Silversprings

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. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 63 (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 demonstrated a proactive and positive culture of safety, characterised by openness and honesty. Overall, actions were identified, incidents were analysed, and outcomes were shared to improve practice. An incident bulletin was produced that highlighted lessons learned from each event. This bulletin was shared with the wider team to support reflective practice and drive improvements across the service. However, during the inspection we found one example where an identified risk had not been effectively acted upon. The service had recognised that one person was at high risk of falls and had taken steps intended to mitigate this. Despite this, on the day of the inspection their footwear remained inappropriate. Although the risk had been identified and actions taken, these measures had not been executed effectively, resulting in ongoing risk. Once this was identified during the inspection, staff took immediate action and sourced suitable footwear. This demonstrated that when risks were identified in real time, staff responded promptly to address them.

The provider worked with people and healthcare partners to ensure safe systems, pathways, and transitions were in place. People reported good access to GPs and health professionals, and care plans included relevant assessments and clinical guidance. The service continued to have good, consistent relationships with a range of local healthcare professionals. This included GPs, community nurses and local pharmacists. People continued to be assessed before being offered a placement at the home. Staff met with the person in their own surroundings and encouraged them to experience the home, either by having lunch and a tour of the building or a short stay. This ensured the home was in line with the person's preferences and their needs could be met effectively.

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. The service had a clear safeguarding policy and reporting procedure. This enabled any trends to be picked up promptly and all concerns were recorded, progressed and actions followed through. The provider notified relevant agencies and followed up with these effectively and requested further support where it was needed. Staff demonstrated a good understanding of safeguarding risks and the circumstances of people who were at risk of abuse. One staff member gave an example of how bruising could indicate abuse, so they would always report it to the registered manager. The provider requested legal authorisations where restrictions amounted to a deprivation of liberty for people who did not have the capacity to consent to these. Decisions about people’s care were made in their best interests and for their safety. Staff showed an understanding of the principles of the Mental Capacity Act 2005 (MCA).

Systems were in place to ensure risks people might face were routinely assessed, monitored and reviewed. People’s care records contained sufficiently detailed information for staff to follow to ensure risks to people were mitigated, so people remained safe when taking part in activities and events of their choice. People’s care records were accurate and up to date, giving staff clear guidance on how to manage specific risks. Staff supported people safely and equipment was available where appropriate.

The provider actively identified and managed potential risks within the care environment to ensure safety for all residents. Equipment, facilities and technology were maintained to support the safe delivery of care. Most rooms were observed to be clean, and essential equipment such as hoists and fire extinguishers were confirmed to be within their maintenance dates. Safety certificates were in place for mains gas and electricity, small appliances, and the fire alarm and related equipment. Internal safety checks were routinely conducted in line with best practice.

However, some environmental hazards and hygiene concerns were noted. For instance, coffee tables in the main lounge obstructed mobility, posing a risk to residents. Additionally, kitchen hygiene needed to be improved in certain areas; bread was discovered to be out of date and some opened food items were not labelled. We brought this to the attention of kitchen staff and they removed all affected items immediately.

Staff were not always deployed effectively to ensure people received timely and consistent support. Although rotas indicated full staffing on the day of inspection, we observed that staff were not consistently positioned where they were required. This resulted in delays in meeting people’s needs. For example, five people waited for their meals for a prolonged period, and others were observed walking up and down corridors seeking staff interaction, with staff not readily available.

The management team told us they had reviewed staffing levels before our inspection and increased hours in response to people’s rising support needs. However, our observations showed these additional hours were not always deployed in a way that improved people’s experience. Some people also told us there were not enough staff available during evenings and weekends, which affected the support they received.

We raised these concerns with the registered manager during the inspection. In response, the provider undertook a reflective practice session with staff and began reviewing their approach to staff deployment. On the second day of the inspection, lunchtime support was timely and more organised, and the provider had introduced additional afternoon staff to improve availability and responsiveness.

The provider operated safe recruitment processes. All staff had access to training and supervision to support their role. Staff confirmed ongoing training, including mandatory and specialist topics where needed (e.g. dysphagia, pressure sores). Staff competencies were assessed and refreshed regularly. Staff we spoke to onsite demonstrated a good understanding, and all were positive about the training they received and felt confident in their roles. Staff members were consistently supervised and underwent two performance appraisals annually.

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. People and their relatives told us the home was clean and they had no concerns. The home was tired in places and in need of decoration. We identified a strong malodour on one corridor which was brought to the attention of the registered manager. Staff received infection control training and implemented their learning in their day-to-day practice. Housekeeping staff were available 7 days a week and understood their role in following guidelines to promote good infection control practices. They told us they were informed of any infections in the home so they could implement the right strategies to mitigate the risk of infections spreading. We observed staff using appropriate personal protective equipment (PPE), such as gloves and aprons when providing care. Staff told us they had no concerns about availability of PPE. People we spoke to also told us that staff use appropriate PPE when supporting with personal care.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff followed clear processes for ordering, receiving and storing medicines. Two staff booked medicines in, and controlled drugs were stored securely in line with legal requirements. Regular checks of controlled drugs were in place.

Staff had the right training and support to manage medicines safely. New staff completed a structured induction and competency assessments, and all staff had their competencies reviewed. If medication errors occurred, staff reported them promptly, monitored people, contacted the GP and completed reflective practice to support learning. Homely remedies [non-prescribed medicines used to treat minor ailments] were used safely with GP authorisation. medicines administration record [MAR] charts were completed accurately.

We observed good practice in the administration of PEG [percutaneous endoscopic gastrostomy] medicines, including correct positioning, flushing and infection control measures. There were robust systems in place to ensure time critical medicines, including Parkinson’s medicines and insulin, were given on time. Emergency kits for low blood sugar were available.

Staff had completed regular medicines audits which had identified areas for improvement and actions taken.