Silvermere 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 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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider carried out detailed and comprehensive assessments of people’s needs before they used the service, and people communicated with us that were involved in the assessment process. Staff told us they continually assessed people’s health and updated records to accurately reflect their needs. For example, where people had lost weight, where appropriate they would refer the person to the GP, increase the frequency of how often they were weighed and ensure the kitchen staff were providing fortified meals and drinks. Care plans were then updated to reflect this information.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People’s care plans were robust and included nationally recognised assessment tools, such as the Malnutrition Universal Screening Tool (MUST) to assess people’s nutritional needs, and ‘Waterlow’, to assess people’s skin integrity and reduce the risk of them developing pressure ulcers. Staff told us they sought and reviewed feedback from other health care professionals involved in people’s care to maximise the health and well-being of people using the service. Staff told us they continually assessed people’s health and updated records to accurately reflect their needs.

The provider did not always ensure temporary staff were provided appropriate information around people needs. However, they did work well across teams and services to support people. They shared their assessment of people’s needs when people moved between different services.

During lunch we found an agency member of staff was not aware of the dietary needs of people and often would not support people proactively until prompted by other staff. This meant people on 1 of the floors were left waiting for their meals to be provided. However, on the other floor staff worked well together to ensure a smooth dining experience.

Throughout the day we observed staff discussing discreetly what work needed to be completed and who needed support. One member of staff said, “Everyone here are kind and supportive. This includes the senior and management staff. We always help each other.”

People’s nutritional and hydration needs were assessed and planned for. Care plans were detailed with the support people needed, care was coordinated between professionals, and staff followed the advice and guidance given to keep people safe. Staff followed the recommendations of professionals who confirmed that the staff team worked closely with them to ensure that people’s health care and medical needs were optimised.

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.

We received positive comments from people and relatives around how people were supported with their health. One person told us, “The doctor comes in every week on a Wednesday and if we need to see him, we leave a note with the carer.” A relative told us, “They get GP when needed.” The relative said their family member had a health condition that predated them moving in and that they had been seen by specialist services.

Care records showed that a range of health care professionals were involved in the care and treatment of people, and staff made appropriate and timely referrals to relevant health care professionals when needed. People who had specific dietary needs, including pureed, vegetarian, and diabetic, received meals tailored to meet their needs and preferences. The chef told us they were aware of how to modify people’s meals. They said, “We are provided with all the training we need. The training is very good.” People’s dietary needs were displayed in the kitchen office on the wall. This showed each person’s likes/dislikes and required diets. Those on a modified diet were also shown in the kitchen on a separate board as a reminder. Where people require fortified foods, they use cream and butter to assist with this, for example using double cream in the mashed potato.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Care plans detailed the outcomes expected from the care and treatment delivered to people, and staff knew what those outcomes were. For example, 1 person was on insulin for their diabetes however, they had not been referred to the GP as staff believed this may no longer be necessary. One relative told us, “They rang a few weeks ago as he was having difficulty sleeping. I said ‘no’ to medication and explained this had happened before and it resolved itself. They agreed to observe for a few nights without medication, and it did settle.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People’s capacity to make specific decisions was assessed and documented in their care plans. Where people had been assessed as lacking capacity to make a specific decision, relatives and relevant health and social care professionals were involved in making a best interests’ decision on the person’s behalf, for example in relation to using sensor mats and living on a floor where doors were locked.

Staff had completed training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards and understood their responsibility to obtain consent from people in line with the MCA. People communicated their choices about day-to-day decisions such as how to spend their day, what to wear, and what they wanted to eat and drink.