CQC report explained · a residential care home
What the CQC found at Sycamore Cottage Rest Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors checked medicines, infection control, equipment and legal safeguards, but did not review the whole Safe question. They found medicine competency and record-keeping issues were being addressed.
- Effective?
- Good
- This question was not assessed in this targeted inspection.
- Caring?
- Good
- This question was not assessed in this targeted inspection, although people told inspectors they were happy with the care and could speak with staff.
- Responsive?
- Good
- This question was not assessed in this targeted inspection. People said they wanted more activities, including a knitting club.
- Well-led?
- Good
- Inspectors checked the management change but did not review the whole Well-led question. The deputy manager and external consultant were supporting the service while a new registered manager was recruited.
What inspectors found, October 2022
Sycamore Cottage Rest Home Limited was inspected but not rated; inspectors found mostly safe care, with medicines, cleaning and management issues being addressed.
This was an unannounced targeted inspection on 20 September 2022. Two inspectors checked concerns about medicines, infection control, equipment and a change in management. They spoke with people, a relative, staff and visiting professionals, observed care and a medicine round, and checked records.
People said they were happy with the care, felt safe, received their medicines and found the home clean. Equipment was available and safety checks and repairs were being managed. Legal safeguards were in place where people could not make particular decisions for themselves.
Inspectors found some shortfalls. Not all staff had been assessed as competent to give medicines, and some night shifts had caused delays to morning medicines and breakfast. There were also gaps in cleaning records, inconsistent bedding laundry arrangements and pressure on cleaning and management staff. Actions were being taken during or after the inspection.
The overall rating remained Good from the previous inspection, but this inspection itself was recorded as inspected but not rated. The Safe and Well-led ratings were not reviewed in full, so they were not changed.
People felt safe
People told inspectors they felt safe with staff and could speak with staff and the deputy manager.
“People confirmed they felt safe in the care of staff.” from the report
Equipment and repairs
People had the equipment needed for their care. Safety checks and repairs were recorded and arranged when required.
“The equipment supplied for the provision of people's care was properly used and maintained, staff received training in its use.” from the report
Legal safeguards
The home had systems to track applications and expiry dates for restrictions on people's freedom. Inspectors found the required legal authorisations and conditions were in place.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Medicines records
Medicine administration records were complete, and extra daily checks had been introduced after recent errors.
“People's medicine administration records (MAR) were complete.” from the report
Visible cleanliness
Inspectors found the home visibly clean to an adequate standard, and people agreed that it was clean.
“The service appeared visibly clean to an adequate standard.” from the report
Delays to medicines
seriousNot all staff had been assessed as competent to administer medicines. On some nights, this led to delays in morning medicines and breakfast.
“The provider's medicines audit had identified that some nights there had been no staff on shift who were competent to administer medicines” from the report
Topical creams not secured
seriousTopical creams were kept in an unlocked cupboard because the key was unavailable. A new cupboard was purchased during the visit.
“The cupboard was lockable, but the key was not available, we found it was not locked.” from the report
Cleaning records
needs fixingSome cleaning records did not show that scheduled cleaning had taken place. The provider said it had taken action to improve and check the records.
“However, there were gaps in some of the cleaning records to demonstrate cleaning had taken place in accordance with the provider's cleaning schedule.” from the report
Management and staffing pressure
needs fixingThe registered manager had left and recruitment was ongoing. Staffing was under pressure, with greater reliance on agency staff, although actions were being taken.
“Staffing was under pressure, despite a recruitment drive.” from the report
More activities wanted
minorPeople wanted more opportunities for activities and relationships within the home. The provider was recruiting an activities co-ordinator and had introduced interim arrangements.
“People told us they felt more opportunities could be provided, in addition to the entertainers who visited, to enhance social activities and relationships within the home.” from the report
- 01How many staff are now signed off as competent to administer medicines, including on night shifts?
- 02Have delays to morning medicines and breakfast been fully resolved, and how are medicine times now checked?
- 03How are topical creams stored securely now, and who checks that the cupboard remains locked?
- 04How are cleaning records and bedding laundry arrangements checked and kept up to date?
- 05Who is currently managing the home while recruitment of a registered manager continues, and what daily support is available?
This was a targeted inspection of specific concerns about medicines, infection control, equipment and management; it did not assess the full key questions, so the overall Good rating remained from the previous inspection. This explanation was written from the published report of 19 October 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2020
Sycamore Cottage Rest Home Limited was rated Good overall, but inspectors found medicines safety and staffing needed improvement.
This was an unannounced inspection on 6 January 2020. It began as a targeted inspection after concerns about medicines, staffing, falls and records. It was then widened to look at Safe and Well-led.
Inspectors found that most medicines were given safely, but two tablets had been left on the floor. The home had already arranged extra medicines training and took steps during the inspection to reduce the risk of this happening again. There were also four staff vacancies, covered in the meantime by regular agency staff.
People told inspectors they were happy with the care and found staff helpful and kind. Risks such as falls and skin problems were assessed, and the manager reviewed incidents and feedback. The home was rated Requires Improvement for Safe and Good for Well-led.
The overall rating stayed Good. This is because the other three areas were not inspected during this visit, so their ratings from the previous comprehensive inspection were used.
Risks were assessed
The home assessed risks such as falls, skin problems, moving and handling and behaviour. Records showed that planned checks and care were carried out.
“Potential risks to people had been assessed from, for example, falls, skin integrity, moving and handling, personal care and behaviours and measures were in place to manage them.” from the report
Kind and helpful staff
People told inspectors they were happy with the service and found staff kind, caring and helpful.
“People told us they found the staff kind, caring and helpful.” from the report
Active safety monitoring
The manager reviewed falls, incidents and accidents and acted when patterns or safety concerns were identified.
“The registered manager reviewed people's falls monthly for any trends and ensured required actions were taken to reduce the risk of repetition.” from the report
Good leadership
The manager was accessible and supported by external management advice. People and staff were asked for their views, and the home worked with local organisations.
“The service worked well with key organisations such as the local authority and the clinical commissioning group.” from the report
Tablets were found on the floor
seriousInspectors found two tablets on the floor, including one under the medicines trolley. The home acted straight away, but inspectors said it would take time to show that safe practice was sustained.
“two tablets on the floor, one under the medication trolley and the other in a person's room.” from the report
Staff vacancies and agency cover
needs fixingThere were four vacancies, two for day staff and two for night staff. Agency workers covered shifts, but staff said this put more pressure on them because agency workers did not know people as well as permanent staff.
“The registered manager told us there were four staff vacancies, two in the day and two at night.” from the report
- 01What happened after the two tablets were found on the floor, and how do you now check that dropped medicines are disposed of immediately?
- 02Has the medicines training for all staff been completed, and how are staff competencies checked now?
- 03How many of the four staff vacancies have been filled, and how much agency cover is still being used?
- 04How do you make sure agency staff know each person's needs, routines and risks?
- 05What changes have you made to show that medicines practice remains safe over time?
This was a targeted inspection that became a focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 5 February 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Sycamore Cottage Rest Home Limited
5 rated inspections over 3 years: the service has improved, from Inadequate to Good.
- October 2022Inspected but not ratedcurrent ratingSafe: Inspected but not ratedWell-led: Inspected but not rated
Read what inspectors found at Sycamore Cottage Rest Home Limited →
- February 2020Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Sycamore Cottage Rest Home Limited →
- February 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- January 2018Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- July 2017InadequateSafe: Inadequate
- September 2016
Registered with the Care Quality Commission on 6 September 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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