All inspections: Sycamore House Care Home

Sycamore House is situated in Hull. It is a single storey building; it is registered with the Care Quality Commission to provide care and accommodation for a maximum of 36 people, some of whom may be living with dementia. The service has 34 bedrooms for single occupancy and one shared bedroom. There is a range of communal rooms throughout the service.

This inspection was undertaken on 11 December 2015, and was unannounced. The service was last inspected on 26 August 2014 and found to be compliant with all of the regulations that we assessed at that time.

There was a registered manager at the service at the time of our inspection. 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.

Staff told us and records confirmed safeguarding training had been completed. Staff told us they felt confident the registered manager would investigate any concerns they raised. Risk assessments were in place to reduce and mitigate the known risks to people who used the service. People were supported by suitable numbers of staff. Medicines were managed safely and administered by trained staff.

Staff had completed a range of training that enabled them to meet people’s assessed needs effectively. Staff received support and mentorship from the registered manager. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made. The registered manager understood their responsibilities in relation to the deprivation of liberty safeguards (DoLS). People ate a balanced and varied diet of their choosing; their nutritional needs were assessed and monitored. Advice from relevant health care professionals was requested and their guidance was recorded as required.

People were supported by attentive and caring staff that understood their preferences for how care and support was to be delivered. Staff knew the people they supported, their likes, dislikes, hobbies and interests and provided them with person centred care. Staff respected people’s privacy and dignity.

People were involved in the planning of their care and records showed that reviews took place periodically. We saw that when possible people or an appointed person had signed to show their agreement with the contents of their care plans. People were encouraged to follow their interest and participate in activities. A complaints policy was in place, we saw when complaints were received they were responded to in line with this.

A quality assurance system was in place that consisted of audits, checks and feedback from people who used the service. When shortfalls were identified action was taken to improve the service as required. The registered manager was a constant presence within the service and understood the requirement to report notifiable incidents to the Care Quality Commission.

The inspection was carried out by an adult social care inspector. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

' Is the service caring?

The service is caring. Staff demonstrated a good understanding of the needs of the people who used the service and could describe how to maintain people's dignity and how to ensure people's choices were respected.

People were supported by attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

People who used the service and / or their relatives, completed satisfaction surveys in relation to the home. Where suggestions or concerns had been raised the provider had listened and made changes to the service.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

' Is the service responsive?

The service is responsive. Care records demonstrated there had been changes in people's needs. We found that other health care professionals, for example doctors and district nurses had been consulted and their advice sought.

We saw that people's care needs were kept under review and care plans, risk assessments and support plans were updated when required.

' Is the service safe?

The service is safe. Systems were in place to make sure that the registered manager and staff learnt from events such as accidents and incidents, complaints, concerns and investigations. This reduced the risks to people and helped to ensure that the service continually improved.

The people who used the service told us they were happy and that they felt safe. We saw that people were treated with respect and dignity by staff.

Staff had completed training in how to safeguard vulnerable adults. This meant that people were safeguarded as required.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly so people who used the service were not put at unnecessary risk.

' Is the service effective?

The service is effective. People's health and care needs were assessed with them, and they were involved in writing their plans of care when possible. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

The majority of staff had received appropriate training and professional development. Specialised training had been completed to ensure the needs of the people who used the service could be met.

' Is the service well led?

The service is well led. The service had quality assurance systems in place and records we looked at showed that identified shortfalls were addressed promptly.

The provider consulted with people about how the service was run and took account of their views.

Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times.

What people who used the service and those that matter to them said about the care and support they received.

A person who used the service told us, 'The staff are very polite, they are kind and helpful.' We asked another person if they were comfortable at the home and if their needs were met; we were told 'I am really happy here, I've only been here for a short time but it feels like my home.'

A relative we spoke with said, 'My relative has not been here that long but my first impressions are that the staff seem kind and are very friendly. I have no complaints so far things have been good.' Another relative told us, 'Mum has been here for a good few years and we have never had an issue.'

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People confirmed they were able to make choices about their care and treatment.

People experienced care, treatment and support that met their needs and protected their rights. People we spoke with told us they received a good standard of care. Comments included, "I enjoy living here, the people and staff are very friendly and supportive" and 'I can have anything I want here."

People were supported to be able to eat and drink sufficient amounts to meet their needs. People told us they enjoyed the food. Comments included, 'I can eat anything I like." and "There's plenty to choose from."

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. We looked around various parts of the service. We found it was clean and free from odours.

There were enough qualified, skilled and experienced staff to meet people's needs. People who used the service confirmed their care needs were being met and the staff attended to them in a timely way.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

People spoken with told us they liked living at the home and that they were well looked after. They said they received their medicines and confirmed they had not run out of their medicines. Comments included, 'I ask them for a flannel and soap so I can manage myself. They get my clothes out for me', 'I went into hospital recently so they decorated my bedroom', 'You can have a bath or a shower whenever you want', 'It's not like home but it's alright', 'The food is very good' and 'If you can do things for yourself they let you ' no I'm not rushed.'

A relative spoken with said they had no concerns about the home.

People spoken with described the staff as 'fine', 'good' and 'very nice and pleasant'. Comments included, 'They are very good. You can't have better', 'They are alright' and 'They always ask if you want anything or if you are well.'

People expressed their views and were involved in making decisions about their care and treatment. People spoken with told us they were able to make choices about aspects of their lives. They said they could get up and go to bed when they wanted and were able to join in some activities. They told us staff promoted their privacy by knocking on doors prior to entering. They told us they had choices about the meals provided.

People spoken with were generally happy with the care they received and told us they were looked after well. They told us they had access to a range of health care professionals. Comments included, 'They couldn't do any more for you' and 'They come and check that I am ok.' One person said 'I have been to the hospital for an appointment.' Another person confirmed that staff called their GP when required. Another person told us, 'I see the hairdresser, the chiropodist and an optician.'

We had a discussion with a visitor following the inspection. They told us they were concerned that staff did not contact health care professionals in a timely manner when their relative was declining food and fluids and losing weight. They told us they had been informed by staff that the person had not eaten and drunk anything for seven days and when they checked they found a doctor or dietician had not been contacted during this time.

People spoken with told us they were happy with their home and it was kept clean and tidy.

People spoken with made generally positive comments about the staff team. However, we were told that staff were very busy and at times had to be prompted or reminded to complete tasks. One person said, 'They are very friendly and most of the time they come quickly ' they are on a tight schedule.'

People told us they felt able to complain and would speak with staff or the registered manager if they needed to complain.

These older reports are from our old approaches to inspection, including those from before CQC was created.

Archived: Sycamore House Care Home

All Inspections

11 December 2015

During a routine inspection

27 August 2014

During a routine inspection

5 June 2013

During a routine inspection

25 September 2012

During an inspection looking at part of the service

22 May 2012

During a routine inspection

Reports under our old system of regulation