CQC report explained · a residential care home
What the CQC found at Silverbirch Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and staff understood safeguarding, health risks, medicines and infection control. Risk assessments had been reviewed and updated regularly, which was an improvement from the previous inspection.
- Effective?
- Good
- Staff had training and understood consent and the Mental Capacity Act. People were supported with food, healthy lifestyles, healthcare appointments and advice from other professionals.
- Caring?
- Good
- People liked the staff and were treated with dignity and respect. Staff involved people in care planning, day-to-day choices and activities that helped maintain independence.
- Responsive?
- Good
- Care plans were reviewed and changed when people's needs changed. People were supported with activities, family relationships and complaints.
- Well-led?
- Good
- People and staff could approach the registered manager. Management checks covered medicines, accidents, incidents and care plans, and this was an improvement from the previous inspection.
What inspectors found, March 2018
Rated Good; inspectors found safe, kind and responsive care, with improvements since the previous inspection.
Inspectors visited the home without notice on 28 December 2017. They spoke with people, staff, family members and healthcare professionals. They reviewed care plans, daily records, medicines records, staff files and the home's checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People appeared comfortable with staff, were involved in decisions about their care and were supported with health needs, activities and family relationships.
The report says the home had improved in Safe and Well-led since July 2016, when both areas were rated Requires Improvement. Inspectors found that risks and care plans were now reviewed more regularly and that management checks had improved.
People felt safe
People appeared comfortable with staff, who understood how to protect them from harm and respond to health risks.
“People were comfortable and as ease around care staff that understood how to keep people safe.” from the report
Respect and choice
People were involved in their care and everyday decisions. Staff supported independence and treated people with dignity.
“People were involved in their care planning and made day to day decisions.” from the report
Activities and family contact
People took part in activities they enjoyed and were supported to maintain relationships with their families.
“People were supported to pursue hobbies and interests that were important to them.” from the report
Improved management checks
The home had introduced checks covering medicines, incidents and care plans. Inspectors judged the management systems to be Good after they had previously been Requires Improvement.
“The management team undertook regular checks of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How often will my relative's risk assessments and care plan be reviewed if their needs change?
- 02How will you support my relative's preferred hobbies, shopping trips, meals and other activities?
- 03How will you involve my relative and our family in decisions about care and health appointments?
- 04What checks do managers now carry out on medicines, accidents, incidents and care plans?
- 05What improvements have been made since the inspection on 28 December 2017?
This was an unannounced inspection covering all five CQC questions, including care records, medicines, staff recruitment, management checks and observations of care. This explanation was written from the published report of 6 March 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2016
Rated Requires Improvement; inspectors found kind, effective care but gaps in risk assessments and quality monitoring.
This was an unannounced inspection on 11 July 2016. Inspectors visited the home, observed care, spoke with people, relatives, staff and a healthcare professional, and checked care plans, medicines records, staff files and quality records.
People were generally seen as safe, well cared for and treated with dignity. Staff understood people's needs, medicines were given safely, staffing levels were sufficient, and people had their health, food and drink needs met. Relatives and people were positive about the care and staff.
The main problems were that risks linked to equipment and behaviour were not always fully assessed or clearly recorded. Activities were limited at times, and people were not regularly asked for their views. Quality checks had improved since the previous inspection, but some improvements had not lasted.
The overall rating was Requires Improvement. Safe and well-led were rated Requires Improvement, while effective, caring and responsive were rated Good. The previous inspection in July 2014 had also found a breach about monitoring quality and safety.
Kind and respectful care
Inspectors saw people being treated with dignity and respect. Staff knew people's preferences and supported their independence.
“Through our observations of staff interactions with people we saw that people were treated with dignity and respect.” from the report
Good knowledge of people
Many staff had worked with people for years and could understand non-verbal communication and changes in wellbeing.
“Many of the staff had worked with people for a number of years and understood people's communication needs well.” from the report
Healthcare support
The home worked with healthcare professionals and acted when people's health changed. Inspectors were given examples of people's health improving.
“Because of these links and the services proactive approach to healthcare people living at the home had benefitted from an improvement in their healthcare conditions.” from the report
Safe medicines and staffing
Medicines were stored and given safely, and there were enough suitably recruited staff to meet people's needs.
“There were sufficient, suitably recruited staff available to meet people's needs.” from the report
Incomplete risk assessments
seriousRisks linked to equipment such as bedrails and hoists had not always been fully assessed. Care plans also lacked enough detail about responding to behaviour that could lead to harm.
“Individual risks to people from equipment they used such as bedrails and hoists had not been fully risk assessed.” from the report
Limited activities
needs fixingPeople had some community opportunities, but there was no activity schedule and limited stimulation at home. Staff did not always use people's interests to plan individual activities.
“There were limited opportunities for people to undertake interesting or stimulating activities when they were at home.” from the report
Weak quality monitoring
needs fixingSome audits failed to identify missing risk assessments and outdated care plans. Improvements made after the previous inspection had not always continued.
“Some of the improvements initially made had not been sustained which meant people could not be confident that the quality of the service would be consistently monitored” from the report
People's views not regularly sought
needs fixingThe home had not regularly asked people for feedback about their care. Meetings and questionnaires had not taken place often enough.
“Meetings for people living at the service did not occur frequently and questionnaires to seek feedback from people had not occurred for some time.” from the report
Privacy of displayed information
minorPersonal information had been displayed where visitors might see it. The manager removed it when inspectors raised the issue.
“Although this information was important for staff to be informed of it had not been identified by the provider that it was not appropriate to have this information on display” from the report
- 01How have you completed and reviewed risk assessments for bedrails, hoists and other equipment?
- 02How do current behaviour plans give unfamiliar staff enough detail to provide safe and consistent support?
- 03What regular activities are now available at home and in the community, based on each person's interests?
- 04How do people who cannot communicate verbally give feedback and make choices, and what communication aids are available?
- 05How do you check that care plans stay up to date and that quality improvements continue over time?
This was an unannounced inspection covering all five rating areas and the overall quality and safety of the home; personal care in people's own homes was registered but was not being provided. This explanation was written from the published report of 4 November 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Silverbirch Home
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- March 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- June 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- June 2011
Registered with the Care Quality Commission on 20 June 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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