Silver Service Carers Ltd achieved an overall Good rating across all five key questions, demonstrating significant improvement from its previous Requires Improvement rating and resolving the prior breach of Regulation 17. The service was characterised by strong leadership, personalised care planning, effective staff training, and consistently positive feedback from people and their relatives.
Strengths
· People felt safe with staff; safeguarding training in place and management understood reporting responsibilities to local safeguarding teams.
· All staff training brought up to date since previous inspection, with refresher dates tracked to prevent lapse.
· Comprehensive, personalised care plans developed with people and relatives, reviewed regularly and accessible in people's homes.
· Strong medication management with regular MAR chart audits, annual competency assessments, and supportive approach to errors.
· Registered manager was highly hands-on, conducting regular spot checks, home visits, and maintaining open communication with people and families.
Quality-Statement breakdown (25)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
Silver Service Carers Ltd provided a safe, caring and responsive homecare service with good outcomes for the 22 people using it, supported by a committed and well-regarded registered manager and team. However, the service was rated Requires Improvement for well-led due to insufficient formal auditing systems, incomplete and disorganised records, and a failure to submit statutory notifications to the CQC.
Concerns (4)
moderateGovernance: “there was a reliance on informal rather than formal systems to assess and monitor the service. For example there was no system to review the daily records written by staff during visits”
moderateRecord keeping: “We found a number of records were not up to date, such as staff training records. Some activities had not been recorded, such as competency checks on staff for administering medicines.”
moderateGovernance: “the registered manager was not fully clear about what events they were required to notify us of. We had not received any notifications from the service.”
minorStaff competency: “Some activities had not been recorded, such as competency checks on staff for administering medicines.”
Strengths
· People felt safe and staff demonstrated strong knowledge of safeguarding and risk management.
· Sufficient staffing levels with flexible deployment to meet changing needs, including out-of-hours responses.
· Staff were well-trained, enthusiastic, and supported through induction including the Care Certificate.
· People's consent and decision-making rights were consistently respected in line with MCA principles.
· Staff treated people as individuals, accommodating preferences including gender, language, and routines.
Silver Service Carers Ltd was rated Requires Improvement overall at this January 2019 inspection, down from Good in 2016, with one breach of Regulation 17 (Good Governance) due to ineffective quality assurance, inadequate risk assessments, and out-of-date staff training. Safe, Caring and Responsive were rated Good, with people reporting consistent, kind and person-centred care from a stable staff team.
Concerns (6)
criticalGovernance: “The registered person had not always assessed, monitored and improved the quality and safety of the care and treatment provided.”
moderateStaff training: “staff had not received refresher training in key areas of care for up to five years... safeguarding of adults, infection control and medicines.”
moderateSupervision / appraisal: “Staff received a six-monthly spot check of their performance... Due to the gaps in staff training, we did not feel this frequency was sufficient.”
moderateCare planning: “where people required support with their medicines or mobility, risk assessments either lacked detail or were not in place.”
moderateRecord keeping: “Records were not always accurate, complete and contemporaneous in respect of each service user.”
minorMedication management: “Some people required different levels of support... Care records were not sufficiently detailed to explain to staff what type of prompting or supervising people required.”
Strengths
· People received support from a consistent team of staff and staff arrived on time for all calls completing all required tasks.
· People and relatives found staff to be kind, caring and respectful, treating people with dignity.
· Robust recruitment procedures were in place to protect people from unsuitable staff.
· People received person-centred care reflecting their likes, dislikes and personal preferences.
· Complaints were handled appropriately in line with the provider's complaints policy.
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot rated
caring: Ensuring people are well treated and supported; equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Planning and promoting person-centred, high-quality care and support; duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated