Archived: Silverlake Care Office

Updated 24 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 7 December 2016 and was announced. The provider was given 24 hours' notice because the location provides a domiciliary care service and we needed to be sure someone would be available to meet with us. This inspection was carried out by one inspector. The inspector visited the office, visited people in their homes and spoke to staff. Follow up calls to people, relatives and staff were made.

The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed the information we held about the service. We looked at information received from relatives, social workers and commissioners and in the statutory notifications we had received during the previous 12 months. A statutory notification is information about important events which the provider is required to send to us by law.

Before the inspection, we sent surveys to people who used the service, relatives and friends of people who used the service, to obtain their views of the care and support. Surveys were returned from 18 people, three relatives, four staff and two community professionals. During our inspection visit, we spoke with the registered manager, the director of care, one member of staff, two people and one relative. Follow up calls were made to another five people and four members of staff. We also received feedback from a social work team and commissioner.

We reviewed two people's care plans and daily records, to see how their care and support was planned and delivered. We checked whether staff were recruited safely and trained to deliver care and support appropriate to each person's needs. We reviewed records of the checks the management team made to assure themselves people received a quality service.

Updated 24 January 2017

Silverlake Care delivers personal care to people in their own homes. At the time of our inspection, 23 people were receiving the service. The service predominantly supports older people and can support people with complex and specialist support needs.

We last inspected the service on 11 November 2013 where no concerns identified.

On the day of inspection we met the registered manager. 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.

People told us they felt safe with the staff that came to their home. Staff were trained in safeguarding and understood the signs of abuse and their responsibilities to keep people safe. Recruitment practices were followed that helped ensure only suitable staff were employed at the service.

Risks of harm to people were identified at the initial assessment of care and their care plans included the actions staff would take to minimise the risks. Staff understood people's needs and abilities because they had the opportunity to get to know people well through shadowing experienced staff during induction before working with them independently. Equipment used to support people was regularly tested to ensure it was safe to use.

People were supported by regular members of staff in a timely manner. Staff were trained in medicines management, to ensure they knew how to support people to take their medicines safely to keep accurate records.

Staff received the training and support they needed to meet people's needs effectively. Staff felt supported by management team and were encouraged to consider their own personal development.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding of MCA and DoLS. People made their own decisions about their care and support. When people lacked capacity the best interest process was followed.

People were supported to eat meals of their choice and staff understood the importance of people having sufficient nutrition and hydration. People were complimentary about the meals staff cooked. Staff referred people to healthcare professionals for advice and support when their health needs changed.

The service received compliments that highlighted the caring culture of the service. People and relatives praised staff for their caring nature and empathy. People told us staff were kind and respected their privacy, dignity and independence. Care staff were thoughtful and recognised and respected people's wishes and preferences.

People and relatives said that the service was responsive to their needs. The service assessed people’s needs so they received support when they needed it.

People received person centred care from a service that had a flexible approach and was responsive to unforeseen circumstances.

People knew how to complain and were confident any complaints would be listened to and action taken to resolve them. When areas of improvement were recognised plans were put in place to resolve them.

People and relatives agreed that the service was managed well. Management understood the service being provided. Staff and management talked about the open door policy which meant management team were approachable. The registered manager understood their responsibilities in terms of notifying CQC of significant events at the service.

The provider's quality monitoring system focused on the experience of people. It included asking people for their views about the quality of the service and field supervisions and observations. We found that there were no robust quality assurance systems to assess the quality of some work, such as reviewing the quality of daily records and auditing medicines. Due to staff knowledge the impact on people was minimal.