Sydmar Lodge

Updated 25 May 2018

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 unannounced inspection took place on 10 and 17 April 2018. It was undertaken by one inspector, a pharmacist specialist, and two Experts 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.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

Before the inspection, we checked for any notifications made to us by the provider and the information we held on our database about the service and provider. Statutory notifications are pieces of information about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law. We also contacted the local authority and various community healthcare professionals who have a role at the service, for their views on the service. We received eight replies.

There were 45 people using the service at the start of our inspection visit. During the inspection we talked with 19 people living at the service and 15 of their relatives and representatives. We spoke with six care staff, a domestic staff member, the cook, the maintenance worker, the activity coordinator, the deputy manager and the registered manager. We also took on board views of some relatives and representatives that the registered manager emailed to us after our first visit.

During our visits, we looked at selected areas of the premises including some people’s rooms, and we observed the care and support people received in communal areas including at meals. We looked at the care plans and records of six people using the service, 20 people’s medicine administration records, the personnel files of three staff, and some management records such as for health and safety, accidents and incidents, complaints, and staff rosters. We then requested some further specific information from the registered manager about the management of the service following our visits.

Updated 25 May 2018

Sydmar Lodge is a ‘care home’. 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.

The service is registered to provide accommodation and personal care for up to 57 people, although the registered manager told us the maximum practical occupancy was 50. There were 45 people using the service at the start of this inspection. The service specialises in dementia care and is operated by a small independent provider that bought the company shortly after the last inspection.

The service had a registered manager, which 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.

This was a comprehensive inspection, to make sure the service was providing care that is safe, caring, effective, responsive to people's needs, and well-led.

The inspection was brought slightly forward due to two separate cases of information of concern about the service being conveyed to us. This information included suggestions of poor personal care, poor cleanliness, poor nutritional support, and understaffing resulting in people not being attended to. However, we found the service was upholding standards in all areas.

At our last inspection of this service, in February 2017, we found two breaches of legal requirements. These were in respect of safe care and treatment, and good governance. The service was rated ‘Requires Improvement.’ The provider completed an action plan to show what they would do and by when to improve the key questions of ‘Is it Safe?’ and ‘Is it Well-Led?’ to at least good.

At this inspection, we found the necessary improvements had been made. There was better communication in support of the effective care of people, and care records were consistently up-to-date. Risks associated with the prevention of Legionella were now being properly managed, and professional passenger lift maintenance was occurring. However, we have recommended the provider review national guidance on upholding health and safety in care homes and embed procedures relating to this.

We found the service was providing people with care and support that enabled them to have a good quality of life. Staff and managers responded to people’s individual needs, preferences and routines. We saw people always being treated respectfully and in a friendly and caring manner. There was consistently positive feedback about the approach of staff, and that they knew people well as individuals.

Most people using the service praised it highly. A typical comment was, “I think the standard of care here is very good. I can recommend this care home to other people.”

All the relatives and representatives we spoke with commented positively on the service. One said, “I believe Sydmar can be rightly very proud of the services it is offering. There is a very special atmosphere at Sydmar created by very kind and caring staff and a real family environment.” People’s visitors were welcomed at any time of the day.

We found the twice-daily activity programme to be outstanding in its breadth and depth. It engaged people well, was at times highly original, and was attuned to involving everyone using the service including those who tended to stay in their rooms. People’s past interests were explored in order to set up opportunities for them pursue them again. For example, one person was supported to go swimming, an activity they had once regularly enjoyed.

The service had strong links with community healthcare professionals, which particularly helped people to receive prompt and effective healthcare support. Community professionals praised how the service worked with them to enable high quality care of people. One told us that Sydmar Lodge provided an invaluable service which they would have no hesitation recommending to anyone. It was evident the service went to great lengths to keep people’s health and welfare under review, and acquire support from the most appropriate healthcare professionals to increase the chances of good outcomes for people. The service also supported people at the end of their life to have a comfortable, dignified and pain-free death.

The service was very capable at supporting people to eat and drink well. Good attention was paid to helping people enjoy the mealtime experience set in a restaurant-style environment. There was effective oversight of people’s nutrition and hydration, with dietitian advice sought and acted on where needed. The service found creative ways to support people at nutritional risk.

The service was strong at ensuring people received personalised care that was responsive to their needs, preferences and routines. It promoted a Jewish ethos but welcomed people of all faiths. Many Jewish customs and celebrations were therefore practiced at the service, which people and their representatives fedback positively about.

The new provider had invested well in the physical environment. Many areas of the premises had been redecorated, and there was ongoing work to complete this with minimal disruption to people using the service. Good standards of cleanliness were maintained regardless.

The service monitored people’s personal safety in a variety of ways to help minimise the risk of accidents occurring or health and welfare concerns developing. This was supported by staffing levels being kept under review, to help ensure people’s needs were consistently met. The service also followed procedures to keep people safe from abuse, and respond accordingly should any allegation of abuse occur.

Medicines were properly and safely managed. We made a few good practice recommendations which the service promptly addressed.

The service ensured staff received comprehensive training and good support to deliver effective care to people. There was good team work in support of this.

There was a positive working culture at the service in support of providing people with high quality care. The service was quick to respond to any concerns raised or suggestions made. The registered manager and the deputy kept up-to-date with good practice recommendations, worked co-operatively with local services, and provided clear leadership and governance of the service. This helped to ensure that everyone involved in whatever capacity worked with appropriately caring and responsive approaches in their interactions and support of people using the service.