Silverjen Limited

Updated 30 September 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by three inspectors and an Expert by Experience.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in [their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced.

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 2 August 2022 and ended on 11 August 2022. We visited the location’s office on both occasions.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed information we had received about the service since they registered with us. We sought feedback professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We reviewed the documentation for seven people receiving care from the agency during our visit to the offices. We also reviewed the medicine records for people, as well as other documentation relating to people’s care. We spoke with the registered manager, office staff and spoke with or received feedback from 11 care staff.

We looked at documentation relating to the governance arrangements within the agency. This included audits, surveys and five recruitment files for care staff. Following the inspection, the registered manager sent us training information for staff and recruitment documentation.

As part of the inspection, the Expert by Experience spoke with eight people and four relatives to gain their views of the care being provided by Silverjen Limited.

Updated 30 September 2022

About the service

Silverjen is a domiciliary care agency providing the regulated activity of personal care which is help with tasks related to personal hygiene and eating to people in their own homes. Where people received the regulated activity we also considered any wider social care provided. The service provides support to people with health conditions or those living with dementia. At the time of our inspection there were 58 people using the service.

People’s experience of using this service and what we found

Systems and processes within the agency were not sufficiently robust to identify shortfalls within the service. Administratively, there was a lack of organisation or delegation to enable records to be accessed by everyone in the office. Although staff loved their job, then felt demoralised by the actions of the registered manager. They told us they only heard the day before which care calls they would be going to the following day which left them feeling worried.

Where people lacked the capacity to make decisions for themselves, the registered manager had not always ensured they had followed the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the persons best interests.

Recruitment of staff covered a range of aspects to help ensure prospective staff were suitable for the role. However, we found that the registered manager was not always following guidance in relation to what checks should be undertaken.

People were happy with the care they received from the service. They told us staff stayed the full time expected and they had not experienced a missed call.

People received the medicines they required and they told us staff were good at prompting them to take their medicines. Although, this was the case, office staff had not robustly audited the medicines records for their accuracy and they had not picked up the shortfalls in the record keeping.

People felt safe in the hands of care staff and risks to people had been identified. and Guidance was in place for staff to help reduce any risk to the person. Where concerns had been raised of possible abuse, these had been reported to the appropriate authorities and investigated by the. Accidents and incidents were recorded and external support was sought where incidents were having an impact on people.

People told us staff treated them with respect and encouraged them in their independence. People told us staff wore appropriate personal protective equipment when providing personal care and they considered people’s individual wishes in relation to their care.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. People were encouraged to be independent and make choices around their care. People were treated as an individual by staff and were provided with respect. Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives;

Carers demonstrated a good ethos, one that was centred on the people they provided care to. Carers had received relevant training in caring for someone who had a learning disability.

Staff received appropriate training to enable them to carry out their role and care for people in a relevant and safe way. Staff supported people to access external agencies when they were unwell or required additional support. Such as the GP or to obtain equipment for them.

People’s needs and preferences in relation to their food and drink were recorded and people were happy with this aspect of their care. Where people were able to, they could make their own decision on how they wished to be cared for. People knew how to make a complaint and individual communication difficulties were recognised by staff.

People were invited to give their feedback on the service they received. Comments were addressed and changes made to accommodate people’s wishes. The registered manager worked with external agencies to compliment the service they provided and they had a vision for the future expansion of Silverjen.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service at the previous premises was Good, published 11 February 2020.

Why we inspected

This inspection was prompted as the service had not been rated since it had moved premises.

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 found breaches of regulation in relation to adherence to recruitment checks, the principles of the Mental Capacity Act 2005 and good governance arrangements during this inspection. We have also made recommendations in relation to medicines administration practices.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will ask the registered provider to provide us with an action plan explaining how they plan to address the shortfalls we have identified on our visit. We will continue to monitor information we receive about the service, which will help inform when we next inspect.