Sycamore Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Some people did not consistently experience person‑centred care. Relatives reported concerns about basic care, including missing belongings such as hearing aids and glasses, long intervals without nail care, and prescribed footwear not being applied. Some care plans contained generic information, which limited assurance that staff understood and followed people’s individual preferences. During the inspection, the provider updated these care plans and began reviewing all plans to ensure they included personalised information.

Despite these concerns, the provider involved people in decisions about their care and treatment. Staff worked with people to respond to changes in their needs and supported them to make day‑to‑day choices, such as when to get up or go to bed, how often they wished to bathe, and what they wanted to eat. People and relatives described the home as welcoming and said staff were kind, gentle and familiar with people’s histories, routines and preferences. Activities staff tailored sessions to individual interests and offered both group and one‑to‑one activities that reflected what people enjoyed. Families also described personalised, compassionate end‑of‑life care that focused on comfort and dignity.

People usually experienced coordinated care, and staff worked effectively with health and social care partners to support continuity. The provider used a dependency tool and rota planning to align staffing with changing needs, and familiar bank staff helped maintain continuity. Staff engaged with GPs, district nurses, public health teams and specialist clinicians, adapting care plans in response to changing clinical advice. Daily “10@10” meetings and governance reviews supported oversight of incidents, falls, wounds and infections, prompting timely actions such as adjusting support levels or introducing additional monitoring.

The provider usually ensured people and relatives received clear information about the service and their care. Regular relatives’ meetings, surveys in accessible formats and open communication with managers gave people opportunities to ask questions and offer feedback. Many relatives said staff were approachable and kept them informed about significant changes such as infections, falls or medication issues. Staff received information through handovers, meetings and noticeboards, and could describe recent learning.

However, not all people and relatives had the same level of information. Some relatives said they had not seen care plans or did not understand why specific equipment or interventions were in place.

The provider usually listened to people and those important to them and acted on their feedback. People and relatives described staff and managers as open and responsive, and gave examples of the service adapting care, routines or activities to reflect people’s wishes. Staff said resident and family meetings, informal conversations and surveys helped them gather and act on people’s views. Records showed families with lasting power of attorney were involved in best interest decisions when needed.

However, involvement was not always evident in day to day interactions or documentation. During observations, some staff delivered task focused care with limited conversation or explanation, reducing opportunities for people to express their views in real time. Low level concerns were not always recorded consistently, making it difficult for the provider to demonstrate how these were addressed over time. The provider showed us a concerns book at the entrance, but relatives needed greater awareness of it so they could use it and be assured their concerns reached senior management and were shared with staff.

People generally had fair access to care, activities and healthcare input regardless of their needs. The home supported individuals with a wide range of clinical and social needs and used dependency tools and Continuing Healthcare (CHC) arrangements to provide additional staffing where required. People were able to access GPs, community nursing, therapies, mental health services and Speech and Language Therapy (SALT), and the home arranged dementia friendly and emergency dental care. Activities staff offered both group and onetoone support, helping people who remained in their rooms to stay engaged. Training in dementia, Parkinson’s disease, behaviour support and catheter care helped staff understand and respond to diverse needs

However, inconsistencies in basic care and occasional communication barriers affected some people’s experience. One relative described difficulty when staff were less confident in spoken English, which contributed to variability in people’s day to day interactions.

Some people did not experience consistently positive outcomes. We found inconsistencies in clinical documentation, including gaps in pain assessment, hydration monitoring and catheter care, and some care plans did not reflect people’s current clinical needs. Relatives also reported omissions in routine care, such as footwear not being applied as prescribed or people not having access to their glasses.

However, most people experienced positive outcomes, and the provider used data effectively to monitor themes and drive improvement. Incident analysis identified trends in falls, infections and pressure damage, leading to increased checks and targeted interventions. Safeguarding oversight, including external deep‑dive reviews, strengthened governance arrangements. Compliments from families and professionals highlighted caring and supportive staff, and staff survey results indicated a stable workforce that contributed to more consistent outcomes.

Care planning for future care, including end of life arrangements, was not consistently robust or personalised. Many care plans were preformatted and did not fully reflect people’s changing needs, particularly in areas such as complex diabetes management, catheter care, pain management and wound care. Key instructions were missing or unclear, including guidance on continuous glucose monitoring, administration of analgesia before dressing changes and catheter management. These gaps meant staff did not always have the clear, individualised information required to plan effectively for people’s future care.

Although these shortfalls were significant, there were areas of positive practice. Respect forms, Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions and anticipatory care plans demonstrated involvement of people and their families, and relatives described compassionate support during end of life care. Governance meetings reviewed clinical risks and informed some proactive adjustments, such as increased monitoring for those assessed as higher risk.