Sycamore

Updated 27 August 2020

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 on 18 February 2020. 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 under the Care Act 2014.

This inspection was not aligned with Ofsted’s inspection. A separate Ofsted report is available at http://reports.ofsted.gov.uk

Inspection team

The inspection team consisted of one children’s services inspector, and one specialist advisor who has expertise in nursing children who require complex care.

Service and service type

Sycamore Resource Centre is a children’s residential ‘care home’ which provides short breaks for children and young people with a range of complex needs and disabilities. Children and young people in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since their registration with CQC. We also looked at information and findings from the last Ofsted inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report

During the inspection

We spoke with one person who used the service and three relatives about their experience of the care provided. We also spoke with seven members of staff including the registered manager, team manager, senior care workers and care workers.

We reviewed a range of records. This included eight people’s care records and six medication records. We looked at documents relating to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including the provider’s policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate the evidence we found.

Updated 27 August 2020

The published date on this report is the date that the report was republished due to changes that needed to be made. There are no changes to the narrative of the report which still reflects CQCs findings at the time of inspection.

About the service

Sycamore Resource Centre is provided by Barnardo’s and serves as a residential short break centre for children and young people with severe, profound and complex physical and learning disabilities. The resource centre consists of five bedrooms which provide overnight accommodation for children and young people aged between 5 and 18 years of age.

The centre is a large home which is significantly bigger than most domestic properties. At the time of our inspection it was registered to provide accommodation for a maximum of five children and young people at any one time. During our visit, three children and young people were scheduled to receive respite. The centre is situated in a residential area, close to the town centre which means that children and young people who attend the centre benefit from accessing a range of activities and amenities in the community.

The spacious nature of the centre was benefitting children and young people. Children and young people who have sensory processing issues and become overwhelmed in busy, noisy environments can benefit from accessing quite spaces without having to retreat to their bedrooms.

Managers and staff made a conscious effort to ensure that the centre was homely and made attempts where possible to avoid any signs both inside and outside of the home which may indicate the nature and purpose of the building. Staff did not wear uniforms, but their own clothing which was appropriate for the nature of their work. Bedrooms had recently been subject to some refurbishment. All rooms had been re-painted and new, bright bedding purchased. This has made rooms brighter and more inviting.

Sycamore Resource Centre consistently applied the principles and values that underpin Registering the Right Support and other best practice guidance. Staff were passionate in their efforts to ensure that the children and young people who used the service were supported to lead active, meaningful and fulfilling lives whilst also providing support for their families, parents and carers.

There was a positive ethos of promoting independence and choice. We found that staff took the time to get to know the interests, preferences and aspirations of the children and young people who attend the centre for respite and involved them in a range of activities which further cultivated their interests and personal development. Children and young people who used the centre benefitted from planned and co-ordinated person-centred support that was appropriate and inclusive for them.

The centre was fully adapted to enable children and young people who rely on the use of wheelchairs and other mobility aids, to move around the home autonomously and with ease. The centre had a sensory space and a large garden and patio to the rear. Both areas could be independently accessed by children and young people who have mobility issues. The outdoor play equipment in the garden area had been specially adapted so it could be used by residents with a range of physical disabilities.

Staff were knowledgeable and well trained to provide complex care. They knew the children and young people they were working with well and knew how to keep them safe from abuse and harm.

The centre was clean and had been specially adapted to ensure that children and young people could move freely and independently without causing injury to themselves or others.

There were clear and effective medicines management procedures in place which avoided medicines errors. Medicines were stored safely.

There were a range of comprehensive procedures and policies in place which staff adhered to. However, some of these policies, such as the policy and guidance relating to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) were in need of review.

Care was effective and met the multiple and complex needs of children and young people.

Good partnership working with outside partners and agencies contributed to effective care.

Training on the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act (MCA) was not mandatory for staff.

Leaders and staff were committed, passionate and demonstrated exceptionally caring attitudes to children and young people.

There was an embedded “think family” approach at the centre. Staff provided on going care and support to parents and carers which was valued by the parents we spoke with.

Care was child centred. The needs, feelings and aspirations of children and young people were paramount.

The centre provided an extensive range of activities and excursions that enriched the lives of children and young people.

Leaders and staff were proactive in collating feedback and using such feedback to continually develop and improve service delivery.

Staff were innovative and creative in the way that they interacted and communicated with non-verbal children and young people.

Leaders were visible, accessible and staff we spoke with told us that they felt well supported and understood.

Processes to monitor quality and performance were effective.

Leaders had a clear passion to continually drive service improvement.

Leaders had successfully embedded a clear culture of transparency and candour. They were open and honest when things went wrong.

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

Parents and carers, we spoke with were full of praise for the centre and staff. One parent we spoke with told us, “They are a life line. My child’s key worker goes above and beyond what they are expected to do. They are in constant communication with me, but also have contacted other professionals to try and get additional support for my son.”

Another parent said, “Sycamore is brilliant. They provide the whole family with support. I totally trust them, which is hard sometimes, but the break means that I can do activities with my other children that I cannot always do when we are all together. They also give my son the experiences and one to one time which I sometimes am unable to.”

We have made several recommendations about infection control, care planning the use of visual monitoring and reviewing consent, policies, procedures and good governance.

We also have made a recommendation that all available plans and information regarding children and young people are available and accessible to staff by adding them to the child’s record.

This service was registered with the Care Quality Commission (CQC) on 12 April 2019 and this was the first inspection that we had carried out at this location.

Why we inspected

This was a planned inspection which we are required to carry out during the 12 months post registration of the service.

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.