Archived: Silverlake Care Office

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.

We looked at two care plans held in the office and talked with the registered manager and one of the directors. We also spoke with three other members of staff, five people who used the service or their family members. All people were positive about the service they received. One person told us 'The staff are lovely they are so good.' Another told us 'The carers always arrive with a smile on their face it cheers your day.'

Care plans and risk assessments were in place and the registered manager, or one of the directors from the office, carried out the assessments prior to delivering care. Staff confirmed they looked at each person's folder in order to carry out the correct care for people.

Staff told us they had received safeguarding vulnerable adults training. They were able to tell us the types of abuse they may see and knew how to report any incidents.

We saw that the manager had carried out appropriate checks when employing new staff. This ensured staff were of good character and had the necessary skills and experience to do the job.

The manager told us the agency was a new service so they constantly monitored their quality provision.