What the CQC found at Silversprings

Medicines, including controlled drugs, were stored, given and disposed of safely. Staff were trained and checked as competent.

“People's prescribed medicines, including controlled drugs were stored, administered and disposed of safely and in accordance with relevant best practice guidance.” from the report

Staff understood how to recognise and report abuse. The manager had dealt with safeguarding concerns appropriately.

“Where safeguarding concerns had been raised, they had managed such incidents well.” from the report

The home was clean and well maintained, with systems to reduce infection risks. Fire safety checks and evacuation plans were also in place.

“The environment was clean; with no underlying unpleasant odours.” from the report

People were referred to health professionals when needed. Records showed access to dietitians, speech and language therapists, physiotherapists and specialist nurses.

“Records showed that people had access to various healthcare professionals such as dietician, speech and language therapists, physiotherapists, specialist nurses and diabetic clinics.” from the report

People, relatives and staff were involved in giving feedback and shaping the service. Complaints were investigated and answered within the expected timescale.

“These had been investigated and responded to appropriately within the expected timeframe and used to improve the service.” from the report

Although enough staff were employed overall, staffing was not arranged well enough at key times, particularly on Tenpenny unit. This affected people's support and safety.

“Although, there was adequate staff employed, the management team were not deploying staff effectively across the service to ensure people's needs were met at key times throughout the day.” from the report

Staff lacked confidence and knowledge in supporting people with dementia and high anxiety. Training had started, but inspectors did not see its learning consistently reflected in practice.

“Therefore, staff were not always providing care that was effective and person centred.” from the report

Mealtimes on Tenpenny unit were chaotic and stressful. Staff did not always have enough time to support people who needed help to eat, creating risks around nutrition and choking.

“People with advanced dementia were not sufficiently supported at mealtimes to ensure they ate enough and were protected from malnutrition, and risk of choking.” from the report

Staff discussed people's care needs in communal areas. Inspectors also found an example of bedding that had been soiled for several days.

“Staff had failed to recognise this did not respect people's privacy and dignity.” from the report

Care records did not give enough guidance about wellbeing, complex needs and meaningful activities. End of life plans generally contained little information about people's preferences.

“Care records did not contain enough information for staff around supporting people's wellbeing or complex, long term specific needs, such as dementia.” from the report

There were inconsistencies in recording best interest decisions. Some decisions about disguised medicines lacked evidence that other options had been tried, and some were made for people who had capacity to decide.

“Best interest decisions had been made for people who had the mental capacity to make decisions for themselves.” from the report