Sycamore House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Accidents and incidents were recorded, monitored and action taken to mitigate risks to people. This included an analysis of incidents of distress and medicines incidents. Where required incidents were reported to external agencies.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Care records were digitalised and were able to be shared easily between professionals, where appropriate. People had pre-admission assessments in place, prior to people receiving care, this included detailed assessments from the local authority. The provider told us they assessed potential new placements, to ensure they would be a suitable match for the people currently living at the service.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Staff were trained and understood their responsibilities to safeguard vulnerable adults. Staff told us they felt comfortable to whistle-blow on poor practice and the management team would listen to them and take action. A staff member said, “The manager is very approachable, they are always ready to help, the manager wants to do things right. I am confident to speak to them at any time.” Notifiable incidents were reported externally as required, such as to the local authority and the CQC. People and relatives told us they felt safe. A relative said, “[Name] is very happy and safe there, I have no issues with their care at all, [name] is content.”

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).The service was working within the principles of the MCA. People had their capacity assessed and DoLS authorisations were in place where required.

Risks posed to people were assessed and mitigated. Staff were trained to deal with incidents of distress. Staff knew people well and told us they supported people with their anxieties, how they identified if people were becoming upset and how they supported people to manage this. A staff member said, “We know people well, meaning behaviours can be avoided. We observe people’s body language, and we calm people by ways of communication.” Staff also told us incidents had reduced within the home. However, the provider’s own positive behaviour support plans could be more detailed, they lacked some detail about possible triggers and step by step guidance about how staff should react at each stage. People did have assessments and detailed plans provided by community learning disability teams. We saw staff observing people during meal-times, to promote their safety. People had safety monitoring equipment in place, where required.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. We found some radiators in bathroom areas to be hot to touch, this was immediately rectified on the day of our assessment. The maintenance team completed regular checks on the environment and completed an ongoing maintenance programme. Fire safety measures were in place, including risk assessments, and people and staff were involved in practice evacuations. Legionella risk management systems were in place and hazardous substances were securely stored. The environment was homely, with new furnishings. Ongoing refurbishments were taking place to maintain the home’s environment; on the day of our assessment a new bathroom was being fitted.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. People, relatives and staff told us enough staff were deployed to meet people's needs. A relative said, “[Name] is extremely happy and content, there is plenty of staff. I visit every 2 weeks. [Name] is settled.” A staff member said, “There are enough staff. People are very safe here, we make sure we make sure we practice a very safe service. Anything people need, we do. I have supervisions, every 3 months, or impromptu if I need to.” Staff were recruited safely; all pre-employment checks were in place and new staff received an induction. Staff were trained to effectively carry out their roles, this included training related to positive behaviour support, autism and communication.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The home was observed to be clean and tidy, including in kitchen areas. Staff had access to personal protective equipment (PPE) and we observed staff wearing PPE appropriately.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff were trained and had their competencies assessed prior to administering medicines to people. Staff completed medicines administration record’s (MAR's), and where people received 'as required' medicines, detailed protocols were in place to guide staff about how and when to use these. Stock was checked daily to ensure people were receiving their medicines as prescribed. Where a person chose to take herbal remedies, this had been reviewed by the GP and was included in this person’s medicines records.