Background to this inspection
Updated
16 May 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 23 March 2017 and was unannounced. The inspection team consisted of two adult social care inspectors.
We spent time speaking to people who lived at the home and observing care practice. We looked at three people’s care records in detail, medication records and other records relating to the management of the service including staff recruitment and training records and policies and procedures. We looked around the home including some people’s bedrooms.
We spoke with five people who lived at the home, the registered manager, four members of care staff, a member of the management team, a person visiting their relative and a visiting district nurse.
As part of our inspection planning we reviewed the information we held about the home. This included information from the provider, notifications and contacting relevant local authorities. The provider had completed a PIR and returned it to us within timescales. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
Updated
16 May 2017
The inspection took place on 23 March 2017 and was unannounced.
Silver Birches residential home is registered with the Care Quality Commission to provide accommodation and to support people with their personal care. The home is registered to support up to ten people. There were eight people living at the home at the time of the inspection.
There was a registered manager in position. This person had previously been deputy manager at Silver Birches residential home and had achieved registered manager status since the last inspection. 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 in January 2016 we found breaches of regulations in relation safety and good governance. On this inspection we found actions had been taken to achieve compliance in these areas.
People living at the service told us they felt safe and staff we spoke with confirmed this. Staff had received safeguarding training and although unsure about what might constitute abuse, told us they would report concerns they had to the registered manager.
Some improvements had been made in the way medicines were managed and we found systems for receipt, storage and administration of medicines were safe.
Accidents and incidents were documented and the registered manager was working on developing an accident analysis matrix to help identify trends and reduce the risk of recurrence.
Risk assessments and personal emergency evacuation plans were in place but were not always a true reflection of people’s circumstances.
The premises were clean, well maintained and appropriate safety checks were in place.
Effective recruitment processes were in place and staff training was up to date. Staffing arrangements needed to be kept under review, particularly in view of the recent changes in staff and current vacancies. Regular staff supervisions had taken place and the registered manager had introduced a programme for annual appraisals.
People were supported to have choice and control of their lives. However it was not clear how people’s consent was obtained in relation to care planning and sharing information with relatives.
Some people had experienced weight loss and we could not be assured systems were in place to make sure people received the diet they needed.
People had access to health care professionals as they needed.
Staff respected people and their belongings. We saw a number of caring interactions between staff and people who lived at the home. People demonstrated fondness towards staff.
Person centred care plans were in place; however staff did not routinely look at these.
People had access to activities, reading materials and music of their choice.
A complaints procedure was in place but this needed updating to reflect current management arrangements.
People had confidence in the registered manager. At the time of our visit the registered manager was having to cover staff vacancies and therefore did not have the time they needed to dedicate to managerial duties. They were confident this situation would be resolved as more staff were appointed.
Some auditing of the quality of the service was being done. However there was a lack of overview at provider level.
We found the provider was in breach of regulation 14 in relation to meeting nutritional and hydration needs.
You can see what action we told the provider to take at the back of the full version of the report.