Silver Oaks Residential 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. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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. The provider had pre-admission assessment processes in place to ensure these were sufficiently robust and helped to identify people’s needs, wishes and preferences. Processes had also been developed to identify if the service was able to meet peoples prior to any admission. People, their relatives and relevant agencies were involved and consulted as part of the assessment processes. Staff were provided with information and guidance through handovers and care plans. A relative told us, “We were involved in a pre-placement assessment to develop a care plan for [Name].”

The provider had systems and processes in place to monitor the weight, food and fluid intake of people and act where required. However, we found staff did not always follow robust monitoring processes to ensure, where people had been assessed as at risk from dehydration, they had consumed sufficient fluids each day. Monitoring records were not completed consistently which meant there could not be effective oversight of the risk of dehydration, though there was no evidence people had been harmed because of this. Additionally, records to monitor people’s re-positioning in bed were not always completed consistently and records to monitor people’s distressed incidents did not provide sufficient information to support effective analysis and review of interventions and approaches in line with best practice. Following our assessment, the registered manager took immediate action to review care records, positive behaviour support strategies and arrange training for all relevant staff. People spoke positively about meal choices. They told us, “The food is superb, the cooks are fabulous” and “The food is good, I have no complaints.” We saw people were given choices in where they wanted to have their meals and the dining room supported a positive dining experience. Staff assisted people who needed support or prompting to eat their meals, and snacks and drinks were provided throughout the day.

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. People had comprehensive care plans that were able to be easily shared between teams and services. Any communication between services was clearly recorded in peoples care records. A health professional told us, “It’s a lovely home, staff really care about the residents. If anything changes in relation to people’s needs, they are on to it and get GP, nurses etc. The staff are all lovely. I can’t say anything bad about it.” Tasks were assigned and shared evenly through the workforce, for example assisting people to eat and drink and supporting with activities.

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. People were encouraged to make choices and supported to remain as independent as possible. We observed staff encourage people and support them to safely move around the service as they wished. People were supported to continue regular routine health checks with dentists, opticians and chiropodists. One relative told us, “Staff have got to know [Name] really well, for example they recognise when [Name] may have an infection. They are quick to call in Paramedics, GP or community nurses for help if need be, and are very good at keeping us informed about any falls or other concerns.”

The provider monitored and responded to changes in people’s needs to improve care and treatment. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Although we found inconsistencies in monitoring records, there was evidence that people were supported to achieve positive outcomes from their care. A relative told us, “[Name] stays in bed and has no pressure sores. When [Name] was in hospital for a period, nurses were really surprised that they had no pressure wounds. That is a positive reflection on the service for sure.” A second relative told us, “[Name] had lost confidence but since moving here they have felt safe and cared for. They have blossomed since being here and enjoy joining in with activities.”

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. People and relatives told us staff sought consent before providing care, were supported to make choices and staff respected their decisions. A relative told us, “I have seen that staff ask permission before undertaking any kind of support for [Name].” We observed staff respected people’s choices and were receptive when people shared their views and wishes. People’s capacity to make decisions and choices, and the support they needed, had been assessed and recorded in line with the mental capacity act (MCA) and best interest processes were followed. Whilst care plans contained evidence of consent from people where they were able to, the registered manager had signed consent for people who lacked mental capacity. Care plans should primarily be signed by the person, or their authorised representative, to confirm agreement and ownership of their care. While a registered manager oversees the care delivery and ensures quality standards are met, the plan itself is meant to be a person-centred agreement between the individual and the care provider. Therefore, we advised the registered manager this practice was not aligned to best practice and the MCA. Additionally, although mental capacity assessments referred to relatives as having power of attorney, records did not state if this covered health and welfare or simply finances. The registered manager told us they would clarify this following our inspection visit.