Silva Care Limited

Updated 18 October 2018

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 check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

The inspection was carried out by one adult social care inspector, who visited on 19, 20 and 24 September 2018. We last visited the service in March 2016, found no breaches of regulations and the service had an overall rating of good.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make.

We reviewed the information included in the PIR along with information we held about the service. This included notifications, which is information about important events which the service is required to send us by law. We looked at monitoring reports completed by local authorities following visits they carried out.

We used a variety of methods to obtain feedback from those with knowledge and experience of the service. Before the inspection we contacted two health and social care professionals who had contact with the service. We reviewed the information they gave us. We sent surveys to people who use the service, relatives, staff and visiting professionals. We received eight from people who received a service, seven from relatives, 22 from staff and five from visiting professionals. You can see what they told us in the findings of this report. We also contacted eight relatives by telephone or email after the inspection for feedback.

During the inspection we talked with six people using the service. We spent time observing how they were cared for. We visited people at two short break services and two places where staff supported a group of people who lived together in their own home. This is called a supported living services. The provider had asked people if they were willing to speak to us prior to our visit. We talked with seven staff including two managers, the quality assurance manager and the registered manager.

We looked at the care records of five people, the recruitment and personnel records of three staff, training records for all staff, staff duty rotas and other records relating to the management of the service.

Updated 18 October 2018

The inspection took place on 19, 20 and 24 September 2018. The provider was given notice as the location provides a domiciliary care service and we needed to be sure that a member of the management team would be available on the day. The previous inspection was carried out March 2016 and there had been no breaches of legal requirements at that time. We had no previous concerns prior to this inspection.

Silva Care Ltd provides personal care and support to people with a learning disability in their own homes and in shared supported living services. A supported living service is one where people receive care and support to enable them to live independently. People have tenancy agreements with a landlord and receive their care and support from Silva Care Ltd.

As the housing and care arrangements are separate, people can choose to change their care provider and remain living in the same house. Silva Care Ltd also provides short breaks in five properties across Bristol. Each property can accommodate between three and four people. People can receive personal care from Silva Care Ltd or from their own personal assistant. They also provide outreach services supporting people with learning disabilities to access day care services. This part of the business does not fall within the scope of registration.

There was a registered manager in post, they were also one of the directors for the company. We have referred to them as the registered manager throughout this report. 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.

The registered manager told us they were supporting at least 45 people per day in the supported living/short stay services and another eight people with support in their own home. The service employed 256 staff working across the company. Of the 256, 153 staff were working in services that were regulated by the Care Quality Commission.

The registered manager told us the ethos of the services was to ensure that the stay was not just about giving family carers a break it was also very much about the person having a good time and have opportunities to go out, socialise, meet up with friends, and develop and maintain independence skills. The staff all conveyed these principles telling us how they put this into practice. There was a ‘can do’ attitude to supporting people lead the life they wanted.

People were receiving care that was extremely responsive and effective and tailored to their needs. Care plans were in place that clearly described how each person would like to be supported. People had been consulted about their care and support. The care plans provided staff with information to support the person effectively. Other health and social professionals were involved in the care of the people and there was very much joint working with them and family. Safe systems were in place to ensure that people received their medicines as prescribed.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management and safe recruitment processes.

Staff received training and support, which was relevant to their roles. Systems were in place to ensure open communication including team meetings and one to one meetings with their manager. Staff were committed to providing a service that was tailored to each person they supported enabling them to plan and achieve life goals Such as seeking employment, gaining skills to enable them to live independently or participating in a certain social event.

People were involved in the day to day running of the service. People were valued and supported to be as independent as possible. People’s rights were upheld, consent was always sought before any support was given. Staff were aware of the legislation that ensured people were protected in respect of decision making and any restrictions and how this impacted on their day to day roles.

The staff were extremely caring and worked closely with the person and their families. There were many examples where the service had gone the extra mile, in supporting people to live the life they wanted, build relationships and networks in the community which promoted wellbeing for the person.

Staff felt they were supported by the management of the service with clear lines of accountability. Champions had been introduced in each service further developing the expertise of staff. Networks had been built with the local authorities with attendance at specific forums. Learning was pivotal in all aspects of the running of the business part of team meetings, supervisions and observations. The provider had introduced different career pathways for care workers enabling them to build on their skills and knowledge. There was a high staff morale and they were passionate about the care and support that was in place.

Staff had embraced person-centred care and supported people as individuals helping them to be independent and achieving their life goals. People and their relatives felt the service really listened and acted on what they were saying.

People were provided with a safe, effective, caring and responsive service that was well led. The organisation’s values and philosophy were clearly explained to staff and there was a positive culture where people felt included and their views were sought. The registered provider was aware of the importance of reviewing the quality of the service and was aware of the improvements that were needed to enhance the service.