independence was promoted and encouraged by the service. People were treated with dignity and respect.

The service was compliant with the requirements of the Deprivation of Liberty Safeguards (DoLS).

People’s care needs were assessed and plans of care put in place. Some of these needed to be more detailed to demonstrate a full assessment of people’s needs had taken place. We made a recommendation regarding ensuring a comprehensive assessment of people’s needs was carried out.

People had access to basic activities living in the home and the service helped people maintain links with the local community.

A system was in place to listen and respond to any complaints.

Checks were undertaken by the service to monitor how it was operating. However these needed making more robust, so they identified a greater range of improvement areas.

Some mechanisms were in place to seek and act on people’s feedback but these were rather limited.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities 2014) Regulations. You can see what action we asked the provider to take at the back of the full version of the report.