Sydenham House

Sydenham House is a residential care home which accommodates up to 19 people in one adapted building. Sydenham House is registered to provide care for older adults who may be living with dementia, physical disability and/or sensory impairment. At the time of this inspection 16 people were living there.

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

We found improvements were needed to ensure people's risks were assessed and mitigated to keep them safe, such as the management of people’s weights, moving and handling and nighttime support.

We found improvements were also needed in relation to medicines administration and the management of environmental risks to people in areas such as the management of legionella and fire safety.

Improvements were also needed to strengthen the provider's quality auditing systems and processes of the service delivery.

The registered manager was aware that improvements needed to be made to the service and was in the process of addressing these.

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.

People and their relatives told us they felt safe living at the service.

Staff understood their responsibility to report concerns and poor practice. Staff knew how to report any incidents and accidents.

Systems were in place to engage with staff and people who use the service.

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 02 July 2018)

Why we inspected

We inspected this service because the previous inspection was more than 5 years ago, and we wanted to check the provider was still providing good quality and safe care. We undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Sydenham House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance.

We made a recommendation to support the provider's systems of assessing and recording people's mental capacity.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Sydenham House is registered to provide accommodation and personal care to up to 19 older people who may also be living with dementia, sensory impairment or physical disability. At the time of our inspection 18 people were living at the service.

We found the following examples of good practice.

¿ The provider had installed a 'visiting cabin' in the grounds in accordance with recognised safe visiting guidance. People were also supported to be in contact with their relatives through telephone and video calls.

¿ People’s relatives were supported to visit them safely at Sydenham House when end of life care was being provided.

¿ Admission to the service was completed in line with COVID-19 guidance. People were only admitted following a negative COVID-19 test. Following admission, they were supported to self-isolate for 14 days to reduce the risk of introducing infection.

¿ People’s health and wellbeing was monitored. People were checked for symptoms of COVID-19 and other potential infections. Monitoring results were shared electronically with the GP which allowed prompt clinical support to be provided to people. People and staff had been supported to receive COVID-19 vaccinations.

¿ The provider’s policy for managing COVID-19 and related infection prevention and control procedures had been reviewed and kept up to date. COVID-19 guidance was also kept up to date for staff reference.

¿ Action had been taken to reduce the risk of an outbreak which included correct use of personal protective equipment (PPE). Staff had received training and support in relation to infection control and COVID-19. Managers ensured staff were following national PPE guidance.

¿ The provider had audited and improved their infection control processes in line with COVID-19 risks. Cleaning schedules had been enhanced, laundry facilities upgraded and risks from waste disposal reduced.

¿ People and staff were tested for coronavirus in line with national guidance for care homes. Staff followed isolation requirements and understood how to reduce risks of an outbreak in the service.

¿ People were engaged with activities which met their wellbeing needs, whilst promoting social distancing. The staff team were committed to maintaining people’s wellbeing during the pandemic.

¿ There had been no cases of coronavirus at the service. The provider had considered how zoning may be introduced and staff cohorted to reduce the spread of infection. The service revised their staffing contingency plans following signposting during our inspection.

Sydenham House is a residential care home for up to 19 people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Sydenham House is registered to provide care for older adults who may be living with dementia, physical disability and/or sensory impairment. At the time of this inspection 19 people were living there.

This home was registered under a new legal entity on 17 May 2018, when the provider changed from being an individual to a limited company. There has been no change to the ownership or management of the home despite the change in legal entity. At the last inspection on 25 February 2015, under their previous registration, the service was rated Good. This was our first inspection since registration of the new legal entity and at this inspection we found the service was Good.

Accommodation at Sydenham House is provided in one adapted building over three floors, with bedrooms located on each floor. The upper floors were accessed via a passenger lift, suitable for wheelchairs, or via the stairs. Most bedrooms had en-suite facilities and adapted communal bathrooms were available to all. People had access to the lounge, dining area, conservatory and garden. The well-maintained garden was large, flat and enclosed, with outside seating areas. Parking was available to the side of the house.

There was a registered manager in post. 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.

Sydenham House enjoyed a good reputation locally and was recommended by everyone we spoke with. People received safe, personalised care from a well-established staff and management team. There were enough suitable staff to meet people's needs. People’s needs were reviewed regularly and risks were managed with the support of health and social care professionals. Staff worked openly with other agencies to safeguard people. The home and specialist equipment were appropriately maintained and people were protected from risks associated with cross infection. There were few incidents, accidents or complaints at Sydenham House, but learning from these and external events was taken forward to improve safety and people’s experience of the service.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's privacy was respected and they were treated with dignity and kindness. People were supported to maintain relationships with others who were important to them. They were supported to access preventative and specialist health care and to live as full a life as possible.

People benefitted from a caring staff team who knew them well, could communicate with them and worked flexibly to meet their needs, including social and emotional needs. People's preferences were taken into account and they were listened to. People received good end of life care. Feedback about the service was sought regularly and this was used to improve the service.

The culture at the home was open and nurturing. People and staff were valued and their needs were prioritised by the management team. Staff and managers worked together and collaboratively with external agencies to ensure the provide the best possible experience for people.

Further information is in the detailed findings below.