Silverwood (Rotherham)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were safeguarded from abuse and avoidable harm. People told us they felt safe living at Silverwood and were involved in making decisions about their safety. The provider learned lessons when things had gone wrong and took immediate action to manage risks. For instance, we saw evidence of very thorough investigations being carried out and of lessons learned and properly embedded into practice. Overall, risks to people were managed well. The provider followed safe recruitment processes and made sure there were enough suitable staff. People were supported to receive their medicines safely. People were protected from the risk of infection, as staff followed safe infection prevention and control practices. The home environment and equipment was kept clean and safe. The provider was working in line with the Mental Capacity Act. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguarding (DoLS).

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives told us they told us they felt incidents and complaints were managed well; investigated, responded to and lessons were learned. Relatives said there was a culture of openness and honesty. A relative said, “[Family member] has lived there for 2 years and is quite happy. [Person] loves it, and the staff are very friendly and helpful. Any questions we ask and they answer, they are never secretive.” Another relative said, “Communication, [staff] are very good on that. When [my family member] had a fall at 10.30pm they were on the blower straight away.”

The registered manager told us they placed a lot of emphasis on creating culture of honesty, openness, and learning, rather than blame. Staff confirmed this. They told us they were encouraged to raise concerns and were confident they would be listened to and supported. Staff were aware of changes made to the service based on lessons learned from recent incidents, accidents and concerns.

The provider had systems and processes in place to investigate and learn from incidents and complaints. Records showed the registered manager analysed incidents, accidents and complaints very thoroughly, to identify any common themes, patterns and lessons to be learned. Action was taken to address lessons learnt, for example, around individual people’s care, how the service was run or training needs for staff. The registered manager used a variety of methods to share learning with staff, such as handovers, 1 to 1 supervision sessions, and team meetings. This enabled staff to reflect and share ideas of how to further improve the service.

We received positive feedback from people about their experience moving into the home. Relatives confirmed they were involved in this process and felt assured staff gathered the relevant information about people prior to them moving in. A relative told us their relative had been happy to be admitted, after they had initially come for a short stay.

The registered manager told us they undertook an assessment before people moved into the home. This involved the person and those close to them and helped to make sure people experienced a safe transition into the service.

Professionals working in partnership with the service spoke positively about the way staff worked with them to address people’s changing needs. For instance, a visiting healthcare professional told us staff were responsive, acted upon their recommendations and communicated well with them. A social care partner told us, “As a social care professional, I have supported numerous clients with moving to Silverwood Care Home for both short term/respite and long-term care. I have always found [The registered manager] very approachable, professional, and accommodating. She shows professionalism in her work, and I have only received positive feedback from residents and their families.”

Records showed staff communicated with other professionals and services and made sure people experienced smooth transitions when using or moving between healthcare and other care services. New admissions and people’s changing needs and were discussed within the staff team during regular meetings. Care was well-organised and monitored daily. When needed, staff referred people to other services, such as GP, community mental health teams, speech and language therapy or social services for additional help. People could use short term care when they needed to.

People told us they felt safe at the service and had staff members they could talk to if they did not feel safe. One person said, “I feel safe enough. [Care staff] are good.” Relatives we spoke with said they had no concerns about their loved ones' safety. A relative said, “[My family member] is looked after well by all the staff, they are lovely with her.” Another relative said, “[My family member] is incredibly happy [at Silverwood]. She is incredibly safe. [Staff] are monitoring her and she now has friends. At home she would not go out and was isolated and only saw us, but when she went into the home and saw people she knew from where she lived, she settled.”

Staff were aware of the provider’s safeguarding policy and could identify signs of possible abuse and neglect. They confirmed they had received safeguarding training and knew how to report such concerns. Staff we spoke with did not have any concerns but said if they did, they were confident the management team would act appropriately. One staff member said, “I would report even the smallest sign of cruelty or abuse. I've not seen any here, it’s a nice, kind team.” The registered manager was aware of their responsibilities and fully committed to ensuring people were protected from abuse. They gave examples of concerns they had reported and action they had taken to protect people from the risk of harm. They understood how to keep people safe, had a clear and effective investigation process and were very thorough when completing investigations. They said any concerns were discussed at each team meeting to make sure staff were aware of any lessons learned and what action had been taken to reduce the risk of recurrence.

Information about safeguarding people was visible around the service, in an accessible format. This helped people and their visitors to know how to report concerns. We saw people were relaxed in the presence of staff and felt able to ask them for support. There was a calm and relaxed atmosphere and staff treated people with respect and kindness. We saw lots of positive interactions between people and staff. There was a culture of openness and communication and we saw no evidence that people were fearful.

There were comprehensive and well written policies and procedures in place regarding safeguarding and whistleblowing, to provide staff with guidance. Records showed incidents were investigated and referred to the local authority safeguarding team appropriately and in a timely way. When necessary, the registered manager investigated safeguarding concerns, worked with the local authority and took action to protect people from harm. Some people would be at risk if they did not have continuous supervision. Where this was the case, the provider applied the suitable Deprivation of Liberty Safeguards. These safeguards make sure people who cannot consent to their care arrangements in a care home or hospital are protected if those arrangements deprive them of their liberty. Deprivation of liberty safeguards applications were submitted to the local authority when people’s liberties were restricted to receive necessary care and treatment. This was monitored by the registered manager and reflected in people’s care records.

People told us staff understood their needs well and supported them to keep safe. One person said, “The [care staff] are very good. Kind-hearted.” A relative said, “We do have regular reviews of [family member’s] care plan and discuss. The last one was a week or two ago. We go through everything. That is quite good. I have made sure I am involved, I live close by and go in every day, I wanted to be involved and still am, all the staff know that. The care plan is reviewed regularly, every 3 months, that works well, the senior on duty and I sit down and [family member] is involved.”

Managers understood the importance of involving people and their families in the risk assessment process. Staff were familiar with people’s needs, identified risks and understood how to support people safely.

Staff had a good understanding of people’s needs and supported people in line with the guidance in their care plans. We saw staff monitoring and reminding people to use their walking aids and helping to adjust their footwear to help minimise the risk of falls. Staff supported people with mobility needs to transfer from wheelchairs to comfortable seating in a safe and sensitive way.

Staff assessed all relevant risks to help make sure people were safe and took action to mitigate any risks identified. People had detailed person-centred care plans and risk assessments in place. Silverwood were in the process of moving from paper files, to an electronic system. New assessments and plans were being completed by staff who knew people well. The service used monitoring systems, such as sensor mats. This helped to minimise nighttime disturbance for people, while reducing the risk of accidents and falls.

People and their relatives felt the environment was pleasant and safe. One person said, “Nice rooms, light and airy.”

Staff told us they received training in all relevant areas of health and safety. They demonstrated awareness of safety procedures and of their responsibilities around maintenance and health and safety in the home.

The environment was safe and well cared for. Care equipment we saw was in good working order. The building was accessible for people with mobility needs and free from clutter. People’s names or items of reference were on people’s doors, which helped people with finding their way around the home.

There were systems for monitoring all aspects of maintenance and health and safety, and records were well organised. People had individual personal emergency evacuation plans and fire safety measures were in place. Fire alarm testing was carried out regularly and fire drills recorded appropriately. The provider made sure health and safety and maintenance checks were completed and appropriate monitoring records and safety certificates were available.

People and relatives told us there were sufficient staff to keep people safe and they felt staff were competent. One person told us, “There’s always someone around when you need them.” A relative said, “Seems enough staff, they may be busy sometimes but plenty on, I can always find someone.”

Members of the management team explained staffing levels were based on the dependency levels of people using the service. They felt supported by the provider in ensuring staffing levels were safe. Staff told us they felt there were enough of them to offer appropriate care to people.

We saw staff worked well as a team to make sure tasks were completed, and they interacted with people in an appropriate way. Our observations showed there were enough staff to safely meet people’s needs and respond to their requests. Staff were visible and available in communal areas and people did not wait long for their support. Staff did not appear rushed. They treated people kindly and with respect.

The provider followed safe recruitment practices. This included requesting references from previous employers and checks with the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions. There were processes to make sure there were enough staff. Staffing levels were monitored by the managers and people’s needs were reviewed in order to establish if staffing levels were sufficient. This meant people's changing needs were considered when deciding the appropriate ratio of staff and ensured safe staffing in the event of emergencies. There were processes in place to make sure staff received the support they needed to deliver safe care. This included training, supervision, appraisal and support. Staff training was reviewed and addressed additional training needs in relation to people’s individual needs.

People and their relatives told us the home was always clean and staff followed good infection prevention and control practice. A relative said, “It is a good home, they are looking after [my family member], it does not smell and that is important. [Staff member’s name] is brilliant.” Another relative said, “They keep it very clean. I always see the cleaners about.”

Staff knew how to protect people from the risk of infection. They told us they had training in hand hygiene and the use of personal protective equipment such as gloves and aprons.

The home was clean, and the laundry was managed safely. We saw staff washed their hands and used personal protective equipment when required, and hand sanitiser was available.

The provider had up to date infection prevention and control (IPC) policies and procedures in place. The registered manager completed regular IPC audits and where the need for improvement was identified, prompt action was taken.

We received positive feedback regarding medicines management from people and their family members. People told us they received their medicines safely and at the correct times. One person said, “[Staff] do my tablets. Always kind. Ask if I’m in pain, if I need a tablet.” A relative said, “[Staff] administer [person’s] medicines properly and as a result [person’s] health has improved considerably. Another relative told us, “Medicine wise, [staff] are brilliant.”

Staff told us they received training to manage medicines safely. Training records confirmed this. Staff and saw supporting people with their medicines, were aware of and followed safe practice. Staff understood and followed procedures to make sure people’s medicines were reconciled when they moved between services and when changes occurred by the GP or hospital.

There were safe arrangements in place for managing people's medicines. Guidance was available to staff and records were in good order, clearly recording when medicines had been administered, or the reason they were not administered. Weekly and monthly medicine audits were completed by senior staff. We saw medicines were kept safely and were well organised. ‘When required’ and high-risk medicines were managed in a safe way.