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Care Home: Silverleigh Cedars

  • Silver Street Axminster Devon EX13 5AF
  • Tel: 0129732611
  • Fax: 0129732559

Silverleigh Cedars is a large, detached, converted and extended property set in its own grounds in the centre of the town of Axminster. The home is laid out in two separate areas - one side is known as Silverleigh and the other side is known as Cedars. Accommodation and personal care is provided for up to 54 older people who may also have a physical disability, mental disorder or a dementia type illness. 540 0 0 0 There are five lounges and two dining rooms plus other smaller sitting areas around the home. There are 36 single bedrooms, 5 double rooms and 4 apartments each consisting of an entrance hall, living room, kitchenette, bedroom and bathroom. 30 of the bedrooms have an en suite W.C. There are bedrooms on the ground, first and second floors. Passenger lifts provide access to all levels. There is also a stair lift. Outside, there are pleasant and interesting gardens with plenty of seating, and a private parking area. Fees for the home are £845- £879 each week and include activity sessions, outings and one monthly hair appointment. They do not include personal toiletries, newspapers or transport to appointments. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at www.oft.gov.uk. A copy of the inspection report for the home is available in a folder in the main reception area.

  • Latitude: 50.779998779297
    Longitude: -3
  • Manager: Mrs Sarah Jennings
  • Price p/w: £862
  • UK
  • Total Capacity: 54
  • Type: Care home only
  • Provider: Silverleigh Limited
  • Ownership: Private
  • Care Home ID: 13981
Residents Needs:
Dementia, Old age, not falling within any other category, Physical disability, mental health, excluding learning disability or dementia

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Silverleigh Cedars.

Key inspection report Care homes for older people Name: Address: Silverleigh Cedars Silver Street Axminster Devon EX13 5AF     The quality rating for this care home is:   three star excellent 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: Sue Dewis     Date: 3 1 0 3 2 0 1 0 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 28 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Silverleigh Cedars Silver Street Axminster Devon EX13 5AF 0129732611 0129732559 silverleigh@cannoncarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Silverleigh Limited Name of registered manager (if applicable) Mrs Sarah Jennings Type of registration: Number of places registered: care home 54 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 physical disability Additional conditions: One person under the age of 65 years may be admitted to the home. Date of last inspection Brief description of the care home Silverleigh Cedars is a large, detached, converted and extended property set in its own grounds in the centre of the town of Axminster. The home is laid out in two separate areas - one side is known as Silverleigh and the other side is known as Cedars. Accommodation and personal care is provided for up to 54 older people who may also have a physical disability, mental disorder or a dementia type illness. Care Homes for Older People Page 4 of 28 Over 65 54 54 54 54 0 0 0 0 Brief description of the care home There are five lounges and two dining rooms plus other smaller sitting areas around the home. There are 36 single bedrooms, 5 double rooms and 4 apartments each consisting of an entrance hall, living room, kitchenette, bedroom and bathroom. 30 of the bedrooms have an en suite W.C. There are bedrooms on the ground, first and second floors. Passenger lifts provide access to all levels. There is also a stair lift. Outside, there are pleasant and interesting gardens with plenty of seating, and a private parking area. Fees for the home are £845- £879 each week and include activity sessions, outings and one monthly hair appointment. They do not include personal toiletries, newspapers or transport to appointments. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at www.oft.gov.uk. A copy of the inspection report for the home is available in a folder in the main reception area. Care Homes for Older People Page 5 of 28 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: three star excellent 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: This unannounced visit took place over 9 hours, one day at the end of March 2010, as part of our usual inspection programme. This was our first visit to the home since a change in the Responsible Individual and Registered Manager for the home. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us how the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. Although only one inspector undertook this inspection, throughout the report there will be reference to what we found and what we were told. This is because the report is written on behalf of the Care Quality Commission (CQC). Care Homes for Older People Page 6 of 28 During the inspection 3 people were case tracked. This involves looking at peoples individual plans of care, and, where possible speaking with the person and staff who care for them. This enables the Commission to better understand the experience of everyone living at the home. As part of the inspection process CQC likes to ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to some people living at the home, some healthcare professionals and some staff. At the time of writing the report, responses had been received from 9 people living at the home, all of which had been completed with help from relatives or staff at the home, 5 GPs and 8 staff. Their comments and views have been included in this report and helped us to make a judgement about the service provided. During the inspection 3 people living at the home were spoken with individually and several more in a group setting, 3 staff, 1 relative, the RI (Responsible Individual) and the manager. Some people living at the home have limited verbal communication skills, and as we are not skilled in their other methods of communication it was difficult for us to have any meaningful communication with these people. However, the interaction between the people living at the home and those who care for them was closely observed. A tour of the communal areas of the building was made and a sample of records was looked at, including medications, care plans and staff files. All key standards were inspected. This report is based on a sample of the evidence available during our inspection process. It does not provide a comprehensive risk assessment of the home. Registered persons are reminded that it is their responsibility to assess and manage risks in accordance with the Care Homes Regulations 2001 ( Health and Social Care Act 2008 (Regulated Activities) Regulations 2009) and other relevant legislation. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: No requirements were made at this visit, but there is a recommendation that care plans provide more evidence to show where identified needs have been met and any action taken to address concerns that have been highlighted. There are also recommendations made that the home ensures everyone has access to a call bell when in a communal area and to review staffing levels due to the contradictory comments Care Homes for Older People Page 8 of 28 we received during the visit and on comment cards. 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. 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 28 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 28 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. The admission procedure ensures that there is a proper assessment prior to people moving into the home, and that they can be assured that their care needs can be met. Evidence: The home usually updates their Statement of Purpose every six months. A copy of this, plus the most recent inspection report, is kept in a folder in the entrance hallway. The homes brochure and website have been updated to include recent photographs. The manager told us that usually the initial enquiry about vacancies came from the family or friends of the person thinking of moving into the home. The manager also outlined the homes pre-admission procedure which included inviting the individual to look around the home and visiting them to carry out an assessment of their needs. The assessment covers all relevant aspects of personal and health and social care needs. The individual may also be offered a short stay at the home before making a decision to move in permanently. The manager told us that a long time is spent on the Care Homes for Older People Page 11 of 28 Evidence: pre-admission process to ensure the home can meet the persons needs and expectations. People and their representatives who were spoken with said that they felt they had made the right decision about moving into the home, and that all their needs were well met. We looked at three files and 2 contained detailed pre-admission assessments. The third file did not contain such a detailed assessment, but the individual had been admitted many years previously. The home also writes to each individual to confirm that their assessed needs can be met. The home does not provide intermediate care. Care Homes for Older People Page 12 of 28 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. Everyone who lives at the home has a care plan which provides staff with information to enable them to meet peoples health and personal care needs on a day to day basis. The management of medication is good and helps ensure people are protected from the risk of not receiving their prescribed medication. Evidence: We looked at the care files for three people living in the home. The manager told us that some changes were going to be made to the current system to emphasise what people can do rather than what they cant. The care files are comprehensive and are divided into two parts - one part covers the health and personal care needs of each person and the other part covers their daily life and social care needs. The files also contain detailed risk assessments covering a range of topics including falls, moving and handling and bed rails. However, while there was a risk assessment on the use of bed rails, there was no evidence that a risk assessment had been Care Homes for Older People Page 13 of 28 Evidence: completed on why bed rails were to be used. For example, what behaviour indicated the individual was at risk of falling from their bed. Also there was no risk assessment for an individual who had difficulty in swallowing and had choked in the past. There were good directions to staff on how any personal care needs should be met. For example will choose own clothes for the day. There was also good information relating to peoples communication methods. For example, may be times when X does not respond; understands but not always able to respond, staff to speak slowly and give X time. There was good evidence to show that care plans are reviewed monthly and some signatures to show that people were involved in reviewing their plans. Recordings (evaluations) were non-judgemental and showed that people are thought of as individuals. However,while there were some good recordings seen, the information does not always evidence that needs identified on the care plan have been met. For example, we saw a lot of appears to have slept well and quite bright recorded. There were also recordings made where issues had been highlighted such as not in a happy mood this morning and low mood, but there was no indication that there had been any intervention by staff over these issues, giving the impression that no action had been taken. The manager assured us that action would have been taken in these cases. Information about visits from and to health care professionals had been recorded in individual care plans, showing clear evidence that people are supported to maintain access to specialist medical services. These included GPs and district nurses. GPs and District Nurses stated via survey forms that they felt the home provides a high standard of care and consults them appropriately and when needed. The home employs a physiotherapist who provides individual and group sessions. Medication administration was well managed and policies and procedures relating to this area were in place. We were told and records show that staff who administer medications have received training that tested their competency. Staff were seen administering medication appropriately. Medication was stored securely and records show that medicines are counted when received into the home. All records were well maintained. All of the people seen during this visit were treated with respect by the staff and their right to privacy was upheld. Personal care was offered in a discreet manner. Staff told us how they respect peoples privacy when helping them with personal care needs. We Care Homes for Older People Page 14 of 28 Evidence: heard staff speaking with people in a kindly, friendly way. People that we spoke with confirmed that staff always treated them with respect. Staff were seen knocking on doors before entering. Care plans are being updated to show peoples wishes regarding their end of life care. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to continue to improve care plans and learn about people and their individual histories. Care Homes for Older People Page 15 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A good range of social outings and activities are available, and there is good daily variation for people living in the home. Menus provide people with nutritious variety and choice. Evidence: Separate care plans have been drawn up covering the social needs of all of the people who live at the home. The document The Personal Story of.... contained some very detailed information and included details of how much people had enjoyed different activities, as well as having a section entitled Things we have learned. However, not all the sections had been completed in the plans that we saw, meaning that staff may not have enough information about the person in order to offer them meaningful choices. The home employs a large team of activities staff to ensure all individual needs are met. There were five activity staff duty during the morning of the visit. Daily activities are displayed on the noticeboard and include swimming, gardening and trips out in the mini bus. Entertainments are organised regularly and include an Care Homes for Older People Page 16 of 28 Evidence: accordion player and visits from the Donkey Sanctuary. The home also has a computer (no internet access at present) and a Nintendo WII for the use of people living at the home. There is a shop at the home where people can purchase toiletries and sweets and a newsletter is produced every 2 months. The interaction between several individuals, staff and their surroundings was closely observed during the afternoon. Staff were reading newspapers and discussing articles with people, some people were chatting, others painting, looking at photographs and others were walking around the home. We saw the majority of people engaged in some way during our visit. Visitors were seen around the home throughout the visit and many positive comments were received from them. One person told us they were confident their relative was being well cared for, also that they were kept informed about any changes in their health and were always made to feel welcome when they visited. Others told us via survey forms that relatives were informed and consulted. We looked at how people are offered choices during the day. People who we spoke with told us that they chose what time they get up and go to bed. The manager and staff told us how people are encouraged to make choices over all aspects of their daily lives, from the time they want to get up, what they want to wear, and what they want to do. There was evidence on peoples care plans about how they are to be offered choices. We saw evidence that menus are varied and balanced and we were told that alternatives are always provided if people dont like the main meals on offer. Menus are displayed on the noticeboard so that people can let the kitchen know if they dont want a particular meal. A sweet trolley has introduced so that people now have about 5 different choices for their sweet. Wine is also offered with meals. Care Homes for Older People Page 17 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good complaints procedure and people can be confident that their concerns will be listened to. Robust procedures are in place to ensure that people are protected from abuse. Evidence: The homes simple complaints procedure is displayed in the hallway, and is also included in the Welcome Pack given to everyone on admission. We looked at how the home responds to complaints. A record of formal complaints is maintained by the home showing the outcome of any investigation. The manager told us that they encourage people to discuss anything they are unhappy about with the staff, so they can be dealt with straight away. Any concerns may also be discussed at hand overs between staff so that things can be changed where needed. No complaints have been received by the Commission since our last visit. People we spoke with were clear about who they would speak with if they were unhappy about anything and felt sure that their concerns would be dealt with. This was echoed by people completing survey forms. The home has a range of policies and procedures in place relating to the prevention of abuse. Records show, and staff told us that they had received training in Safeguarding Adults issues. Staff that we spoke with were able to discuss different forms of abuse Care Homes for Older People Page 18 of 28 Evidence: and said that they would report any suspicions they had to the manager. They were also able to tell us who they would report any concerns to, outside of the home, if necessary. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to promote the use of advocacy services. Care Homes for Older People Page 19 of 28 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 provides a pleasant, comfortable and safe environment for those living in, working at and visiting the home. Evidence: A tour of communal areas of the home and of some of the bedrooms was made. There are several communal spaces, including some quiet areas, where people can sit away from the general bustle of the home or access games and hobby materials. All areas of the home are maintained to a high standard, with maintenance people employed to ensure that all areas are regularly decorated and repairs carried out promptly. The gardens and exterior of the home were neat and tidy and in good order. There is easy access into and out of the home. Some bedroom doors have been fitted with push button door openers, to allow those people who use wheelchairs independent access to and from their bedrooms. All bedroom doors are fitted with locks. The front door has a coded entry system in operation when there is no-one in reception. Those who are able have their own front door key and know the code to leave the home. There is a range of aids and adaptations to help staff to help people who live at the home to be as independent as possible. These include ramps, grab rails and bath hoists. Pictures have been put onto toilet and bathroom doors to help people locate Care Homes for Older People Page 20 of 28 Evidence: these rooms. However, one person commented via a survey form that some people were unable to access call bells in communal areas as there were no cord free bells available (see also Staffing). The bedrooms of people who live at the home are individual and reflect the personality of the occupant. People have been helped to choose a picture for their bedroom door to help them identify their room. For example one lady has a picture of shoes on her door because of her interest in fashion and another person has a picture of artists brushes because of their interest in art. The home is being refurbished to make it more user friendly for people with dementia. Hand rails and door frames are being painted in a contrasting colour, lighting has been improved and flooring has been replaced. There is a programme underway to ensure all hot water taps are fitted with temperature controls and to ensure all radiators are covered in order to keep people safe. The home was very clean and tidy throughout. Staff confirmed that they had received training in the control of infection. Disposable gloves and aprons were seen in individual bedrooms and other areas around the home. There are currently two separate laundry areas, both of which have an impervious floor covering to minimise the risk of cross infection and contain suitable equipment. The manager told us that there are plans to have one large laundry area. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to continue to update signage throughout the home. To introduce aromatherapy to help promote and enhance a calm and relaxing quality to peoples lives and to always look to improve the environment. Care Homes for Older People Page 21 of 28 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. A wide range of training is provided and the numbers and skill mix of staff on duty are sufficient to meet the needs and numbers of people currently living at the home. Recruitment procedures are robust and ensure that people who may be unsuitable to work with vulnerable people are not employed at the home. Evidence: On the day of the visit there were 49 people living at the home. On duty during this time were the manager, deputy manager, administrative assistant, 12 care staff, 9 ancillary staff (kitchen, domestic and maintenance staff) and 5 activities staff. People that were spoken with felt that there were enough staff at the home to meet their needs. Visitors told us that there always seemed to be plenty of staff around. However, one person commented via a survey form that at times people were left alone in the lounge with no way of calling for help as there were no cord free call bells available. Staff were praised by people living at the home when we spoke with them and people made comments on survey forms such as most of the staff are brilliant, very caring and friendly, Always someone around to help me and show me where to go. However, another commented that a few of the staff are not as sensitive as others and another commented Sometimes needs higher staffing levels. Several staff also commented on survey forms that they felt more staff were needed at times especially Care Homes for Older People Page 22 of 28 Evidence: to cover holidays and sickness. Staff that we spoke with demonstrated a good awareness and understanding of peoples needs. They were able to describe peoples personal preferences in the way they received care as well as displaying a good knowledge of their individual needs. Staff were seen treating people with respect and spending time listening to them. Three staff files were looked at. All files contained all the required information including satisfactory CRB (Criminal Records Bureau) checks, two written references and proof of identity. This ensures that people are protected from the risk of harm by staff who may be unsuitable to work with vulnerable adults. Staff receive training in a variety of ways, including distance learning and in-house training. Records show and staff confirmed that they have received a variety of training including, Fire, catheter care, health and safety, moving and handling and infection control. All staff are due to receive in-depth training in caring for people with dementia. On the day of our visit many staff were receiving this training and several staff told us how much they were enjoying it. The AQAA (Annual Quality Assurance Assessment) submitted by the manager shows that 37 staff currently have an NVQ (National Vocational Qualification) level 2 or above. All staff have received training in Safeguarding Adults issues and all new staff receive a full induction in line with Skills for Care recommendations. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to not have a uniform, therefore breaking down the barrier of resident and carer, also to strive for Excellence in Dementia Care. Care Homes for Older People Page 23 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and has robust management systems in place to check the quality of the services and facilities provided. This results in practices that promote and safeguard the health, safety and welfare of people who live and work in the home. Evidence: The manager of Silverleigh Cedars has worked in the care sector for several years. She is currently studying for an NVQ level 4 and has recently been registered with the Commission. One staff member commented via a survey form that staff work together well as a team and are supported by management. The manager told us that there was no-one living at the home that is subject to a deprivation of liberty authorisation and we saw no evidence to show that anyone living at the home is having their liberty deprived without an authorisation. The home has a good range of methods for checking the quality of the care provided by the home. Regular meetings are held, and questionnaires have been sent to people Care Homes for Older People Page 24 of 28 Evidence: living at the home, relatives, visitors and staff in order to obtain their views on the home. We were told that a report will be prepared that will detail any areas for improvement and show how they will be addressed. One staff member commented via a survey form that staff are able to voice their concerns and are listened to. The procedure for dealing with individuals finances is robust, records were well maintained with 2 signatures being obtained for all transactions. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit, provided evidence that Silverleigh Cedars complies with health and safety legislation in relation to the maintenance of equipment, storage of hazardous substances, health and safety checks and risk assessments. Policies and procedures are not always inspected during the visit but the information provided on the AQAA helps us form a judgement as to whether the home has the correct policies to keep people living and working at the home safe. Information provided by the home, evidenced that policies and procedures are in place and along with risk assessments are reviewed regularly and updated where necessary, to ensure they remain appropriate and reduce risks to people living and working at the home. So that the risk of burning from hot surfaces is minimised there is a programme in place to ensure all radiators within the home are covered. All windows above ground floor level are fitted with suitable restrictors, in order to minimise the risk of anyone falling from these windows and all hot water taps will be fitted with thermostats to minimise the risk of people being scalded. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to continue to listen to peoples opinions and enable them to be involved in the development of the home. Care Homes for Older People Page 25 of 28 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 26 of 28 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 You are recommended to ensure daily recordings evidence where identified needs have been met, and any action taken to address concerns that have been highlighted. You are recommended to ensure that everyone has access to a call bell when in a communal area. You are recommended to continue to review staffing levels in line with the needs and numbers of people living at the home. 2 3 19 27 Care Homes for Older People Page 27 of 28 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 28 of 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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