Silomarg Ltd

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment, the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

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 were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff knew people well and provided care that reflected their individual lifestyles, preferences and routines. Rather than delivering care in a standardised way, staff adapted their support to what was important to each person. For example, one staff member described how they supported a person who preferred less interaction by carrying out part of their support, leaving them with some space and then returning to the room a few minutes later. This respected the person's preferences whilst ensuring they received the support they needed.

The registered manager told us about the specific things people enjoyed, such as talking about their pets or favourite television programmes. They said, "I think with it being a small service we know our clients well, good continuity of care and not having to keep rebuilding relationships. We try and make them laugh." Relatives also described a personalised approach where staff paid close attention to people's wishes and preferences and were flexible when these changed.

People were supported to continue activities, routines and relationships that mattered to them. Staff encouraged people to remain involved in daily tasks wherever possible and promoted independence by supporting people to do as much as they could for themselves. The provider also demonstrated flexibility when people's preferences changed, working with people and their relatives to adapt support around their wishes and priorities. This meant people experienced care that was centred around them as individuals, supporting them to live in the way they chose and maintain the routines and activities that were important to them

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People received consistent and coordinated care from a regular team of staff who knew them well and understood their needs, preferences and routines. Relatives told us this consistency helped people feel comfortable and ensured staff could respond effectively to their needs.

Staff worked alongside healthcare professionals and other services to ensure care remained coordinated when people's needs changed. Information was shared appropriately and referrals were made when additional support was required. This helped ensure people received the right support at the right time and reduced the risk of gaps in care.

The provider maintained effective communication with relatives and professionals to support continuity of care and positive outcomes for people. This meant people experienced joined-up care and support, with staff and services working together to ensure their needs were met consistently and effectively.

The provider did not always supply appropriate information in formats that were tailored to individual needs. The provider had systems in place to share information about people's care and support needs. However, improvements were required to ensure information was consistently detailed, accessible and tailored to people's individual needs. Whilst there was no evidence people had been adversely affected, records did not always provide sufficient guidance to support consistent, person-centred care. For example, we reviewed a Positive Behaviour Support (PBS) plan which did not clearly reflect recognised PBS principles or provide sufficiently detailed information about the person's needs and preferences. The plan lacked clear guidance regarding behaviours, potential triggers, early indicators, appropriate staff responses and least restrictive approaches. Important information about the person's interests and preferences was not explored in enough detail to support staff who may be unfamiliar with the person. The document also did not clearly state who had written it, when it had been completed or when it should be reviewed. Staff supporting this person knew them well and were able to talk through how they support them in detail. The provider responded promptly to this feedback and took action to address the areas identified. The concerns identified were minor and did not result in people experiencing harm.

The provider did not have easy read information available. Although there was no evidence people using the service required this at the time of our assessment, the provider's systems did not fully demonstrate how they would ensure information was available in accessible formats should people's communication needs change or new people with these needs begin having support from this service.

Staff demonstrated a very good understanding of people and relatives were positive about communication with the service. Staff were able to give detailed examples of how they communicate with a person who uses expressions to communicate. This meant people benefited from staff who knew them well, although improvements were needed to ensure records provided the same level of detail and guidance.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider listened to people and those important to them and encouraged them to share their views about the care they received. Feedback was sought through discussions with people and relatives, as well as through surveys. When previous surveys had not generated responses, the provider reflected on this and adapted their approach to encourage greater engagement.

Compliments and complaints were recorded and monitored. Where concerns were raised, these were investigated and responded to appropriately. This helped ensure people and their representatives were listened to, and any learning opportunities were identified. Relatives told us the registered manager and staff were approachable, responsive and willing to listen. They described a service that worked collaboratively with people and their families and was accommodating when requests or changes to care arrangements were made.

People and those important to them were encouraged to contribute to decisions about their care and support. The provider valued feedback and used it to help shape the service and ensure people's views were considered. This meant people and their representatives felt listened to, involved in decisions about their care and able to raise concerns with confidence that they would be acted upon.

The provider assessed people's needs before accepting referrals to ensure they could provide safe and appropriate care. They were open and transparent about their availability and capacity and only accepted care packages they could deliver consistently and safely.

One professional told us the provider communicated clearly and promptly when they were unable to meet a request, enabling alternative arrangements to be made without unnecessary delay. The provider also worked with health and social care professionals to support people to access care when it was required. This meant people had equitable access to care and support, and decisions about service provision were made fairly, transparently and with people's needs in mind.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff understood people's individual circumstances and adapted their approach to ensure support met their needs and preferences. The provider worked flexibly with people and those important to them to achieve positive outcomes. One professional told us the provider was willing to accommodate preferred care call times wherever possible and explained this flexibility had often helped facilitate safe and timely hospital discharges. Staff also worked closely with people, relatives and professionals to ensure care could be adapted when needs changed. This meant people experienced personalised care and support which helped them achieve positive outcomes and reduced the risk of unequal experiences.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff understood people's changing needs and worked with people, relatives and other professionals to plan for significant life events and transitions. Where appropriate, people were supported to access specialist services and healthcare professionals to ensure their wishes and preferences continued to be respected as their needs changed.

Staff were trained to support people at the end of their lives and spoke compassionately about providing care during this important time. One staff member described supporting people and their families during end-of-life care, working alongside healthcare professionals to ensure people remained comfortable and received appropriate support. They also told us how they remained with one person's family following their death, providing reassurance and emotional support until healthcare professionals arrived.

Staff knew people well and understood what was important to them, enabling them to provide personalised and compassionate support during periods of change and increased vulnerability. This meant people and those important to them were supported sensitively during important life changes and received dignified care at the end of their lives.