Background to this inspection
Updated
9 January 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. 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 Care Act 2014.
Inspection team
The inspection team consisted of one inspector, one assistant inspector and one specialist professional advisor who was a nurse.
Service and service type
The Sycamores is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 on the first day and announced on the second.
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. This included feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
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. We used all this information to plan our inspection.
During the inspection-
We spoke with eleven people who used the service and four relatives about their experience of the care provided. Four people also completed feedback cards and returned these to us during the inspection. We spoke with eleven members of staff including the registered manager, deputy manager, two nurses, one senior care worker, three care workers, an activity co-ordinator, a maintenance operative and an administrator. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included ten people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found with additional evidence provided in respect of the provider’s systems for governance.
Updated
9 January 2020
About the service
The Sycamores is a care home providing personal and nursing care for up to 84 younger and older people who may live with dementia, a learning disability, or physical disability. At the time of the inspection there were 61 people who lived at the home.
The home was purpose built and people live on three units over three floors, two which are predominately nursing care and one for people living with dementia without nursing needs.
People’s experience of using this service and what we found
Quality monitoring systems were being developed but there was scope to further improve these in some areas, for example in improving the consistency and accuracy of people’s records and to ensure good practice was considered within medicine audits.
People's care plans and risk assessments, on most occasions, reflected people’s needs and preferences although there were some inconsistencies found. However, staff were able to explain how they provided appropriate, safe care that reflected people’s needs and preferences. People also expressed overall satisfaction with the care they received.
People were safe, and staff knew what to do to minimise risks to people as far as this was possible without infringing their rights. There were enough staff available to keep people safe and staffing levels were reviewed and changed to reflect changes in people’s needs.
People were supported by care staff who had the skills and knowledge to meet their needs, although some staff did identify further training or guidance in specific health conditions would be helpful. People expressed confidence in staff skills and knowledge and staff understood, felt confident and well supported in their role. Peoples health care needs were met as staff worked effectively with health care professionals
People were supported to have maximum choice and control of their lives and staff understood they should support them in the least restrictive way possible; the policies and systems in the service supported this practice.
People had access to food and drink, with most people enjoying their meals, and the service offered specialist or culturally appropriate diets when needed.
People were supported by staff that were caring and expressed interest in them. People and the support they provided them. People received person centred care and support based on their individual needs and preferences. Staff were knowledgeable about people, their needs and preferences and used this to develop good relationships. People’s privacy, dignity and independence was respected by staff.
The service was responsive to information from people and relatives. People could complain, and concerns were listened and responded to by the staff. Complaints and comments were used as a tool to drive improvement of the service.
People, relatives and staff were able to share their views with staff and were involved in planning their care. People said they enjoyed their life at The Sycamores and said their care usually reflected their needs and preferences. People were able to follow their chosen routines and had access to a range of activities.
People said the registered manager and staff were approachable, listened and responded to them and acted on feedback they shared with them. The registered manager had demonstrated they were not complacent and had improved the service since our previous inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Requires Improvement (report published 11 December 2018).
Why we inspected
This was a planned inspection based on the previous rating.