Archived: Sycamore Court Nursing and Residential Care Home

Updated 30 December 2014

The inspection team consisted of an inspector 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.

During the visit, we spoke with 11 people living at the home, four relatives, three nurses, five care staff, the activities coordinator, the home manager (manager), the care manager and the senior district manager. As part of the inspection process, we also spoke with a local GP and a contracts officer from the local authority.

Before the inspection, we reviewed information we held about the home including a pre-inspection report provided to us by the service. We spoke with Clincial  Commissioning Groups (CCG) and the local authority safeguarding team to obtain their views on the service and the quality of care people received.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Some people with specific physical or psychological needs were unable to speak with us. Therefore we used other methods to help us understand their experiences. We used the Short Observational Framework for Inspection (SOFI) during lunchtime. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We looked at all areas of the building, including people’s bedrooms, and the communal areas. We also spent time looking at five people’s care records. 

The last inspection of this service was in September 2013, where no concerns were identified in the areas in which we looked.

Updated 30 December 2014

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection. Sycamore Court Nursing and Residential Care Home provides accommodation and nursing care for up to 40 people, who have nursing needs, including frailty and mobility issues, as well as those in all stages of dementia. There were 35 people living at the home on the day of our inspection.

There has not been a registered manager in post since June 2014 but reasonable steps in a timely manner have been taken.  A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider. During this inspection, the senior district manager confirmed that an application would be submitted to CQC and they were currently providing additional support to the newly appointed home manager. They also told us that continuity of care and support was provided by the care manager (a qualified nurse and clinical lead), who, at the time of the inspection, had been working at Sycamore Court for eight months..

People's individual care and support needs were assessed before they moved into the service and detailed and comprehensive care plans and risk assessments were maintained and reviewed regularly. People and their relatives confirmed that they had been involved, or had the opportunity to be involved, in assessments, care planning and reviews.

People were treated with respect and dignity by the staff. They were being spoken with and supported in a sensitive, respectful and professional manner. We saw that care workers always knocked on the door before entering bedrooms.

People told us they felt safe. Relatives we spoke with said they felt confident and reassured that their loved ones were safe and a family friend, who regularly visited the home, told us they were “100% sure” that their friend was safe. There were systems in place to assess and manage risks and to provide safe and effective care.

The care manager told us that an individual’s dietary requirements formed part of their pre-admission assessment and people were regularly consulted regarding their food preferences. Menus and people's individual nutritional requirements were regularly discussed during residents' meetings. Healthcare professionals, including speech and language therapists and dieticians, had been consulted as required.

People were provided with choices such as whether they wished to join in with an activity and they told us their choices were respected. The activities coordinator told us that people had the opportunity to take part in a range of social and recreational activities, reflecting their interests and preferences, both in and outside the service.

People were registered with local GPs and had access to other health care professionals, including practice nurses and physiotherapists, as required. Pressure relieving mattresses were in place where assessments had highlighted a risk of pressure damage to the person’s skin.  All appointments with, or visits by, health care professionals were recorded in individual care plans. People told us their physical healthcare needs were effectively met by the home. One person said “If you’re feeling unwell, they are quick to arrange a doctor to come in.”

There were sufficient numbers of suitable staff to keep people safe and meet their needs. Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up to date plans were in place to promote good practice and develop the knowledge and skills of staff.

Staff told us that communication throughout the home was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They confirmed that they felt valued and supported by the managers, who they described as very approachable. However they also told us that they had not received formal supervision for several months.

As well as regular residents and relatives’ meetings and satisfaction questionnaires, the manager told us they frequently carried out a range of internal audits, including care planning, medication and staff training. The manager also told us that they operated an 'open door policy' so people who used the service, staff and visitors to the home could discuss any issues they may have.