We carried out a review of the data available to us about Silk Court Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Silk Court Care Home, you can give feedback on this service.
Silk Court Care Home accommodates people in one building across three floors, with each person having their own bedroom with en-suite bathroom. There were also communal living rooms, communal dining areas with kitchens, a main kitchen and access to a secure garden.
We found the following examples of good practice.
There were clear procedures in place to ensure visitors could enter the home safely, with a requirement to take or show a negative lateral flow device (LFD) COVID-19 test before entering the home. There was a designated visitor testing area where relatives could enter via an external door. Relatives were given information about visiting and were kept updated about any changes in visiting procedures in the home.
Relatives were given information about becoming an essential care giver in line with current guidance. This ensured every person in the home would be able to have a visitor even if the home was advised to restrict visits in the event of a COVID-19 outbreak.
The service was taking part in regular COVID-19 testing for people and staff in line with current guidance. The provider was aware of new testing guidance that would be coming into place from the 16 February 2022 and had updated staff in preparation of this, with information displayed in the designated staff testing area.
We saw the provider was aware of their responsibilities regarding the requirement to ensure visiting professionals were vaccinated against COVID-19. As there was refurbishment work taking place during the inspection, this included building and maintenance contractors.
The provider carried out weekly stock checks to ensure staff had a sufficient supply of personal protective equipment (PPE). Staff had ongoing IPC training and there were helpful posters displayed throughout the home reminding staff about the correct way to wear their PPE. We observed staff following best practice throughout the inspection.
Staff were confident about the actions they had to take if there were new positive cases of COVID-19 in the home and how they would support people who had to isolate. There were discreet signs placed on people's doors to highlight their isolation period, with separate processes in place for the safe management of their laundry. One staff member said, "We know what to do and how to do it. I feel we are doing well to reduce any infections."
Staff told us they felt supported in their role and had been kept regularly updated with any changes throughout the pandemic. The provider had a focus on staff wellbeing and was aware of the challenging periods staff had worked through since the start of the pandemic. A staff member told us wellbeing was regularly discussed, with access to counselling sessions through the local authority if required.
The management team carried out regular IPC audits, which included observations and spot checks across the home. The provider had introduced IPC champions to help ensure staff were following best practice and understood their key responsibilities.
The registered manager told us they had continued to be well supported by the provider, the local authority and a range of health and social care professionals. Their weekly conference calls included advice and guidance from Public Health and the local authority IPC team. The registered manager said, "It has been challenging but it is important we keep going."
We found the following examples of good practice.
• Staff and people using the service approached the pandemic as one community whilst encouraging and supporting each other through the various challenges, such as stringent cleaning schedules, getting used to PPE, and COVID-19 testing and vaccination.
• The registered manager acknowledged that all staff had gone the extra mile. For example, staff sustained rota cover including by doing essential work across different working roles.
• The service ensured that visitors to the home were carefully screened so that they did not present a risk to people in the home. Their temperatures were checked at the door. Personal protective equipment (PPE) including face masks, disposable gloves and aprons were provided for visitors before entering the home. Social distancing was observed. This was aimed at preventing and controlling the spread of infection.
• Staff had a good understanding of infection prevention and control measures. They had been provided with infection control training and regular updates. The home had enough and appropriate PPE.
Silk Court Care Home is a residential care home providing personal and nursing care to people aged 65 and over. At the time of the inspection 47 people, including those living with dementia were using the service. The service can support up to 51 people.
People's experience of using this service
The provider used creative ideas to ensure people’s hobbies and individual interests were met and a wide variety of activities provided. Staff used innovative techniques to stimulate people’s memories and imagination which helped to motivate them to remain well.
The registered manager used inventive ways for people review of the menu and meals. Staff had a clear understanding of people’s meal preferences and nutritional needs.
The registered manager understood equality and diversity and created links with voluntary services to celebrate cultural, religious and gender identities.
People said staff were helpful, kind, compassionate and respectful. Comments included, “They respect my intelligence” and “I am never talked down too, which is rather perceptive of them.” The provider asked people for their feedback of the service. People’s responses were positive.
The provider’s safeguarding processes guided staff to recognise and report any allegations of abuse. The registered manager referred allegations of abuse to the local authority team for investigation and a clear record was made of the outcome.
Staff managed people’s medicines well. Staff understood how to support people to have their medicines as prescribed. People gave mixed views on whether there were enough staff available to support them. The registered manager completed a review of the staff mix. As a result, the staffing levels were increased.
Assessments placed people’s needs at the centre of the care provide. Staff completed assessments to identify people’s care needs and potential risks to their health and well-being. Management plans were put in place to manage and reduce any risks and concerns.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 this service was outstanding (report published on 12 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Silk Court is a care home providing accommodation for up to 51 older people, some of whom were living with dementia. The home is located in Bethnal Green close to shops and local amenities. The purpose built building has three units namely, Velvet (ground floor), Satin (first floor) and Cotton (second floor). The bedrooms were single occupancy with en-suite facilities. The building and units were accessible by wheelchair and had a passenger lift. At the time of our inspection, 49 people were living at the service.
At the last inspection of 4 and 5 August 2014, the service met the regulations inspected and was rated Good overall and Outstanding in Caring.
The service had a registered manager. 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 and associated Regulations about how the service is run.
People living at the service and their relatives were extremely happy with the high standards of care they received. People using the service, their relatives and health and care professionals commended staff for their compassionate and caring manner. They were consistent in describing the positive impact of the care provided at Silk Court Care Home on people’s well-being.
The registered manager and provider actively promoted a person centred culture at the service. People knew the registered manager very well, said she was visible at the service, and spent time with them. The registered manager and provider demonstrated excellent leadership.
The registered manager and provider exceeded expectations in the provision of social activities and engagement for people using the service. People immensely enjoyed taking part in a variety of activities provided at the service and in the community. The registered manager engaged people and health and social professionals to design creative activities in ways which enriched each person’s life. Staff supported people to live an active, independent and full life as possible
People experienced exceptional high standards of care because the registered manager had developed solid relationships with external organisations, health and social care professionals and the local community. People living with dementia received specialist support which significantly improved the quality of their lives. Staff had a sound understanding of dementia care and used their specialist knowledge to provide care in line with best practice and to communicate effectively with people.
People using the service and staff were highly complimentary of the registered manager, her leadership and the running of the home. People felt very valued, listened to and were able to talk to the registered manager about any concerns about their welfare. The service was proactive and welcomed people using the service, their relatives, and health and social care professionals and staff to voice ideas about how to develop the service. The registered manager audited the quality of care and made changes when needed.
Staff delivered people’s care and support with respect for their dignity and privacy. People received all-inclusive care that enhanced their quality of life. Staff had developed positive relationships with people using the service and their relatives. People consistently praised staff for meeting their individual needs and preferences and going over and above to make them comfortable and happy.
The registered manager assessed each person’s needs and found creative ways of reviewing and anticipating changes in people’s health and well-being. Health and social care professionals were very pleased with the responsiveness of staff to people’s conditions and their application of guidance given.
Staff managed risks to people’s health and well-being in accordance with the identified strategies and support plans in place. Staff followed the safeguarding policies and procedures in place to keep people safe from avoidable harm and abuse. The registered manager deployed a sufficient number of staff to meet people’s needs. New staff underwent appropriate recruitment and selection checks to ensure their fitness and suitability to provide care at the service.
People received care from a motivated and competent staff team who took pride in their roles. Staff attended regular training and received supervisions, an appraisal and feedback about their performance.
Staff championed people’s rights to freedom and choice in their day-to-day service provision. People received care and support in line with the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
People benefitted from timely access to healthcare services. Medicines were managed, administered and stored safely. People received food that met their nutritional and hydration needs. People spoke positively about the quality of meals and the choices available to them.
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 undertook an unannounced inspection of Silk Court Care Home on 4 and 5 August 2014. The service provides care and support for up to 51 older people. There were 51 people using the service when we visited.
At our last inspection on 17 March 2014 the service met the regulations inspected.
The service had a registered manager who had been in post since July 2011. 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.
Safeguarding adults from abuse procedures were robust and staff understood how to safeguard the people they supported. Managers and staff had received training on safeguarding adults, the Deprivation of Liberty Safeguards and the Mental Capacity Act 2005. Staff demonstrated a good understanding of their responsibilities.
People and their relatives were involved in decisions about their care and how their needs were met. People had care plans in place that reflected their assessed needs.
Recruitment procedures ensured that only people who were deemed suitable worked within the service. There was an induction programme for new staff, which prepared them to do their role. Staff were provided with a range of training to help them carry out their duties. Staff received regular supervision and appraisal to support them to meet people’s needs. There were enough staff employed in the service to meet people’s needs although some staff told us they felt under pressure when members of staff were absent due to sickness.
People were supported to eat and drink and their nutritional needs were closely monitored. People were supported effectively with their health needs and had access to a range of healthcare professionals. People were involved in making decisions about what kind of support they wanted.
Staff, people who used the service and relatives felt able to speak with the manager and provided feedback on the service. They knew how to make complaints and there was an effective complaints policy and procedure in place. We found complaints were dealt with appropriately and in accordance with the policy.
The service carried out regular audits to monitor the quality of the service and to plan improvements. Where concerns were identified action plans were put in place to rectify these.
People felt satisfied with the service provided at Silk Court and involved in their care. One person said, "it's lovely here, they treat me like their own." Family members were happy with the way staff cared for their relatives and the service they received.
The provider sent the Care Quality Commission an action plan to address the area of non-compliance and during the inspection we saw that this had been implemented. Care plans had been updated and staff received dementia training to improve how they worked with people who had dementia. Staff said they felt better skilled in supporting people who had dementia. This had a positive effect on the wellbeing of people who used the service.
People felt safe and were satisfied with the service provided at Silk Court. They felt involved in their care. One person said, 'it's nice here, I have been here for three years.' Another person said, 'it's very jolly here, everyone joins in.'
The Short Observational Framework for inspections highlighted that staff were not sure how to manage the behaviours of two people who were constantly asking to go home and getting agitated as lunchtime progressed.
The provider had systems in place for assessing and monitoring the quality of the service.
Three people using the service spoke with us. When we asked about being treated with respect we were told 'the staff are kind and treat me with respect and gentleness' and 'I'm always allowed to be private'. When asked about their care we were told 'the staff are kind and treat me with respect and gentleness', 'I like living here the staff are nice and you can have a laugh with them' and 'I can join in, I like helping to do things'. When we asked about how safe people felt living at Silk Court we were told 'I feel safe living at the home', 'I feel safe living here, the staff are kind and I like them'.
A relative who was visiting the home said the care at Silk Court was 'excellent' and that it was 'welcoming and not institutionalised', 'It's a home where you would want to be'.
We spoke with two relatives of people using the service. They told us'it's like a little community, we love it'. They felt that staff were friendly and helpful and shared decisions about their relative's care with them, 'they talk with us it's very informal'. This person also told us that prior to choosing Silk Court they visited without prior notice on a few occasions and found that the staff and standard of care were consistently good regardless of the day or time of their visit.
A relative told us they had 'peace of mind knowing their [relative] was well cared for. We live hours way but we trust the staff here to look after my [relative]'. They also said that the staff were 'helpful and friendly'. Another relative praised staff for 'making the living environment feel personal' for their relative.
Please refer to each essential outcome, below, for more detailed comments about specific aspects of the service that is provided at Silk Court and the main report for other comments that people made to us.