About the service Silvanna Court is a care home providing personal and nursing care to up to 83 people. The service provides support to older people and people with dementia. At the time of our inspection there were 78 people using the service. The home is split over three separate floors, each with communal lounges and dining areas.
People’s experience of using this service and what we found
Medicines were not always managed safely as some PRN (as required) medicines were given routinely without the appropriate records to identify the reason the PRN was given or the outcome. Risks were not always effectively assessed or addressed. There were not always enough staff on duty to support people safely. Accident and incidents were analysed but key information was often missing to ensure the analysis was effective. Staff were trained to recognise and respond to concerns of abuse. There were adequate infection prevention and control measures in place.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Care was not always responsive to people's assessed choices and support needs. People and relatives told us people were not always supported with their personal care needs in the way they wanted.
There were gaps in management oversight and systems for auditing at the service did not identify the concerns we found during the inspection. There was a new manager in post who was not yet registered with CQC.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was good (published 6 July 2018). At this inspection the service has deteriorated to requires improvement.
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We received concerns in relation to staffing levels, and people’s personal care needs. As a result, we undertook a focused inspection to review the key questions of safe, caring and well led and well-led only.
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 good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, caring and well led relevant key question sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Silvanna Court on our website at www.cqc.org.uk.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We will continue to monitor the service and will take further action if needed. We have identified breaches in relation to safe care and treatment, staffing, dignity and respect and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.