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Silvermead Residential Home Inadequate

The provider of this service changed - see old profile

We are carrying out a review of quality at Silvermead Residential Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 17 December 2020

During an inspection looking at part of the service

Silvermead Residential Home, hereafter referred to as Silvermead, is a residential care home that provides personal care and support for up to 13 people with a learning disability, autism or who have complex needs associated with their mental health. At the time of the inspection there were 9 people living at the service.

Staff confirmed they had received additional training in infection prevention and control and the use of PPE including masks, gloves, aprons and hand sanitiser. However, this information was not clearly evidenced within the home’s training records or within staff files. This meant you could not be assured which member of staff attended which training session.

It was not evident from our observations that seating arrangements in the lounge or dining room enabled people to socially distance, in line with Public Health England's current Covid 19 guidelines.

The manager gave us assurance that individual risk assessments had been completed to identify staff who might be at higher risk or in a clinically vulnerable group because of their individual health needs. However, these could not be found at the time of the inspection.

Information regarding Covid 19 was available within the home for both staff and people in an easy read format. However, we found the provision of signage within the service could be enhanced. For example, information regarding hand washing could be in bathrooms/toilets and information regarding donning and doffing could be in the donning and doffing designated area.

We found the following examples of good practice.

Systems were in place to help manage the risks and prevent the spread of COVID-19.

Visitors to the service had been restricted. There was a clear system in place for visitors to ensure they followed the current guidance on the use of personal protective equipment (PPE) and social distancing.

Staff provided instructions on arrival at the service to ensure visitors understood the infection prevention and control protocols they needed to follow to keep people safe.

Visitors to the service were asked to wear PPE, have their temperature checked, wash their hands and complete a health declaration questionnaire before they would be allowed to enter the main part of the building.

There were sufficient stocks of PPE available and staff were seen to be wearing PPE appropriately.

People and staff took part in regular COVID-19 "whole home" testing. People and staff who tested positive followed national guidance and self-isolated for the required amount of time.

Cleaning schedules and procedures had been enhanced to include more frequent cleaning of touch points such as handrails and light switches.

We were assured this service met good infection prevention and control guidelines.

Further information is in the detailed findings below.

Inspection carried out on 29 November 2019

During a routine inspection

About the service:

Silvermead Residential Home, hereafter referred to as Silvermead, is a residential care home that provides personal care and support for up to 13 people with a learning disability, autism or who have complex needs associated with their mental health. At the time of the inspection there were 12 people living at the service.

People’s experience of using this service and what we found

People told us they liked living at Silvermead. We found the service was not operating in accordance with the regulation and best practice guidance. This meant people were at risk of not receiving the care and support that promoted their wellbeing and protected them from harm. Although the provider demonstrated a strong commitment to people living at the service. They did not have sufficient oversight of the service to ensure people received the care and support they needed that promoted their wellbeing and protected them from harm.

The service did not consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

Systems and processes to monitor the service were not effective and did not drive improvement. These included concerns with records, risk management, medicines, a lack of person-centred care, and the environment.

People were not always protected from the risk of avoidable harm. We found where some risks had been identified, it was unclear what action had been taken to mitigate those risks and keep people safe.

Other risks were well managed, for example, risks had been identified in relation to people’s health care needs and records demonstrated that action had been taken to minimise these.

Whilst we did not find people were being disadvantaged, people were not supported to have maximum choice and control of their lives and staff were not supporting people in the least restrictive way possible.

The service did not have good systems or processes in place to help ensure people received the care and support they needed in accordance with their wishes.

Whilst it was clear that staff care deeply for people, their right to privacy was not always understood or respected.

Staff told us they felt supported and appreciated by the provider and manager. We found the service did not have an effective system in place for recording what training staff had received. This meant that neither the provider or manager could be assured that staff had the necessary skills to carry out their roles.

People were not protected by safe recruitment procedures. We looked at the recruitment files for four staff members. Whilst some recruitment checks had been carried out, others had not.

People were encouraged to share their views through regular reviews and relatives felt comfortable raising complaints and were confident these would be acted on.

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

Rating at last inspection

The last rating for this service was requires improvement (published on 7 January 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in regulation in relation to safe care and treatment, safeguarding people from abuse, the need for consent, dignity and respect, training, recruitment, notifications, and governance. We have also made recommendations in relation to staffing levels and end of life care. Please see the action we have told the provider to take at the end of this report.

Follow up

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements. If the pr

Inspection carried out on 14 November 2018

During a routine inspection

This was the first inspection since the provider registered with the Care Quality Commission on the 22 November 2017. Prior to this the provider was registered under a different name. The new registration has not affected the accommodation and care arrangements for people living at Silvermead.

Silvermead is a residential care home, which provides accommodation, and supports the needs of people with a learning disability and associated conditions such as autism. 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.

The service was registered to accommodate and support a maximum of 13 people. At the time of the inspection 11 people were living at the service.

The requirements of the provider’s registration meant the service had to have a registered manager 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. At the time of this inspection a registered manager was in post.

We reviewed whether or not the service was being run in line with the values that underpin ‘Registering the Right Support’ and other best practice guidance. The Care Quality Commissions policy relating to ‘Registering the Right Support’ states that people with learning disabilities and autism can live an ordinary life as any citizen. The values that underpin this policy include choice, promotion of independence and inclusion. We found improvements were needed in the overall culture and running of the service to help ensure these values continued to be maintained and promoted.

The planning and delivery of care was not in all cases personalised and did not always take into account people’s choice, preference and aspirations. Staff were very caring and observations we made clearly demonstrated that people felt safe and cared for in their home. Other agencies were positive about the service and said the management and staff were very caring and provided particularly good support when people were unwell, or at end of life. However, the care planning process did not demonstrate that consideration had been given to people’s lives beyond their immediate need for the service. Care plans did not include information about people’s goals or how the service would support people to develop their skills and independence.

The culture and some of the practices we observed were not personalised and did not always promote people’s independence, privacy and dignity. For example, we saw staff doing tasks for people, instead of encouraging people to do for themselves. Practices in relation to medicines and the management of finances were not personalised and did not take into account people’s preferences, skills and independence. Some of the language used by staff about people did not respect their age or promote people’s dignity.

Systems were in place to monitor the quality of the service. However, the provider did not have a clear set of values and aims against which to measure quality and outcomes for people and auditing processes had not identified areas of concern found during this inspection.

Staff were aware of risks associated with people’s care. For example, some people had risks associated with their diet and eating. Referrals had been made to speech and language therapists and any guidance was followed by staff to keep people safe. However, information about some known risks and how staff would mitigate them had not been clearly detailed for staff to follow. The absence of this written detail could mean staff did not have the information required to provide consistent care and to keep people safe.