Inspection on 07/04/09 for Silverdale

This is the latest available inspection report for this service, carried out on 7th April 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Silverdale 26/01/06

Silverdale 31/08/05

Silverdale 24/02/05

Silverdale 18/08/04

Silverdale 01/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Key inspection report Care homes for older people Name: Address: Silverdale 20 Bents Avenue Bredbury Stockport Cheshire SK6 2LF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Steve Chick     Date: 0 7 0 4 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Silverdale 20 Bents Avenue Bredbury Stockport Cheshire SK6 2LF 01614305010 01614305019 silverdale@boroughcare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Borough Care Limited care home 47 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service only. Care home only - code PC, to people of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: - Old age not falling within any other category - Code OP. Dementia - Code DE (maximum number of places: 28). Mental disorder, excluding learning disability or dementia over 65 years Code MD (E) (maximum number of places: 4) The maximum number of people who can be accommodated is: 47 Date of last inspection Brief description of the care home Silverdale is a purpose built residential care home that is registered to provide care for up to 47 older people over the age of 65 years, including 28 people who have a diagnosis of dementia and four people with a diagnosis of mental disorder. Silverdale Care Homes for Older People Page 4 of 26 Over 65 28 4 47 0 0 0 Brief description of the care home provides permanent residential care services and day care services. The home is one of 12 homes owned by Borough Care Limited. The registered manager is a Mrs Maureen Hayes who has been in post since 1st April 2005. Accommodation comprises of 47 single bedrooms, 19 of which have en-suite facilities. The home is divided into four units; each has its own lounge, dining room and kitchen area. Several smaller seating areas are situated around the home and provide quiet private areas for people living at the home and their visitors. Day care facilities are available for up to five people each day, Monday to Sunday. Day care service users have their own lounge and dining room facilities on the ground floor of the home. The building is suitable for people using wheelchairs and has a passenger lift to access the first floor. There is a good-sized garden area with a pond and patio areas for peoples use. Silverdale is situated in the Bredbury area of Stockport, close to the motorway network. Public transport is easily accessible. There are a number of shops, post office, chemist and churches all within walking distance. Fees for accommodation and care at the home, as at April 2009 varied between 355 and 430 pounds per week. A service user guide and a copy of the latest inspection report are displayed in the reception area of the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. We (the Care Quality Commission) undertook a key inspection, which included an unannounced visit to the home. This meant that no one at Silverdale knew that the visit was going to take place. For the purpose of this inspection four service users were interviewed without any staff present, as were two people visiting service users. Additionally discussions took place with the manager and four staff members were interviewed in private. We also looked at information we have about how the service has managed any complaints, what the service has told us about things that have happened in the service, these are called notifications, and any relevant information from other Care Homes for Older People Page 6 of 26 organisations. Before the site visit, we asked for surveys to be sent out to some staff, asking what they thought about the care at the home. Six staff returned their surveys to us. Some of the information from these surveys is included in the report. We also asked the management of the home to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA). This is a legal requirement. The AQAA told us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, some of these comments have been included in the report. Information in the AQAA gave good evidence that the manager was continually looking at ways to improve the service for the benefit of the residents. We undertook a tour of the building and looked at a selection of service users and staff records as well as other documentation, including staff rotas, medication records and the complaints log. There had been no safeguarding issues or complaints of which we were aware since the last inspection. In May 2008 we undertook an annual service review of Silverdale. This did not involve a visit to the service, but was a summary of new information we had received since the previous key inspection. This did not cause us to change our view of the home nor to change our inspection plan. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 26 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are only admitted to the home after an appropriate assessment to ensure the home can meet their needs. Evidence: The manager told us in the AQAA, that they ensured that all residents were assessed before entering the home and that prospective service users were encouraged to visit Silverdale before making a decision to move in. We looked at a selection of service users files. All had a written copy of an assessment which had been undertaken before the service user first moved to Silverdale. There was documentary evidence of social work assessments as well as Silverdales own assessment. One service user who had only been living in the home for a few months confirmed that their needs had been assessed and that family members had visited Silverdale on Care Homes for Older People Page 11 of 26 Evidence: her behalf. Silverdale does not offer intermediate care. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health, personal and social care needs are met by the consistent implementation of policies and procedures. Staff practices also serve to promote the dignity of the service users. Evidence: We looked at a sample of service users files. All had a written copy of a plan of care which addressed individuals care needs. There was documentary evidence that service users were involved in the care planning process. Service users and visitors who were asked, confirmed that they could influence the way in which care was provided. One visitor confirmed that they were involved in the annual review of their relatives care and that they were confident they could meet, more often if necessary. Visitors described good communication with staff at the home. One person told us that among the best things was the fact that they felt they had a positive relationship with Silverdale. Staff who were asked, told us that they were confident that the combination of the Care Homes for Older People Page 13 of 26 Evidence: written care plans and daily records, the verbal handover at each shift change and their personal knowledge of each service user meant they were kept up to date about the changing needs of each individual living at Silverdale. Staff who returned a survey to us all said that they had up-to-date information regarding service users. They also told us that passing information worked well, either always (2) or usually (3). Service users who we spoke to, were all positive about the way in which their care needs were being met. One service user described as one of the best things about living at Silverdale as feeling I can call on people if Im not well. Another service user said the carers really care, they do very well for us, ... [I] couldnt give it a better name. There was good documentary evidence that service users had access to the full range of medical services available in the community. The manager had told us in the AQAA that there was a good relationship with all other visiting professionals including dentists, opticians and district nurses. All service users, visitors and staff who we asked, told us they were confident that medical support was obtained, when necessary, and in a timely manner. One example was seen where records indicated that a service user who was being weighed regularly demonstrated significant fluctuations in their weight. Discussion with the manager indicated that this had been looked into and was understood to be a problem with the scales rather than the health of the service user, although they acknowledged that this was not effectively recorded. Medication presented as being appropriately and securely stored. A small sample of the medication administration records was looked at. They all presented as being appropriately maintained to demonstrate that service users were receiving the correct dose of medication at the correct time. The manager told us that, subject to a risk assessment, service users could administer their own medication and that this was monitored on a weekly basis to ensure safety. All service users who we asked, reported positively on the way in which their privacy and dignity were maintained. Service users confirmed that they could lock their bedroom door and that staff always knock on doors and wait for a response. One service user commented that staff treat it like my home. Observation of staff and service user interactions indicated a relaxed but professional approach. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An appropriate range of activities was available for service users, and visitors are welcome in the home, which enhances service users fulfilment and social stimulation. The provision of food to maintain service users health and well-being is good. Evidence: During the tour of the building a clear list of planned activities was seen to be publicised on the noticeboard. We talked with the activities coordinator who was able to provide evidence of a range of activities which service users could participate in if they wished. The activities coordinator also saw her role as involving a wide range of service users and made a special effort in connection with birthday parties, anniversaries and traditional festivals such as St Patricks day and pancake day. Service users and visitors who we asked, confirmed that there was a range of activities available. Not all service users wished to take part in communal activities. One service user told us that amongst other things they liked about living at Silverdale was the fact that I can sit in my room and do what I like . Visitors told us they were able to visit at any reasonable time and were always made to feel welcome by the friendly staff. One visitor told us that he had been told by staff Care Homes for Older People Page 15 of 26 Evidence: to treat his visits as though he was visiting his mother at her home. Service users told us that they were free to get up and go to bed when they chose. They also said they could spend time in their room or in the communal areas. One service user confirmed that they could have their meals in their bedroom if they wished. Service users who we asked, were all positive about the provision of food. One person described the food as second to none. Service users confirmed that there was a choice of menu and one service user said that if you dont like either they will always do something else. During this unannounced visit a meal was sampled which was very tasty. The meal tables were laid with cruet and drinks and one service user was observed being assisted by a member of staff very appropriately, during a calm and pleasant mealtime. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected from abuse and exploitation by the homes policies and practices and are confident that any complaints they may have would be dealt with appropriately. Evidence: Silverdale has a written complaints procedure which has been found to be appropriate on previous inspections and was not looked at again on this occasion. All service users, visitors and staff who we talked to were confident that any complaints would be listened to and responded to appropriately by the management team at the home. One service user said they listen to anything you tell them and they do everything possible. All staff who returned a questionnaire to us told us that they knew what to do in the event of any concerns being expressed to them. We looked at the complaints log which presented as an appropriate record which demonstrated how any complaint had been investigated, and the outcome. The manager told us in the AQAA that all new staff received some training in connection with the protection of vulnerable adults on their induction. Staff who we talked to confirmed they had received training around the protection of vulnerable adults and demonstrated an understanding of the need to maintain vigilance and if necessary to whistle blow. All service users who we spoke to told us that they felt safe Care Homes for Older People Page 17 of 26 Evidence: at Silverdale. One service user said that amongst the best things about living at Silverdale was [I] cant feel more at home, comfortable with staff. We were not aware of any complaints or allegations made in connection with Silverdale since the previous inspection. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Evidence: Before the inspection visit the manager had told us in the AQAA that 35 staff had received training in the prevention and control of infection. This should help to ensure that staff practices lead to service users living in a pleasant and hygienic environment. At this unannounced visit, a tour of the building was undertaken which included communal areas and a selection of service users bedrooms. Communal areas included a designated smoking room and a pleasant garden area. Bedrooms appeared to be personalised to meet the individual taste of the person whose room it was. There was prominent signage to identify toilets and bathrooms, which would help to promote the independence of some service users. Several bedrooms had memory boxes next to the corridor side of the bedroom door. These contained photographs and other memorabilia to assist individual service users to recognise their own rooms. The home presented as clean and tidy with no unpleasant odours. All service users, visitors and staff who we asked, told us that this was the normal state of the building. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skills mix of staff on duty promotes the independence and well being of service users. Recruitment and vetting procedures are generally effectively applied to minimise the risk to service users of inappropriate staff being employed. Evidence: The manager told us that the usual staffing arrangements were six carers and one care supervisor between 08:00 -- 22:00 and three carers between 22:00 -- 08:00. We were given a copy of the staff rota for the week ending 01/04/09 to verify this. Staff who returned a survey to us said that there were enough staff on duty either always (1) or usually (5). The manager told us in the AQAA that 25 of the 33 staff held NVQ II (National Vocational Qualification) or above. The NVQ is a nationally recognised qualification which is intended to provide people with the skills and experience to improve the way in which they offer care. During the visit the manager confirmed these figures and told us that five staff held NVQ III. Certificates to verify this were not available to be looked at, at the home, as they were held at the companys headquarters. The manager told us in the AQAA that all staff have a four-day induction period at head office and that all senior staff were accredited trainers in moving and handling. Staff who we spoke to confirmed that the management team at Silverdale encouraged Care Homes for Older People Page 20 of 26 Evidence: staff to attend a range of training courses. Staff also told us that individuals supervision sessions were used to ensure that staff were up to date with basic mandatory training, including first aid, fire awareness, POVA and moving and handling. All staff who returned a survey to us said that they had received relevant training. We looked at a selection of records relating to the recruitment and vetting of staff. These gave good evidence that appropriate references and CRB (criminal record bureau) disclosures were obtained before a successful applicant started work. However, not all application forms gave a full employment history. Examples were seen where there was a gap in a persons employment history without a corresponding written explanation of the reasons for that gap. This level of detail is important to ensure that all reasonable steps are taken to minimise the chance of employing people who are unsuitable to work with vulnerable service users. We spoke with one service user who told us that they had been involved on an interview panel to assess an internal staff promotion and that they believed their views had been taken into account. This level of involvement of service users in the running of the home is very positive. All service users and visitors who we spoke to were positive about the staff teams competency and approach. One service user said Im delighted with people here, another said the staff were nice, [with a] respectful approach and a third described the staff as very friendly and helpful. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is competent to run the home, use the quality audit systems and implement the health and safety procedures for the benefit of service users and staff. Evidence: The manager has been found to have the appropriate qualifications and experience at previous inspection visits and this was not reassessed on this occasion. Staff who we spoke to told us that the management team were approachable and supportive. The manager provided us with a comprehensive quality report for the year 2007 -2008. This included an action plan, although it was not clear to what extent the outcome of the quality assurance process was shared with service users. We looked at a selection of records relating to money held by Silverdale on behalf of service users. These records presented as being appropriately maintained, including receipts being kept for purchases made on behalf of any service user. We asked one visitor if they were confident about the way in which the home looked after their Care Homes for Older People Page 22 of 26 Evidence: relatives spending money. They told us they were confident that the procedures were appropriately applied and that they didnt need to give the issue a second thought. The manager had told us in the AQAA that equipment in the home was regularly serviced and tested. We looked at a small sample of records to confirm this, including lift and hoists service records and fire protection and alarm records. These presented as being appropriately maintained. Staff who we spoke to, told us that personal protective equipment, such as disposable gloves and aprons, were always available for use to minimise the risk of cross infection. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Records which may indicate a health problem for a service user should clarify what actions have been taken to ensure the health and well-being of the service user is maintained. The manager should ensure that a record is kept of the reason for any gaps in the employment history of any staff member. This is so that the manager can demonstrate that all reasonable steps had been made to minimise the risk to service users of inappropriate staff being employed. The manager should ensure that the findings from any quality assurance process which involves seeking the views of service users are shared with service users, to demonstrate how their views influence service provision. 2 29 3 33 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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