This inspection took place on 3 January 2018 and was unannounced. This means prior to the inspection people were not aware we were inspecting the service on that day.

Silverwood is situated approximately six miles from Rotherham. It is a purpose built home providing care for up to 64 people. The home is registered to provide accommodation for persons who require nursing or personal care. The home has bedrooms on the first and ground level of the building. The ground level provides care to people with a diagnosis of dementia. There is ample parking and gardens to the rear of the building. On the day of our inspection there were 57 people living in the home.

There was no registered manager in place for the service. The home had a manager who was in the process of registering with the Care Quality Commission (CQC). 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.

Our last inspection at Silverwood took place on 16 and 17 December 2015. The home was rated ‘Good’. At this inspection we found the service remained ‘Good’.

People who used the service told us they felt safe living in the home. Their relatives spoke positively about the standard of care and support their family member received.

We found people received care that was in line with their assessed risks and care plans.

The registered provider had a policy and procedure in place for the safe management of medicines. Staff were working in accordance with this policy which assisted in keeping people safe and well.

There were sufficient numbers of staff available to keep people safe and there were effective staff recruitment and selection procedures in place. Staff were appropriately trained and supervised to provide care and support to people who used the service.

People enjoyed the food provided and were supported to receive adequate food and drink to remain healthy.

People were provided with access to relevant healthcare professionals to support their health needs.

The relationships we saw between people who used the service, their relatives and friends and staff were warm and friendly. The atmosphere in the home was calm and relaxed.

People's privacy, dignity and independence were maintained by staff that were caring and respectful.

Staff knew the people they were supporting and provided a personalised service. Support plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

People were supported to join in with social activities they were interested in and time was spent with some people on a one to one basis. There was a plan in place to enhance and improve the range and quality of activities made available to people.

People and their relatives had been asked their opinion of the quality of the service via surveys and by the regular meetings with the managers.

Staff said communication in the home was good and they always felt able to make suggestions. There were meetings held for all staff and additional meetings for groups of staff, for example, senior care workers.

There were systems in place to continuously assess and monitor the quality of the service, with a strong emphasis on promoting and sustaining improvements.

Further information is in the detailed findings below.

The inspection took place on 16 and 17 December 2015 and was unannounced on the first day. At the last inspection, in April 2014, the service was judged compliant with the regulations inspected.

The service has a registered manager who has been registered with the Care Quality Commission since January 2015. 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.

Silverwood is situated approximately six miles from Rotherham. It is a purpose built home providing care for 64 people. At the time of this inspection there were 62 people living at the home. The home has bedrooms on the first and ground level of the building. The ground level provides care to people with a diagnosis of dementia. There is ample parking and gardens to the rear of the building.

The requirements of the Mental Capacity Act 2005 were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment.

People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made. We also spoke to a visiting community nurse who said, “The staff act in a timely manner to seek my advice. I think the home is well led and the care is very person centred."

There were sufficient staff with the right skills and competencies to meet the assessed needs of people living in the home. Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink. People we spoke with told us they enjoyed the meals and there was always something on the menu they liked.

People were able to access activities. The activity co-ordinator had developed a weekly plan of activities. People could also access religious services which were held periodically at the home. People we spoke with told us they were looking forward to the Christmas festivities.

There was a strong and visible person centred culture in the service. (Person centred means that care is tailored to meet the needs and aspirations of each individual.) We found the service had a friendly relaxed atmosphere which felt homely. Staff approached people in a kind and caring way which encouraged people to express how and when they needed support. Everyone we spoke with told us that they felt that the staff knew them and their likes and dislikes. One person said, “They understand perfectly what my requirements are.”

Staff told us they felt supported and they could raise any concerns with the registered manager and felt that they were listened to. People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it. We noted from the records that one formal complaint had been received in the last 12 months and two concerns which were immediately resolved.

There were effective systems in place to monitor and improve the quality of the service provided. We saw copies of reports produced by the registered manager and the provider. The reports included any actions required and these were checked each month to determine progress.

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff, and staff were given support and guidance to ensure that they cared for people safely. People were protected from the risk of infection because appropriate guidance had been followed. People were cared for in a clean, hygienic environment

Systems were in place for managers to monitor the quality of the service and make sure it was run safely

Is the service effective?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Care plans contained assessments of people’s care and support needs. These assessments described the steps staff should take to ensure each person’s needs were met. Staff received appropriate support to meet the needs of people living at the home.

Audits and reviews took place to ensure that care was delivered in a way that met people’s needs.

Is the service caring?

Our observations showed that staff were caring and respectful towards people. Every care task we observed took place in a patient and kind manner. People spoke positively about their experience of receiving care at the home.

Is the service responsive?

Staff acted on people’s needs and in accordance with their wishes. Where people needed specific support or care, we saw evidence that this was delivered in accordance with people’s needs.

Is the service well-led?

There was a quality assurance system in place, where external staff carried out a quality monitoring programme. This was detailed and thorough.

Before people received care and treatment they were asked for their consent and the provider acted in accordance with their wishes. The appropriate procedure was followed where people were not able to give consent. We spoke with two relatives and they told us that people were always given a choice.

People who used the service had a care plan which was relevant to their individual needs. People we spoke with told us they enjoyed living at the home. One person said, “Its lovely here, I am looked after well.” We saw that people were listening to music of their choice as when a particular song was played one person said, “I like this one, it’s my favourites.” We asked one relative what they liked about the service and they said, “It’s that sense of security when you leave that you know you have left your relative in safe hands.”

We found that the home worked well with other professionals. People who used the service were supported to access other professionals when required.

We found that the provider had appropriate arrangements in place to manage medicines. Staff were knowledgeable about the system. We found that staff were appropriately trained in the safe administration of medication and in the use of the electronic system.

We found that people who used the service were supported by enough qualified, skilled and experienced staff to meet their needs.

The provider had an effective system in place to regularly assess and monitor the quality of service that people received.

We found there was an effective complaints system in place. People knew how to complain and felt their concern would be resolved.

We spoke with eight people who use the service about their views regarding the meals provided at the home. They told us that they were satisfied with the standard of meals and there was a good variety of choice at each meal. One person told us “We are asked what we want for our lunch and they offer us two or three choices.” One person told us “When it’s our birthday we get a small cake and we have a buffet which is nice.”

We spoke with a number of people who used this service about their experiences while living at Silverwood. Most said they enjoyed living at the home and staff were very kind. One person said: “Staff gave me a key to my door so that I could lock it when I was out of the room; I also lock my door during the night, so that I don’t get disturbed by other residents.” We observed lunch in three dining areas and some people told us that they had not enjoyed their meal. One person told us the meal was not very nice, although it was usually better than on that particular day. One person said, “The service was poor”.

We spoke with six relatives and most told us they were very satisfied with the care provided at the home. One relative said: “The staff do their best, but we wish there were more staff.”