Archived: The Sycamores

Updated 8 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 19 November 2015 and was unannounced. The inspection team consisted of two adult social care inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise was consulting people who use services and supporting an older family member.

Prior to our inspection we reviewed all the information we held about the service. This included information from notifications received from the registered provider and feedback from the local authority safeguarding and commissioners. Before this visit we had received information of concern about record keeping, managing the risk of falls and responding to complaints.

We used a number of different methods to help us understand the experiences of people who lived in the home, including observations and speaking with people. We spoke with nine people who used the service, four members of staff, three relatives, the manager, the operations manager and three community professionals. We looked in the bedrooms of five people who used the service with their permission. During our visit we spent time looking at four people’s care and support records. We also looked at two records relating to staff recruitment, training records, maintenance records, and a selection of the service’s audits.

Updated 8 March 2016

This inspection took place on 19 November 2015 and was unannounced.

We previously inspected the service on 18 October 2013 and at that time we found the registered provider was meeting the regulations we reviewed.

The Sycamores is registered to provide care for up to 40 older people. Accommodation is available on two floors accessed by a lift. All bedrooms are single occupancy with en-suite facilities. At the time of our inspection there were 40 people using the service.

The service is required to have a registered manager. 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.’ The service had not had a registered manager since 24 February 2014. A manager had been in place since that time and had left the service on 9 October 2015. The current manager was the registered manager at another location run by the same provider and had submitted their application to commence registration with CQC at this location. At the time of our inspection this was not finalised.

People who lived at The Sycamores told us they felt safe. Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. However systems were not in place to immediately investigate evidence of abuse because a medicines error had not been reported to safeguarding or investigated. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Risk assessments minimised risk whilst promoting people’s independence. There were enough suitably trained staff to meet the assessed needs of people who used the service.

Medicines were managed in a safe way for people.

People’s capacity was considered when decisions needed to be made and support provided when necessary to support and enable people to air their views. This helped ensure people’s rights were protected when decisions needed to be made.

People were supported to eat a good balanced diet and people enjoyed the food served. A range of healthcare professionals were involved in people’s care as the need arose.

People’s individual needs were met by the adaptation, design and decoration of the service.

Staff were caring and supported people in a way that maintained their dignity and privacy and people were supported to be as independent as possible throughout their daily lives.

People’s needs were reviewed as soon as their situation and needs changed, however some records were not updated and contained minimal information. Accurate and secure records were not always maintained in relation to care that was being delivered. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The new manager was addressing this and some improvements had been made.

People and their representatives were involved in care planning and reviews.

People told us they knew how to complain and told us staff were always approachable.

The culture of the organisation was open and transparent and the manager was visible in the service.

The manager held meetings with people who used the service, relatives and staff to gain feedback about the service they provided to people.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of people were met and the service provided was to a high standard. However, this system had not addressed some of the problems we found with reporting and investigating safeguarding concerns and keeping accurate and secure records.

You can see what action we told the provider to take at the back of the full version of the report.