We carried out a review of the data available to us about Sycamore Care Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Sycamore Care Centre, you can give feedback on this service.
Sycamore Care Centre is a care home that provides personal and nursing care for up to 113 people, some of whom are living with dementia. Care is provided across 9 units situated within 4 different buildings. At the time of the inspection there were 107 people living in the home.
People’s experience of using this service and what we found
People felt very safe living in the home and with the support they received from staff. People and relatives spoke highly of the staff and said they were kind and caring. Relatives told us, “The staff are well trained. They’re very good with my [family member]. They know how to speak to people. I couldn’t fault the staff, they’re marvellous” and, “It is safe here, the girls are great with [family member]. She is well supported and well looked after.”
Staff safeguarded people from abuse. Risks to individuals and the environment were well managed. There were enough staff to meet people’s needs. The provider learned from accidents and incidents to mitigate future risks. Medicines were safely managed. Infection control processes were embedded into the service and staff followed government guidance in relation to infection control and prevention practices, in particular, relating to COVID-19. Relatives told us, “Yes it’s clean, they clean the carpet every day. It’s very safe, clean and tidy” and, “The home is immaculately clean.”
People’s needs were assessed before they moved into the home and on an ongoing basis. Staff were suitably trained and received regular supervisions. People were supported with their nutritional needs and to access a range of health care professionals. People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
People were well supported and cared for. Staff treated people with respect and supported them in a dignified manner and in line with their wishes. One relative told us, “The staff know my [family member] really well. They treat her with respect and do encourage her. They are very kind people.”
People received person-centred care and care plans detailed how they wished to be supported. Staff knew how to effectively communicate with people and communication methods were detailed in care records. People and relatives knew how to raise concerns and any complaints received were fully investigated and actioned. People were supported with their social needs and enjoyed a range of activities.
The home was well managed. People and relatives were complimentary about the home and the care people received. The provider had an effective quality assurance process in place which included regular audits. People, relatives and staff were regularly consulted about the quality of the service through regular communication, surveys, meetings and reviews.
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 good (published 23 May 2018).
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Sycamore Care Centre is a 'care home'. 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. Sycamore Care Centre provides personal care for up to 113 people. At the time of our inspection there were 102 people living at the home who received nursing and personal care, some of whom were living with a dementia. The service is set in its own grounds and consists of four units: the Lodge, the Mews (which is split into four smaller sub units called Cedar, Hawthorn, Maple and Willow), the Villa and the Cottage.
A registered manager was in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We last inspected this service in November 2015 when it was rated ‘Good’ overall, although we found the provider had breached Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment. This was because medicines were not managed effectively. We returned to the service in August 2016 to check whether improvements had been made in this area. In August 2016 we found improvements in medicines management. The rating for the key question ‘is this service safe?’ remained ‘Requires Improvement’ as we needed to be sure consistent good practice could be sustained over time. During this inspection, we found improvements in medicines management had mostly been sustained. Overall, the service remained ‘Good.’
Staff had completed training in safeguarding vulnerable adults and understood their responsibilities to report any concerns. Thorough recruitment and selection procedures ensured suitable staff were employed. Risk assessments relating to people's individual care needs and the environment were reviewed regularly.
Staff received appropriate training and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to have enough to eat and drink and attend appointments with healthcare professionals.
There was a welcoming and homely atmosphere at the service. People were at ease with staff and people and relatives said staff were caring. Staff treated people with kindness and compassion.
Staff had a clear understanding of people's needs and how they liked to be supported. People's independence was encouraged without unnecessary risks to their safety. Support plans were well written and specific to people's individual needs.
Relatives and staff felt the service was well managed. Staff described the registered manager as approachable and said there was an open culture. There was an effective quality assurance system in place to ensure the quality of the service and drive improvement.
Further information is in the detailed findings below.
legal requirements in relation to medicines.
We undertook this focused inspection to check that they had met legal requirements and to confirm that they had followed their action plan and made improvements to the service. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Sycamore Care Centre on our website at www.cqc.org.uk.
Sycamore Care Centre is registered to provide personal and nursing care for up to 113 older people with general care and mental health needs. At the time of this visit 103 people were using the service. The service is set in its own grounds and consists of four units (the Lodge, the Mews, the Villa and the Cottage).
The current manager has been in post since the beginning of August 2015. They are in the process of applying to the Care Quality Commission (CQC) to become the registered manager. A registered manager is a person who has registered with the CQC 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.
At our focused inspection on 10 August 2016, we found medicines were managed safely. The provider had followed their plan and legal requirements had been met.
The inspection took place on 19 and 20 November 2015 and was unannounced. At the previous inspection in October 2014 the service was given an overall rating of ‘good’.
Sycamore Care Centre is registered to provide personal and nursing care for up to 113 older people with general care and mental health needs. At the time of this visit 106 people were using the service. The service is set in its own grounds and consists of four units (the Lodge, the Mews, the Villa and the Cottage).
At the time of our inspection the registered manager had been absent since the end of July 2015. An acting manager was appointed at the beginning of August 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. The service had notified us about this and an acting manager had been in post since the beginning of August 2015.
We found the provider had breached Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the service did not have accurate records to support and evidence the safe administration of medicines. Medicine records were not always completed correctly or in a timely manner, which placed people at risk of medicine errors.
You can see what action we told the provider to take at the back of the full version of this report.
People told us they felt safe because they were well looked after. The provider made sure only suitable staff were employed. Thorough background checks were carried out before staff started to work with people who used the service.
Staff completed safeguarding training as part of their induction and then at regular intervals. Staff we spoke with said they would raise any concerns immediately. This meant they knew how to deal with any concerns about people’s safety.
Accidents and incidents were recorded accurately and analysed by the manager. Measures were put in place which significantly reduced the number of falls people had. Risks to people’s health and safety were assessed and reviewed regularly.
Staff received appropriate training and regular supervisions and appraisals. Staff understood the Mental Capacity Act 2005 for those people who lacked capacity to make a decision, and Deprivation of Liberty Safeguards to make sure people were not restricted unnecessarily.
People’s health needs were assessed and monitored. People were supported to maintain a balanced diet. Staff knew people’s likes and dislikes well. Care records were personalised to each individual and were reviewed regularly.
People and relatives spoke positively about the caring and friendly attitude of staff. One person told us, “The best thing about the place is the staff – they’re lovely. You can’t help but bond with them because they are so nice.”
The people, relatives and staff members we spoke with felt the service was well-run. The provider had an effective quality assurance system and people’s views about the service were frequently sought to check where any improvements could be made. People and their relatives had several opportunities to raise suggestions and comments about the service.
People felt the atmosphere in the home was very good. Staff members we spoke with said staff morale was good and they felt valued.
This inspection took place on 07 October 2014 and was unannounced. We visited again on 09 October 2014 and the provider knew we would re-visit on that date.
Sycamore Care Centre is a 113 bed care home. The service provides personal and nursing care to older people with mental health and general care needs. The service is set in its own ground and is a detached converted building with extensions to the rear and side. It is placed in a mainly residential area but has access to amenities and services.
The home has a registered manager in place.
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.
We saw records that showed staff had been trained in recognising and responding to suspicions of abuse. Staff could articulate their understanding well.
People’s needs were assessed and good plans were in place showing their needs. We saw that staff knew what those needs were and were effective in meeting people’s needs.
People were encouraged to live healthy lifestyles within the home. Special provisions were made for those people who had special dietary requirements such as limitations due to diabetes, specially prepared food because of difficulties swallowing, or supplements to help them sustain or gain weight.
Day to day people were given choices about the things they wanted and the things they needed. Records and observations showed that staff supported people to make choices for themselves where they could. When people were not able to make choices for themselves, the home was careful to ensure their rights were protected by ensuring other important people such as family or health care professionals were involved in decisions made for them. We saw assessments of peoples mental capacity were undertaken and where required they involved peoples families, GPs, other health professionals and the local authority.
The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards exist to ensure people are only deprived of their rights if it is within their best interests. The registered manager understood the home’s responsibilities under the Mental Capacity Act 2005 (MCA) and we saw records in the care files that showed the home had followed this requirement and received confirmation that it was appropriate from the authority
We examined the medication records and observed the processes for giving medication and saw that the staff used safe methods to ensure people received the medicines they should when they needed them.
The home smelled and looked clean and the home had effective systems in place to manage infection controls.
We saw records relating to staff training. They were comprehensive and showed clearly what training staff had undertaken and what needed renewing. We staff putting some of that training into effect. For example we saw several instances where staff used hoists to move people. The seemed capable and confident in using the equipment.
We saw that people were consulted about their care We saw records showing how they had been involved what they said and what they wanted from the home. We saw staff putting that information into practice such as preferences about the food they ate. We saw in day to day interactions that staff were courteous and always asked people before performing a task for them.
We saw good records showing where people were at risk from dehydration and malnourishment. We saw that the home monitored those high risk areas. In one case we saw that the person was not always achieving their required daily fluid intake. We asked staff about that and they said they were seeking guidance from a dietician to look at ways of improving the situation.
We saw good assessments and care plans in relation to people’s health needs. There were corresponding day to day records that showed how staff were helping people meet those needs by seeking guidance from other health care professionals, the local authority or main stream services such opticians and dentists.
People living there and their families spoke highly of the care given by the nurses and care staff.
People felt the home was well run and staff checked that people and their relatives felt this way through group meetings and surveys of people living in the home, their families and other professionals involved with the home.
Staff received the support and guidance they needed to meet people’s needs. Records showed that staff had suitable training to care for the people who lived there.
People thought that staff were active in getting the support people needed. We were told, “The nurses here are tenacious to pursue care and get results. They persist until they get answers for us.”
When talking about the changes that staff within the home had made on one person’s life a relative said, “My [relative] is now like a different person I have my [relative] back.”
Apart from leaving some medicine records on top of medicine trolleys unattended we staff were careful to protect people’s privacy and dignity. We saw that they were careful to ensure people were covered appropriately, we saw them shutting doors behind them when they delivered personal care. We saw them speaking quietly so they could not be overheard when asking a personal question.
One relative told us, “The staff are really good at ringing us to tell us things that have happened and ask our opinion about things,” Another said, “I get phone calls all of the time. I was fully involved in the decision to get a DoLS (Deprivation of Liberty Safeguards) authorisation in place for my relative and fully agreed with it.”
We saw records of various surveys the home undertook to gain the opinions of people who lived there, their relatives and the staff who worked in the home. These showed various suggestions about changes and we saw that the manager included these in plans to develop the service.
We saw good evidence that people’s plans and assessments were changed over time as their needs changed. Relatives felt they participated in the care planning processes. One relative told us, “The nurses here are tenacious to pursue care and get results. They persist until they get answers for us.”
We examined training records and saw that staff had received training relative to the roles they undertook. We looked at the records for staffing and saw that the home had sufficient staff with the right training to provide the care needed. There were two people who provided a range of activities for people who lived in the home. We saw group activities such as ball games to improve suppleness and coordination, we saw games being played and we saw individuals getting personal attention in one to one situations.
Staff felt they were well managed and had access to the registered manager when they needed it. The spoke about supervisions (one to one personal guidance about their roles) and training and they felt they had sufficient training to do their jobs well.
The registered manager and the provider had systems in place to check how the home was performing. They gathered information from people who lived there their relatives and the staff. The results of those surveys were readily available in each area of the centre. The manager had systems that gathered information about care plans and if they had been reviewed following changes in need. We saw evidence of that updating process in both paper and electronic records.
The manager informed us the home had a system in place [the daily report] where they gathered information daily from each unit. That information was passed around all of the senior management team who shared any queries or concerns amongst the staff team. This included actions that needed to be taken within a given time frames.
The daily report and reports from staff who worked nights formed part of the agenda for the homes Monday morning head of department/ senior staff meetings. The provider had systems in place that checked that day to day management tasks were being undertaken There were systems to check that staff had supervision, training and annual reviews of their work. There were systems to capture information about falls, complaints and other incidents that were then included in plans of Monday morning senior meetings.
A relative told us they were confident their family member was being looked after; they said 'we couldn't ask for more', and that their relative was 'really well since she came here". Another person said, 'We're always really happy with the care she gets' and another 'We are confident when we leave her that she will be alright.'. We saw staff speaking to people in a kind and respectful way. We also observed that people were clean and well groomed.
We saw effective recruitment and selection processes for the staff to make sure people using the service were being supported by staff who were fit, appropriately qualified and physically and mentally able to do their job. The system for recruiting was robust and checks were carried out to ensure people were able to carry out their role safely.
People's records were detailed, up to date and gave staff information on how to meet their needs. They were written in a way that described how a person wanted to have their needs met and focused on them as individuals. Records of how the building, facilities and equipment were maintained and checked for safety were well organised and up to date.
Due to the physical and mental health needs of the people living in the home it was not possible to get some peoples views. However we were able to speak to a number of the people living there and we spoke to visiting relatives and representatives and visiting professionals.
All of the people living in the home who were spoken to said that they were happy with the service provided by the staff. A person living in the service told us that the staff were 'brilliant' and another said that 'things couldn't be better and another said ' you cant get any better than this'. When we asked people about the food, one person said that they thought it was 'excellent'.
One visiting relative told us that they were confident that their family member was being looked after and another, when asked about the care being given to their relative, said 'you couldn't fault it'.
Another visiting relative told us they chose Sycamore Care Home from a recommendation from a family friend. When asked about the Sycamore Care Home being provided they said 'We have peace of mind. We know our ' is safe and well cared for.'
They told us the regular sounding of bells was intrusive.
We were told, things could be better, but nothing will change.