CQC report explained · a residential care home
What the CQC found at Silverdene Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found risks were assessed, staff were trained, medicines were generally given as prescribed, and infection control measures were in place. They found that topical creams and thickener were not always recorded, but the recording system was changed during the inspection.
- Effective?
- Good
- The home was working within the principles of the Mental Capacity Act. People had support with choices, nutrition, healthcare and staff training, and the previous breach about consent had been resolved.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Good
- Inspectors found stronger quality checks, action plans for problems and greater oversight from senior management. Staff said managers were visible, approachable and supportive.
What inspectors found, February 2022
Rated Good; inspectors found safe, kind and well-managed care, with some records and shared-space issues to keep under review.
This was an unannounced focused inspection on 12 January 2022, with 24 hours' notice because of COVID-19 concerns. The inspector spoke with people and staff, observed care, checked care and medicines records, and contacted relatives and professionals.
The home was rated Good overall and was rated Good for Safe, Effective and Well-led. Inspectors found enough trained staff, safe recruitment, support with medicines, food and healthcare, and systems that had improved since the previous inspection.
There were some shortfalls. Staff did not always record topical creams or thickener in drinks, although the electronic care system was changed during the inspection. The report also noted limited shared space in one part of the home and that relatives were not always told about health changes straight away.
This was a focused inspection. Caring and Responsive were not examined during this visit, so their previous ratings were carried forward into the overall rating.
Enough trained staff
Inspectors found enough staff to meet people's needs. Staff had completed relevant training and pre-employment checks were completed before they started.
“There were enough staff on duty to meet people's needs.” from the report
Support with choices
People were supported to make everyday choices, with capacity assessments and best-interest decisions used where needed.
“Silverdene was working within the principles of the MCA.” from the report
Health and nutrition
People's eating, drinking and health needs were monitored. The home worked with a range of health and care professionals.
“People were supported to maintain their health and wellbeing.” from the report
Improved management checks
The provider had introduced a more structured system for checking quality, with named people responsible for audits and action plans for issues.
“The provider had introduced an improved quality assurance system.” from the report
Infection control
The recent COVID-19 outbreak was managed effectively, with testing, protective equipment and separation of staff teams.
“A recent COVID-19 outbreak had been effectively managed.” from the report
Medicine records
needs fixingStaff did not always record when they applied creams. Thickener was also recorded only four times a day even though some people had thickened drinks more often.
“Care staff did not always record when they applied topical creams.” from the report
Keeping relatives informed
minorRelatives generally felt informed, but said they were not always told about changes to their relative's health straight away.
“On the whole they keep me informed about any appointments, even if not always about changes.” from the report
- 01How do you now check that staff record every topical cream and every drink containing thickener?
- 02What changes were made to the electronic care planning system, and how do you know staff are using them consistently?
- 03How would you support my relative if they became anxious in the area with limited communal space?
- 04How will you tell me promptly about changes in my relative's health or treatment?
- 05What were the previous ratings for Caring and Responsive, which were not inspected during this visit?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 3 February 2022 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 2019
Rated Requires Improvement; inspectors found kind, person-centred care, but weaknesses in consent, recruitment, medicines and quality checks.
Inspectors visited without warning on 11 and 12 September 2019. They spoke with people living at the home, a relative and staff. They reviewed care plans, medicine records, staff files, training records and quality checks.
People generally felt safe and said staff were kind, respectful and knew them well. The home supported people to build independence, take part in activities and maintain relationships. However, inspectors found gaps in recruitment records, medicines management, some cleaning arrangements and risk records.
The home did not properly record a capacity assessment and best-interest decision for one person who was given medicines without their knowledge. This was a breach of Regulation 11. The overall rating was Requires Improvement, with Safe, Effective and Well-led also rated Requires Improvement. Caring and Responsive were rated Good.
Kind and respectful staff
People said staff treated them with kindness and respect. Staff knew people well and supported their privacy and dignity.
“People told us the staff were kind and respectful towards them.” from the report
Building independence
Staff helped people develop communication, travel and daily living skills. Some people were supported towards more independent living.
“The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.” from the report
Person-centred care
Care plans included people's routines, interests, likes, dislikes and social history. People were involved in reviewing their care.
“Care plans were person centred and detailed people's preferred routines.” from the report
Activities and relationships
People took part in activities at home and in the community. Staff also helped people keep in contact with family and friends, including during hospital stays.
“People were supported to take part in hobbies and interests.” from the report
Consent and covert medicines
seriousOne person was given medicines without their knowledge, but there was no recorded capacity assessment or best-interest decision. This breached Regulation 11.
“One person was given medicines covertly (without their knowledge) and there was no recorded mental capacity assessment, nor was there a best-interest decision in relation to this arrangement.” from the report
Recruitment records
seriousThe home could not show that it had recorded its decisions after concerning information appeared in two criminal record checks. One employment history was also incomplete.
“Two staff members' criminal record checks we reviewed highlighted information of concern.” from the report
Medicine management
needs fixingInspectors found unsecured thickening agents, no temperature monitoring for some medicines and missing instructions for some as-needed pain relief. The provider took some immediate action.
“However, we found thickening agents that are used to thicken some people's food and drinks were not kept securely in one part of the home.” from the report
Cleaning and infection control
needs fixingMost of the home was clean, but inspectors found mould in a kitchenette and an overflowing bin. The provider said it was addressing these issues.
“One kitchenette had mould visible on the walls and ceiling.” from the report
Quality checks
needs fixingAudits had found some problems but had missed the recruitment, medicines and consent shortfalls. CQC recommended that the provider review how it checks quality and safety.
“We recommend the provider reviews their processes for assessing and assuring the quality and safety of the service.” from the report
- 01What action have you taken to ensure every person receiving medicines covertly has a recorded capacity assessment and best-interest decision?
- 02How do you now record and risk-assess decisions to employ staff when criminal record checks contain information of concern?
- 03How are medicine storage temperatures checked, and where are thickening agents kept now?
- 04What new checks confirm that care plans and risk assessments, including bed-rail and pressure-ulcer risks, are complete and accurate?
- 05How do you check that your audits identify problems in recruitment, medicines management and consent before CQC finds them?
This was an unannounced planned inspection of the newly registered care home covering all five CQC questions; it was the first inspection under the new legal entity, although the previous rating was Good. This explanation was written from the published report of 27 November 2019 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 Silverdene Residential Home
2 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- February 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- October 2018
Registered with the Care Quality Commission on 5 October 2018.
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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