Silverdale Nursing Home

Updated 5 January 2023

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of two 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

Silverdale Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Silverdale Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for one month and had applied to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 1 November 2022 and ended on 9 November 2022. We visited the location’s service on 1 November 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.

During the inspection

We spoke with 6 people who lived at the home and 1 visiting health professional. We also spoke with the owner, the manager and the clinical lead whilst we were on site. We also spoke with a consultant who worked for the health and social care consultancy recruited to support with the management of the home.

We spoke with 5 relatives by telephone. We also spoke with nurses, senior carers and care staff who worked at the home by telephone.

Updated 5 January 2023

About the service

Silverdale Nursing Home is a care home providing personal and nursing care for up to 27 people in one adapted building. The service provides support to older people some of who are living with dementia. At the time of our inspection there were 17 people using the service.

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

Medicines were not always administered safely. Where people’s medicines had not been signed for as administered, staff did not always escalate this as soon as they could. Protocols for as required medicines were not always consistent with how people’s medicines were prescribed. People’s diverse needs were not always considered in full in line with the Equality Act 2010. Regular staff supervision had not yet been implemented to ensure oversight of staff competency. People and relatives told us they were not always asked for feedback regarding the home and were not always kept up to date with changes. The provider did not always share information with other agencies. Audit systems were in place, but documentation was not always completed in full to show where actions had been addressed.

Relatives told us people were safe. Systems were in place to manage accidents and incidents and there had been a reduction in reported incidents at the home. People were supported by staff who knew how to keep them safe and who had completed safeguarding training. Risk assessments were followed by staff and there was clear oversight of clinical concerns. People were supported by staff who had been safely recruited. Environmental improvements had been made at the home to prevent the spread of infection and staff complied with infection prevention and control policy. Where things went wrong, action had been taken to reduce the risk of reoccurrence.

People’s assessments were personalised and included their life stories. People were supported by staff who were knowledgeable and were provided with enough training opportunities. People’s mealtime experience was positive, and they were provided with choice of meals and drinks. People’s dietary needs were met in line with their care plans. The home had been adapted to make it more suitable to meet the needs of people living with dementia. People’s health needs were monitored, and referrals were made to health professionals when needed. 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.

People were supported by staff who were kind and caring to them. People were supported by staff who promoted their independence and enabled them to do what they could for themselves. Staff supported people’s privacy and dignity.

People were given choice and control and their care was delivered in a person-centred way. People had communication care plans in place and staff communicated with them in a way that maximised their understanding. People were encouraged to engage in a wide range of activities of their choice. A complaints policy was in place that was followed. Where people were at the end of their life, their wishes had been discussed and recorded.

The provider worked closely with commissioners and health professionals to improve the quality of care provided. Systems in place for staff deployment ensured an appropriate number of suitably skilled staff worked on each shift. The manager and staff were clear about their roles and responsibilities. There was a positive culture at the home that promoted positive outcomes for people and staff told us it was now a much better place to work.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 14 June 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 14 June 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well Led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Silverdale Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.