Archived: Sycamore Care Services

Updated 26 February 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector. An Expert by Experience made telephone calls to people using the service and their relatives on 3 October 2019. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

The service had a manager registered with the Care Quality Commission. The registered manager was also the provider of the service. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider, registered manager or representative of the organisation would be in the office to support the inspection.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with four people who used the service and four people’s relatives about their experience of the care provided. We conducted the inspection with a director of the service. Following the inspection, we emailed both permanent members of staff and asked them some questions. A written response was received from one staff member.

We reviewed a range of records. This included five people’s care records and four people’s medication records. We looked at two staff files in relation to recruitment, training and ‘spot checks’. We also looked at personnel files for the registered manager and director. A variety of records relating to the management of the service, including policies and procedures were viewed.

Updated 26 February 2020

About the service

Sycamore Care Services is a domiciliary care service. It provides personal care to people living in their own houses and flats within Cambridgeshire and Wisbech.

The service was supporting nine people at the time of inspection. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Information relating to people’s individual risks were not always recorded or provided enough assurance that people were safe. Suitable arrangements were not in place to ensure the proper and safe use of medicines. People were often not informed if staff were running late and call preferences were not always followed. Required recruitment checks on staff were not robust to ensure staff were suitable. Lessons were not learned, and improvements were not made when things went wrong. People were protected by the prevention and control of infection.

Not all staff, including the provider and director’s training was up to date. Staff’s competence to carry out their role and responsibility had not been assessed. Robust induction arrangements for staff were not in place. There was no evidence to demonstrate staff had received spot check visits. People were supported as needed with meal and drink provision to ensure their nutritional and hydration needs were met, however improvements were required at weekends. People received ongoing healthcare support to ensure positive outcomes. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Though people using the service and their relatives said staff were caring and kind, our findings did not suggest a consistent caring service or a service that was always respectful and treated people with dignity. People and their relatives stated they had little input and involvement in the development of the care plan. People were able to maintain their independence where appropriate.

Care plans were not detailed. People and those acting on their behalf knew how to raise a concern or complaint. However, complaints were not recorded to evidence the provider was following their policy and procedure.

The leadership, management and governance arrangements did not provide assurance that the service was well-led, that people were safe, and their care and support needs could be met. Quality assurance and governance arrangements at the service were not reliable or effective in identifying shortfalls in the service. There was a lack of understanding of the risks and issues and the potential impact on people using the service. The provider was not familiar with regulatory requirements.

Why we inspected

This was a planned inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

We will meet with the provider and request an action plan to understand what they will do to improve the standards of quality and safety. We will work alongside the provider, Local Authority and CCG to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within six months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of their registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

This service was registered with us on 4 September 2017 and this is the first inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk