Handsale Limited - Silver Trees Also known as Laurel Court

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The overall rating for this key question has remained requires improvement. The previous breach of legal regulations had not been met although some improvements had been made. The provider’s governance arrangements were not always identifying shortfalls found during our inspection. This included medicines not stored safely and medicines administration records not completed on the morning of our inspection. Mental Capacity Assessments and Best Interest decisions needed to be completed for acoustic monitoring, fluid charts needed all entries completed, care plans lacked information around people’s re-positioning needs and risk assessments needed to be undertaken. People’s personal evacuation plans (PEEPs) lacked important information about the person’s mobility and equipment they used. The registered manager took actions to address most of these shortfalls although the provider’s governance arrangements should have identified these shortfalls. People and their families spoke positively about the care provided and the registered manager was accessible to people, staff and relatives. Positive feedback was provided from health and social care professionals. One professional told us, “I have found (the service) to be a friendly and a well-managed care home”. Staff felt supported by the management of the service and the registered manager spoke proudly of how diverse the staff team was. Staff were supported to achieve their full potential such as undertaking training and completing qualifications.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff felt it was a nice place to work and that management were supportive. One member of staff told us, “Management are very helpful”. The registered manager had an open-door policy and they held open sessions where staff, people and residents could discuss any concerns should they need to.

Staff were supported to attend various meetings such as clinical meetings, head of department meetings, staff meetings and the registered manager held open sessions where people, staff and relatives could raise any concerns with them. Records of these meetings confirmed discussions held and areas of improvement following incidents and safeguarding issues. Feedback from people and their relatives was shared in the entrance lobby of the care home.

The registered manager was supported by a team of senior staff as well as an area manager, a human resource manager and the nominated individual. Staff felt it was a nice place to work. They told us, “It’s good” and “It’s a good staff team to work within”. Visiting professionals felt the home was well managed and important issues were raised when needed.

The management team were accessible to staff, people and relatives. Recent changes to the management structure had been made to support staff with their training and well-being. The deputy manager and the registered manager both undertook shifts within the home. They felt this was a way they could ensure they were familiar with people and their individual needs and was also an opportunity to support staff should they need to.

Most staff felt able to raise any concerns with the management of the home. One member of staff felt able to raise any concerns in the staff meeting should they need to. They told us, “I could raise with them if needed. I could complain to the manager”. Another member of staff told us, “Management always asking if okay”. The registered manager was accessible to staff and they encouraged staff to speak directly with them should they need to. Staff were not familiar with the provider’s whistleblowing policy although the registered manager had discussed this within staff meetings.

The provider and the registered manager wanted an open culture within the service. The provider’s whistle-blowing policy had been discussed in staff meetings and the registered manager confirmed they held open door sessions where people, staff and relatives could raise any concerns with them. They confirmed the provider whistle-blowing policy was also accessible to staff within the staff room and communal areas of the home.

The registered manager spoke proudly of the staff who worked in the home and they encouraged a diverse work force with staff who had a range of back grounds, skills and experience. The management was supportive of overseas workers to work towards achieving their nursing qualifications and other social care qualifications. They told us they worked with the local college to provide students with experience of working in a social care setting.

The registered manager confirmed how they supported staff to achieve their full potential. They gave examples where staff had been supported with the flexibility to work whilst gaining qualifications which they had now achieved.

The registered manager, deputy and team leader were accessible to staff, people and relatives. Staff attended handover meetings and team meetings and there were also clinical meetings and head of house meetings. Staff, people and relatives felt able to raise concerns with the management of the service.

The provider had quality assurance systems which covered medicines, daily records and environmental aspects. Care plans were reviewed once a month. However, these quality assurance systems did not always identify shortfalls such as where risk assessments were needed due to the person having vulnerable skin and where the person was being re-positioned or where two people’s thickener was not stored safely. Medicines administration charts and fluid charts were not always accurate and up to date. Mental Capacity Assessments and Best Interest decisions were not in place for acoustic monitoring and people’s personal evacuation plans (PEEPS) did not contain important information about the person’s mobility and equipment they used. At our last inspection the provider had failed to ensure shortfalls were being identified. Although the registered manager took actions to address most of these shortfalls, the provider’s quality assurance system should have identified these shortfalls prior to our inspection. The registered manager was open about incidents and safeguarding investigations and outcomes. Statutory notifications were being submitted when required to CQC and the service was displaying the rating in the lobby on the notice board.

People accessed services such as hairdressing and podiatry. This supported and enhanced people’s well-being. People could participate in activities such as music and movement and dog therapy. People had visitors and how people wanted to spend their time was respected such as if they wanted to spend time in their room or in the communal areas of the home.

The management had good working relationships with health and social care professionals and people had referrals made when needed. Regular clinical meetings were an opportunity to review people’s individual needs.

Health and social care professionals shared positive feedback about the service. They said staff were knowledgeable about the residents. Staff knew important information and that they felt residents were happy and well cared for. They also felt that the home was well managed, and staff were friendly and important issues were raised when needed.

The management team worked in partnership with others. This included, St Peters hospice and food providers. There was a recent project where people had been supported to have their health and medicines reviewed. Where people could be supported to have their medicines reduced this was undertaken. The local brokerage team made referrals to the service. The service also had rehabilitation beds where people could be assessed prior to going home.

The service had a learning culture were the management and staff discussed incidents including any actions and learning. Staff meetings and supervisions were an opportunity to review any learning needs. Senior staff were responsible for monitoring daily records such as food and fluid charts, repositioning charts and person care records.

The registered manager and management team shared any lessons learned including best practice. The provider and registered manager sought feedback from people, staff and relatives through meetings, surveys and by providing feedback through the care home review scheme. External contractors undertook surveys and the registered manager confirmed these were shared with head office so any environmental work such as decorating, and furnishings could be agreed so actions could be taken.