Silverpoint Court Residential Care Home

Silverpoint Court is a residential care home providing personal care to up to 36 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 28 people using the service.

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

People were not protected from the risk of harm. People’s care plans and risk assessments were not accurate and daily care records did not evidence people received appropriate support with their healthcare needs.

People’s medicines were not always safely managed, and guidance was not always in place to ensure staff knew how to support people with their medicines. The provider’s fire safety documentation was not up to date and did not provide staff with clear guidance about how to support people safely.

The provider did not have robust processes in place to ensure accidents and incidents were documented appropriately and safeguarding notifications had not always been raised when necessary. Incidents had not been analysed to ensure lessons were learnt and improvements made.

The provider had not ensured staffing levels, or the deployment of staff across the service, adequately met people’s needs. We observed people waiting for prolonged periods for staff to support them.

The provider did not have oversight of the service and the systems in place to monitor the safety and quality of the care provided were not effective. Staff did not always feel listened to and people’s relatives did not always feel involved in the service or kept up to date about people’s care.

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 Good (published 02 May 2019).

Why we inspected

We received information of concern in relation to the management of risks to people’s health and safety and the provider’s processes for reporting safeguarding concerns. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Silverpoint Court residential care home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to people’s safety, staffing and the oversight of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

Staff knew people well and were kind and sensitive to their needs. They treated people with dignity and respect and promoted their independence. Positive relationships had been formed between staff and people using the service.

Staff were recruited safely. There were enough staff to meet people's needs and people told us when they needed assistance, staff responded promptly. Risk assessments were in place to manage potential risks within people's lives, whilst also promoting their independence. People’s medicines were managed safely. Incidents and accidents were investigated and actions taken to prevent recurrence. Effective infection control processes were in place.

People's needs were assessed prior to them moving into the service to help ensure they were cared for and supported effectively. Staff knew people’s care and support needs. They had received relevant training, support and supervision to enable them to effectively fulfil their roles and responsibilities. People were provided with a nutritious and varied diet and they were complimentary about the quality and choice of food offered. Staff worked well with external professionals to promote people’s health and wellbeing. People had access to social activities and events.

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

The culture of the service was person-centred. The registered manager was visible around the home and staff had a clear understanding of their roles and responsibilities. People were encouraged to express their views on the service they received and be involved in the running of the service. There were effective quality assurance systems in place to drive continuous improvement.

More information is in the detailed findings below.

Rating at last inspection: Good (report published 21 December 2016)

Why we inspected: This was a scheduled inspection based on the previous rating.

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

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

Silverpoint Court Residential Care Home is registered to provide accommodation with personal care for up to 36 older people, some of whom may be living with dementia related needs. There were 33 people receiving a service on the day of our inspection.

The service had a 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.

At our last inspection we found the service was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010; Regulation 13 Management of Staff and Regulation 23 Supporting Staff. During our inspection we found improvements had been made in these areas and in accordance with the new regulations.

People told us the service was a safe place to live. The registered provider’s recruitment procedures ensured that only suitable staff were employed. People were supported by staff that had the skills and experience needed to provide effective care and there were enough staff to help keep people safe, meet their needs and protect them from harm and abuse. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.

People’s capacity to consent had been assessed. The registered manager and staff demonstrated a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).

Staff knew people very well and were kind and sensitive to their needs and ensured their privacy and dignity was respected. People told us they were happy with the care and support they received. People’s nutritional needs were met and people were supported to maintain a healthy and balanced diet. People received support to access health care professionals and services when required.

Where possible people and their families were involved in the planning and review of their care and support; care plans were person centred and were regularly reviewed. Staff promoted people’s independence and encouraged people to do as much as possible for themselves. Staff shared information effectively which meant that any changes in people’s needs were responded to appropriately.

There were systems in place to regularly assess and monitor the quality of the service provided and people living and working in the service had the opportunity to say how they felt about the home and the service it provided. The registered manager was able to demonstrate how they measured and analysed the care and support provided to people, and how this ensured that the service was operating safely and was continually improving to meet people’s needs.

We found that the provider did not always document when someone lacked capacity and required decisions made for day to day activities, such as, being supported with taking medication.

We noted that the premises were free from unpleasant odours. Although there were some areas, such as trims on furniture, that were in need of repair or replacement these did not affect the safety of people using the premises.

People were protected against the risks of unsafe premises and equipment because the provider had systems in place to ensure the maintenance of both premises and equipment. We saw that the provider had a preventative maintenance plan, regular servicing contracts and responsive maintenance log for both moving and handling equipment, and premises systems, for example gas and electricity.

We saw that staff had been recruited using appropriate processes and checks such as interviews and uptake of references prior to a job offer. We found evidence that records relating to this; people's care; and other records relating to the running of the service were accurate and kept securely.

The relatives considered that the care delivered is excellent and they 'Cannot speak too highly of the carers'. They also said they, ''Liked the atmosphere in the home, we are always offered a drink, we have eaten here and the food is lovely'.

The staff we observed delivering care were kind and did not rush the people they were looking after. People who lived here had detailed risk assessments in place. Their care planning documentation is being updated to contain more detail and individual information.

Staff said they feel supported, they receive training and regular updates to deliver individual care to the people that live in this home.