Silloth Nursing and Residential Care Home

We found the following examples of good practice:

All staff and essential visitors used appropriate personal protective equipment (PPE).

The home had sufficient supplies of appropriate PPE which was stored hygienically and kept safe.

Staff were provided with separate areas to put on and take off and dispose of PPE safely.

Staff supported people's social and emotional wellbeing. Where people required additional support, they were referred to appropriate services.

The provider explained the quality systems they had in place to check the service was providing safe care.

Deep cleaning of all areas of the home was completed and recorded.

All staff, including catering and housekeeping staff had undertaken training in infection prevention and control. This included putting on and taking off PPE, hand hygiene and other Covid-19 related training.

The provider supported the well-being of their workforce. This included dedicated mental health support via a telephone service and helping with shopping, or other errands, if staff had become unwell and were unable to do so.

Further information is in the detailed findings below.

Silloth Nursing and Residential Care Home provides personal and nursing care to 37 older people, including some people who may require physical support. The service can accommodate up to 38 people.

The care home accommodates people across one adapted building at ground floor level.

People’s experience of using this service and what we found

Silloth Nursing and Residential Home provided people with an outstanding service. The home was recognised nationally as a beacon for end-of-life care in 2016 and was awarded the "National Gold Standard Framework (GSF) 'Beacon' Award - Winner." This accreditation was renewed in 2019 and they were awarded Platinum status. A relative commented, “The relentless commitment, love and care given to [Name] by everyone here is unequalled.”

People, relatives and healthcare professionals continued to describe the service as exceptional and extremely responsive to people's needs. A relative told us, “This is who they are at Silloth home both deeply professional and deeply personal. It’s an exceptional place for people, families and for staff.”

The service’s vision and values were person-centred to make sure people were at the heart of the service. Staff were enthusiastic and believed passionately in the ethos of the service. A relative told us, “[Name] has just come in, they’re now completely pain free for the first time, which is wonderful so much better.” This vision was driven by the exceptional leadership of the management team. A visiting professional commented, “Without exception, the care, compassion and professionalism provided by staff has been outstanding.”

People were extremely well-cared for, relaxed and comfortable. A person commented, “Home is best, but if you can’t be there this place is next best.” The service was very flexible and adapted to people's changing needs and wishes. A relative commented, “It’s marvellous here, I cannot describe to you how this place is a cut above the rest.”

The registered manager had ensured resources and skilled staff were available to support people and a number of staff were appointed as champions in certain subjects.

Staff consistently strived to ensure that people had the best possible care, and that they were supported in a compassionate, dignified and safe way. The management team had forged successful partnerships with an array of other stakeholders and aimed to provide an excellent care experience for people.

Records were extremely personalised, up-to-date and accurately reflected people's care and support needs. Care was completely tailored to each individual and risks were well-managed.

People, relatives and staff were confident about approaching the registered manager if they needed to. They recognised that their views and feedback were valued and respected and consistently used to support quality service development.

People and their relatives were involved and supported in decision making. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The management of medicines was safe and people received their medicines in a timely manner as prescribed. People received a healthy, well balanced and nutritious diet. They were provided with opportunities to follow their interests and hobbies. The home was part of the local community.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was outstanding (published 17 February 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Silloth Nursing & Residential Home is registered to provide nursing and personal care for up to 38 people some of whom may have a physical disability. There were 37 people in the home on the day of our visit. The home is on one level providing spacious accommodation and ample communal areas. All bedrooms are single with ensuite toilets and the home provides a range of equipment suitable to meet the needs of people living there. There is an interior courtyard with raised flowerbeds for residents and extensive views across the Solway towards Scotland.

There was a registered manager employed at the home. 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 and associated Regulations about how the service is run.

People who used the service and relatives we spoke with consistently highly praised the skills of staff working in the service. One person living in the home told us, “It's very reassuring that we have such good nurses here, they are always on hand to seek advice from. I get attention straight away.” A relative summed up the views we consistently gained from all the relatives we spoke to by saying, “It was a huge comfort to us knowing (relative) was being cared for at this home and we will be eternally grateful for this and the way they were looked after her in her final days, a rock of support every step of the way. This home makes a difference to people’s lives, they should never change.”

People received ongoing healthcare support from a range of external healthcare professionals and people’s health and nutrition were effectively monitored and responded to in line with nationally recognised practice. The registered manager took a pro-active approach to ensuring people who lived with a dementia related illness received care based on best practice.

The home was recognised nationally as a beacon for end of life care and was awarded the “National Gold Standard Framework (GSF) ‘Beacon’ Award - Winner” as the best nursing home in the country in November 2016 for end of life care as well as retaining this GSF Beacon status for the third year running. We received feedback from a relative who told us, “During the year that [relative] spent at the home [relative] received care that surpassed all of our expectations, especially during the last two months of her life. She received holistic care of the highest quality and her needs and choices were respected until her death. The staff also cared for us as a family, and fully involved us in our [relative]’s care.”

A healthcare professional told us, "My team have tremendous admiration and respect for the leadership and excellent standards shown by all the staff at Silloth Nursing home. Another professional said, "It is always a pleasure to visit Silloth Nursing Home because it proves to us there is good care out there, although we recognise that Silloth Nursing Home is a very rare gem."

People were supported with care and compassion and there was an ethos of care which was person-centred, valuing people as individuals. Without exception people who used the service, relatives and health professionals voiced that staff demonstrated exceptional kindness and compassion. Relatives told us, "I know my relative gets the very best care here. I'm 100% sure of that." We saw a relative had completed a recent survey and commented, ‘My [relative] is treated with respect and dignity, their needs are exceptionally well met and above all else they are safe and receive excellent medical attention."

We found that this home was particularly effective in delivering consistently high quality care because of the emphasis it placed on building a really strong staff development programme. The provider valued their staff and saw them as an asset when delivering high quality care to people. Staff received extensive training and support to meet people's needs effectively.

Staff were very highly motivated and proud of the service. There was an emphasis on developing staff potential within a positive learning environment to create a high quality service. Staff had regular opportunities to reflect on their practice and to request any additional support or training. Staff were 'champions' in specialist areas. Champions had received additional training and skills in their specific areas. Skills were then shared within the rest of the staff team to create more positive outcomes for people who used the service.

The service was thoroughly committed to ensuring good links with the community and placed a strong emphasis on enhancing people’s lives through the provision of meaningful, imaginative activities and opportunities.

People were at the centre of care planning. People told us that they were made to feel "in charge" and "in control" from the time they first made the decision to move into the home. The staff knew the people they were supporting really well and treated them in a respectful but friendly way. One person told us, “I get exceptionally good support from all the staff, from the matron right through to the cleaners and handyman. They help me lead my life exactly as I would wish it.”

People were safe because risks had been identified and managed. All the staff in the home had completed training to give them the skills and knowledge to carry out their roles and to ensure people in the home were safe. A relative said, "Words cannot say how excellent the care is. The staff team are amazing. Nothings too much trouble and I have total confidence that my relative gets the best treatment. The staff are so skilled and good at what they do.”

Systems were in place for the safe storage, administration and disposal of medicines. Records showed people received their medicines as prescribed and in their preferred manner.

There was a strong emphasis on supporting people to eat and drink well. Staff encouraged those people who were reluctant to eat with their nutritional intake. People were supported to eat a well-balanced diet and those who were at risk of malnutrition and/or dehydration had their food and fluid intake monitored. People told us of the high quality and range of the meals provided.

The service was managed by an experienced, knowledgeable and motivated registered manager and deputy who worked in partnership with other organisations to develop new and best practice. People received a high standard of care because staff were guided by an experienced and committed management team.

The staff team spoke positively about the support they received and were highly motivated and enthusiastic. They spoke about wanting to ensure people received a high standard of personalised care and spoke positively about the team work and support they got from each other to achieve this.

The provider had a range of quality monitoring systems and made improvements in response to people's feedback, the audits and in response to accidents and incidents. There was a strong commitment to deliver a high standard of personalised care and continued improvement based on the views of people who used the service and the enhancement of their lives. Complaints were taken seriously, thoroughly investigated and lessons learnt from them.

Comments included, 'It is great here. As soon as I walked in the door I knew this was the place for me' and 'The staff are so kind and encourage me to do as much as I can myself but they are there when I need help with my shower'.

We saw that people were able to join in sociable activities and go on outings if they wished. Staff were pleasant, polite and we saw that people who used the service were treated with respect and dignity.

We found that people's care and support needs had been assessed and kept under regular review to help ensure people received the care they needed. We saw that people had access to health and social care professionals when this was necessary.

There was sufficient staff on duty to provide appropriate care and support to ensure people were safe and as independent as possible.

We found that there had been no complaints made about this service either by people who lived there or by relatives. We contacted the local authority and they had not received any complaints or concerns.

We learned that people were fully aware of their options and choices in terms of the care and support provided. People told us that their consent was sought on a daily basis and that any care or nursing interventions were only done after their consent was given.

Everyone we spoke with had nothing but praise for the way the care was delivered:

"Care is exceptionally good...and is well organised, with good checks on my welfare."

The home was clean, bright and airy with all the resources necessary for a comfortable life for all the residents.

Staffing levels were good and this meant that the home was well organised and good care provided.

The home had received no complaints but people felt comfortable to complain about things if necessary. The home had suitable procedures in place to manage complaints promptly and appropriately.