Background to this inspection
Updated
7 December 2022
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was undertaken by two 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.
Service and service type
Sycamore Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Sycamore Court is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post.
Notice of inspection
This inspection was unannounced. Inspection activity started on 28 October 2022 and ended on 31 October 2022. We visited the location’s service on 28 October 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We spoke with people, relatives and staff and gathered information relating to the management of the service. We reviewed a range of records. This included four care plans. We spoke with five people living at the service and two visiting relatives. We also spoke with seven members of staff, including a regional manager, the manager, the deputy manager, a registered nurse, care staff and ancillary staff. We contacted 12 relatives by telephone, spoke with the local authority, and requested further evidence from management at the service.
Updated
7 December 2022
About the service
Sycamore Court is a residential care home providing nursing care and support for up to 40 people. People were living with a range of needs associated with the frailties of old age and some people were living with dementia or other mental health needs. 39 people were living at the service on the day of our inspection.
People’s experience of using this service and what we found
We saw the required improvements had been made since the last inspection in respect to the deployment of staff, the analysis of accidents and incidents and culture and staff morale. The provider had systems in place to monitor the quality of the service. However, we identified some further areas of practice that need improvement in relation to the management of the service.
People told us they felt safe and they received care that met their needs. A relative told us, “The home seems well managed, it’s all very calm. I haven’t got any complaints, they are all stars to me.” Another relative added, “I’m confident it’s well managed, it’s clean and very friendly.” Risks to people had been identified and assessed. Staff were recruited safely and there were enough staff to meet people’s needs. Medicines were managed safely. Infection prevention and control processes protected people from the risk of infections.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 25 July 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.
Why we inspected
The inspection was prompted in part due to concerns received about staffing levels and care delivery. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We carried out an unannounced comprehensive inspection of this service on 26, 27 & 30 May 2022. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sycamore Court on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.