We carried out a review of the data available to us about Silverdene Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Silverdene Residential Home, you can give feedback on this service.
Silverdene Residential Home is a residential care home for people with a learning disability, autistic people and / or a physical disability. Accommodation is provided in two neighbouring detached properties and a bungalow located in the grounds of the other homes. The properties consist of the original older residential premises, a small bungalow and a more modern building that was split into two distinct areas. Each building has its’ own kitchen, bathrooms and communal facilities. At the time of our inspection, 16 people were living at Silverdene. The home is registered to support up to 19 people.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of the safe, effective and well led key questions, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
The service was developed and designed prior to the introduction of Right support, right care, right culture and is larger than current best practice guidance. The size of the service having a negative impact on people’s lives was mitigated by the home having four distinct areas, each with their own staff team and facilities.
People were able to make their own choices, with support where needed. People received person-centred support and staff clearly explained how they promoted people’s dignity, privacy and independence.
Risks were assessed and guidelines were in place to manage these risks, including if people became agitated. Staff knew how to report any concerns and incidents. Staff had the training to carry out their roles and had been safely recruited. Staff said they felt well supported by their colleagues and the management team. Regular supervision and team meetings were held, and staff were able to raise any ideas or concerns they had.
Current government guidelines for infection control, the use of PPE, COVID-19 testing for staff and visitors and vaccination as a condition of employment were being followed.
People received their medicines as prescribed. Their nutritional and health needs were being met.
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 quality assurance system had been improved, with action plans in place for any issues identified through the regular audits. The providers senior management team and directors had greater oversight of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 27 November 2019) and there was one breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended that the quality assurance system was reviewed. At this inspection we found improvements had been made and the quality assurance systems were more robust.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 11 and 12 September 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the need for consent.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. 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 requires improvement to good. This is based on the findings at this inspection.
As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. We looked at infection prevention and control measures under the Safe key question. This included checking the provider was meeting COVID-19 vaccination requirements.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Silverdene Residential Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Silverdene Residential Home is a residential care home for people with a learning disability and/or autism or a physical disability. Accommodation is provided in two neighbouring detached properties and a bungalow located in the grounds of the other homes. The properties consisted of the original older residential premises, a small bungalow and a more modern building that was split into two distinct areas. Each area has its’ own kitchen, bathrooms and communal facilities.
The service was developed and designed prior to the introduction of Registering the Right Support and other best practice guidance. The service was a large home registered for the support of up to 19 people. Eighteen people were living at the home at the time of our inspection. The service is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the service not being clearly identifiable as a care home from outside the premises.
People’s experience of using this service and what we found
People told us they felt safe, and staff were aware of procedures to report any concerns about people’s safety or wellbeing they might have. However, some improvements were needed to ensure the service was consistently safe. Although a range of checks were carried out on staff before they were employed, the provider had not always clearly recorded how they made decisions to employ staff when these checks indicated information of potential concern. The service was visibly clean, but we found some issues such as an overflowing bin, and mould in one of the kitchens. The provider was aware of these issues and was taking action to put them right.
People were supported to have maximum choice and control of their lives and staff, in most cases, supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, we found the service had not carried out a capacity assessment or best interest decision in relation to a significant decision about one person’s care as was needed.
Staff assessed people’s needs in a wide range of areas and produced plans to guide staff how to meet these needs. People told us they liked the food and were encouraged to eat healthily. People told us they were supported to access healthcare services, and we saw a range of health and social care professionals had been involved in people’s care. The service was actively seeking ways to try and improve the consistency of support people received when moving between care settings, such as when they were admitted to hospital.
People received support from a consistent staff team who knew them well. People told us staff treated them with respect and were kind and caring. Staff supported people to build skills and promoted people’s independence. For example, they had supported people to access training enabling them to travel independently and to be involved in household tasks including cooking.
People told us they were involved in planning and reviewing their care. People’s preferences, likes, dislikes and interests were recorded in their care plans, and staff were aware of these. Staff supported people to engage in meaningful activity and occupation, which had had a positive impact on people’s wellbeing. This had included exploring work and volunteering opportunities for people and supporting people to take part in activities and interests. Staff supported people to maintain relationships with those important to them.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. 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. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Consistent staff teams worked in each part of the service to help ensure consistent, person-centred care was delivered.
Staff felt they worked well as a team and told us they got the support they needed. A range of audits and checks of the home were undertaken. Whilst these had identified some of the issues we found during the inspection, this had not included the shortfalls in relation to recruitment practices, nor the failure to follow proper processes when making decisions on behalf of a person who lacked capacity. The provider worked with other services and explored best practice guidance to help them identify how they could improve the service. People’s opinions about the service were sought and acted upon to improve quality. For example, the service had also explored ways of increasing the feedback they received from people and how they could better consult with people and their families. This had included holding a festival event and a coffee morning.
We have made a recommendation that the provider reviews their processes to check the quality and safety of the service.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 05 October 2018 and this is the first inspection.
The last rating for this service was good (published 03 July 2017). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection based on the time since the service was registered.
Enforcement
We have identified one breach in relation to the need for consent in accordance with the Mental Capacity Act.
Please see the action we have told the provider to take at the end of this report.
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. We will request an action plan from the provider to understand what they will do to meet the requirements of the regulation where we have found a breach.