Sycamore Rise Residential Care Home

Updated 13 May 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 was carried out by 2 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

Sycamore Rise residential 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. Sycamore Rise Residential care home is a care home without 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 a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included, feedback, concerns, investigations, action plans and statutory notifications which the provider is required to send to us by law. We also sought feedback from professionals. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service, 2 relatives and 1 visiting professional. We spoke with 7 staff members. These included, 3 care assistants, a senior carer, the deputy manager, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at 3 people’s care records, associated documents, medicines records and medicines related documentation. We also looked at 3 staff files, training and supervision records, as well as records relating to the operation and management of the service. We undertook a tour of the building, observed medicines administration and their storage, and completed observations in the communal areas.

Updated 13 May 2023

Sycamore Rise Residential care home is a residential care home providing personal care to up to 32 people. The service provides support across three floors. The service provides support to younger adults, older people, people living with dementia and people who require support with their mental health. At the time of our inspection there were 28 people using the service.

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

Medicines were not always managed safely. Systems and process were not robust enough to ensure medications were administered and disposed of safely. Risks were not always being identified and managed in the environment and some people did not have risk assessments in place. Recruitment processes were not always safe as appropriate checks were not always being completed. The service was staffing at safe levels, however, due to recruitment issues and sickness, agency was being relied on. We have made a recommendation around maintaining recruitment and staffing tools. Infection prevention and control practices were not robust. People and families told us they felt the service was safe.

Staff were consistently receiving training in key areas and had good levels of compliance. We have made a recommendation the service includes training around learning disabilities and increased non mandatory courses. Supervisions were occurring. Pre-admission assessments were being completed and care plans covered key areas, although some plans required updating. People were having their diet and nutritional needs met and told us they enjoyed the meals. The provider worked in partnership with other agencies to maintain people’s health and wellbeing.

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 being treated with dignity and respect. People and relatives told us staff were caring. People could have visitors without restrictions and people and families were being encouraged to express their views on their care. People’s independence was being supported.

An activities coordinator had been recruited and activities in the home were taking place, although they were limited due to staffing issues. Records showed care was person centred and people were able to make everyday choices. People had communication care plans in place to ensure the support they need to communicate and receive information was in a way they understand. No one in the service was at end of life at the start of our inspection. The service was supporting people and families to plan end of life care. A complaints procedure was in place and the information was made accessible to people. People and families told us they felt able to complain.

Systems and processes were not always effective to oversee and manage the service. The provider did not record or provide structured support and oversight to the registered manager. The views of people, families, staff and professionals were regularly being sought and analysed. Staff and residents’ meetings were regularly occurring. People, families and visiting professionals spoke positively around the management and service. Staff told us they did not always feel heard. The provider was aware of duty of candour and was making appropriate notifications.

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 good (published 29 October 2019).

At our last inspection we recommended that the provider considered improving activities and the provider put in a formal process for overseeing the home and providing management support. At this inspection we found some improvements have been made in relation to activities however, not enough improvements have been made in relation to provider oversight.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safe management of medicines, assessing and managing risk, infection control practices, safe recruitment, and oversight of the service at this inspection. We made recommendations around recruitment and staffing tools and additional training.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.