The Sycamores

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff had opportunities to update their skills and professional development. Staff demonstrated an understanding of the Mental Capacity Act (MCA) 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their relatives told us they felt safe.

Care records contained clear information covering all aspects of people's individualised care and support and staff had a caring approach to working with the people who used the service. At the time of inspection the service was reviewing all care plans.

People had access to a range of activities in and outside the home.

Staff were confident in supporting people with medicines and knew people very well.

There was a clear management structure and staff clearly understood their roles and responsibilities. There was an open and transparent culture in which staff felt valued and able to approach the registered manager. Staff told us they felt valued and really enjoyed their role. The management team continued to work to improve the service provided and work as much as possible with people if they had any concerns or complaints. We saw lessons had been learnt through review of accident and incidents.

Further information is in the detailed findings below

The inspection of The Sycamores took place on 22 December 2015 and was unannounced. We previously inspected the service on 21 October 2013. The service was not in breach of the Health and Social Care Act 2008 regulations at that time.

The Sycamores is a converted property with a purpose built extension. It is part of the Holly Bank Trust which is an organisation specialising in providing education, care and support for young people and adults with profound complex needs. The home provides care and support for up to eight people. On the day of our inspection, seven people were living at The Sycamores.

At the time of our inspection the registered manager was not available, a temporary manager was providing support to the home in the short term. 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.

Relatives we spoke with told us their family member was safe. Thorough recruitment practices reduced the risk of employing people who may be unsuitable to work with vulnerable people. Systems for managing people’s medicines were safe.

There were regular staff handovers throughout the day to ensure relevant information was communicated to staff.

New staff received induction and all staff received on-going training and supervision to support them in their role.

Where people living at the home had their liberty restricted, an authorisation was in place to ensure this was lawful and their rights were protected.

People were provided with appropriate support to eat and drink, from staff who were kind, caring and attentive. People’s privacy, dignity and independence were respected.

Holly Bank Trust supported people to participate in a range of activities. People’s care plans were person centred and recorded people’s likes, dislikes and preferences.

There was a system in place to manage complaints in the event a complaint was raised.

Relatives felt Holly Bank Trust was a good organisation. Feedback from staff was also positive. The organisation had various systems in place to continually monitor the quality of the service to ensure people received safe and effective care.

We found that the service took appropriate steps to identify risks of abuse and prevent abuse from happening.

Care workers who administered medicines to people had received suitable training and had been assessed as to their competence. The manager confirmed that only care workers that had completed the assessment to administer medicines did so. Medicines were securely stored and discontinued medicines were disposed of by a pharmacy as described in the home's policy.

As part of the recruitment process we saw that care workers had completed application forms which provided sufficient information to ensure prospective employees were of good character.

There were effective recruitment and selection processes in place. The manager explained to us that care staff were interviewed and that they were subject to Criminal Records Bureau (CRB) or more recently Disclosure and Barring Service (DBS) checks.

We spoke with a general practitioner who told us "I have absolute confidence in the staff here, they are so caring and meet the needs of the residents very well".