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 pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. We did not give the home notice that we were going to carry out an inspection and arrived unannounced.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
Silverbirch is a home for up to nine adults who had a learning disability. The home is an adapted residential property. Special bathing and lifting facilities had been provided for people who were unable to move independently and who needed support from staff to wash and bathe.
People who lived in the home, their relatives, staff and health care professionals who visit people at Silverbirch told us they felt people were safe. Staff we spoke with were aware of what abuse was and demonstrated in their conversations with us that they would not accept abusive practices in the home. Staff told us what they would do in the event of them witnessing abuse happening. People we asked told us this was a service they would be happy for a relative of theirs to use. However we found that the premises had not been kept clean. When we looked around the home the bathrooms, floors, tables and chairs were all dirty. This was unpleasant for people and could increase the risk of cross infection and bad smells. Broken furniture had not been removed or replaced and people could have hurt themselves on this. You can see what action we told the provider to take at the back of the full version of the report.
We observed staff working with people throughout the time of our inspection and heard how staff spoke with people. All our findings provided evidence that staff were kind and compassionate. Staff spoke about people with enthusiasm and could share with us people’s needs and tell us about their family. This showed staff had taken time to get to know about the people they were supporting. However we did hear staff speaking to people in a way that was not respectful of them as adults.
Staff told us they had been trained and supported to meet the needs of the people they worked with. Staff were able to describe people’s needs to us, and the ways they worked to meet them. During our inspection we found evidence that people’s conditions had improved in the time they had lived at the home. This showed the care and support being offered was meeting their needs and being effective.
People were supported to be as involved in their lives as possible. We saw people were offered choices about what to do, what to wear and what to eat. We saw that people had been involved in making significant decisions about their lifestyle and treatment for health conditions as far as they were able. We observed staff using a variety of different ways to offer people choice according to the individual needs of the person they were supporting. Staff we spoke with were able to describe how each person expressed themselves, which was particularly important when people didn’t use words to communicate. This meant people could be confident staff would understand their needs and wishes.
People lived in an environment that was homely and had been adapted to meet their needs, however we found the home had not been kept as clean as it should have been or that repairs or replacement of broken furniture had not been undertaken as promptly as it should have been. People could choose how they wanted their rooms decorated and people had been involved in choosing colours, furnishings and carpets for communal areas of the home. People had been supported to obtain the specialist equipment they required included walking aids, adapted beds and mattresses and wheelchairs.
The management was strongly focussed on the needs of the people living at Silverbirch. The manager demonstrated a very detailed and active knowledge about each person and had “hands on” involvement every day in people’s care and support. However the management systems of the home were not well established and we found that some records had not been updated, and that systems to ensure quality and safety were routinely checked were not robust. The manager was already of aware of this prior to our inspection and was able to demonstrate what action he had taken and planned to address this.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report