CQC report explained · a nursing home
What the CQC found at Sycamore Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People were generally supported safely, with enough staff, safeguarding procedures and infection control arrangements. However, medicines records were not always accurate and inspectors found some potential environmental hazards.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward to calculate the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward to calculate the overall rating.
- Responsive?
- Good
- Care plans reflected people's needs, preferences and communication needs. The home offered activities, supported religious choices and provided appropriate end-of-life care.
- Well-led?
- Good
- The home had an established management team and systems for checking quality, risks, care plans, complaints, incidents and maintenance. People, relatives and staff had opportunities to give feedback.
What inspectors found, March 2023
Rated Good overall, but Safe Requires Improvement because medicines records and some environmental issues needed attention.
This was an unannounced focused inspection on 24 January 2023. Inspectors spoke with people living at the home, relatives and staff. They observed care and checked care records, medicines records, recruitment files and records about running the home.
The home had enough staff to keep people safe, safeguarding procedures and good infection control arrangements. Care plans were personalised, activities were available, and people were supported with communication and end-of-life care. Complaints and incidents were investigated and used to improve the service.
Inspectors found some medicines recording problems, including fridge temperatures and records of waste medicines. They also found some potential environmental hazards and minor gaps in care plans. The manager took prompt action after these issues were raised.
The overall rating improved from Requires Improvement to Good since the previous inspection. Safe remained Requires Improvement, while Responsive and Well-led improved to Good. This inspection did not assess Effective or Caring, so their previous ratings were carried forward.
Enough staff and safeguarding
Inspectors found enough staff to keep people safe and suitable recruitment checks were in place. Staff understood how to recognise and report abuse.
“The registered manager ensured there were enough staff to keep people safe and meet their needs.” from the report
Personalised care
Care plans described people's individual needs, preferences and communication methods. Staff supported people in a caring and considerate way.
“People received care and support in a planned way that reflected their individual needs and personal preferences.” from the report
Activities and relationships
The home offered varied activities and helped people maintain social, cultural and religious interests. Inspectors saw activities taking place during the visit.
“The home offered people a range of timetabled activities and support to engage in these.” from the report
End-of-life support
People's wishes about end-of-life care were recorded, and inspectors found that people were supported to have a comfortable and dignified death.
“People were supported at the end of their life to have a comfortable and dignified death.” from the report
Management and improvement
The management team used audits, meetings and checks to identify issues and make improvements. The manager responded to concerns raised during the inspection.
“The registered manager maintained a system of checks and audits to monitor the quality of the service and make improvements when needed.” from the report
Medicine records
needs fixingOn one unit, fridge temperatures were not always recorded accurately and waste medicine records were not always up to date. The provider took prompt action after the inspection.
“On one unit staff did not always keep up to date records of waste medicines before they disposed of them.” from the report
Environmental hazards and repairs
needs fixingInspectors found some potential hazards and repair issues, including a person's window or radiator. The manager provided evidence of action after the visit.
“However, we identified some potential environmental hazards.” from the report
Some care plan details
minorTwo people's plans were unclear about using the call bell, and one person's food preferences lacked detail. Staff updated or addressed these points after inspectors raised them.
“However, two people's plans were not always clear on their use of a call bell to request staff support.” from the report
Night staffing concerns
minorAlthough the manager said staffing levels were sufficient, some staff said having enough staff was difficult at night. The manager said staffing was reviewed and adjusted when needed.
“Most staff told us there were enough staff on shift but some said this was difficult at night.” from the report
- 01What checks have you completed since the inspection to make sure medicine fridge temperatures are recorded accurately?
- 02How do you now record and check medicines that are being disposed of?
- 03What repairs or environmental hazards were identified, and have they all been resolved?
- 04How do you make sure there are enough staff at night when staffing is difficult?
- 05What are the current ratings for Effective and Caring, which were not assessed during this inspection?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 15 March 2023 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, December 2021
Rated Requires Improvement; inspectors found kind and effective care, but medicines, safety risks and care records were not always well managed.
This was an unannounced inspection on 23 November 2021. Inspectors spoke with people living in the home, visitors and staff. They observed care, reviewed care records, medicines records, staff records and the home's checks, and made a partial tour of the premises.
People generally said they felt safe, liked the staff and had their needs met. Inspectors found enough staff, suitable training, good infection control, good support with food and healthcare, and kind and respectful care. People were offered choices and supported to be as independent as possible.
However, some bedrails created a risk of people becoming trapped. Medicines were not always stored or given safely, and guidance for some medicines was missing. Some care plans were incomplete or too general, and the home's checks had not found these problems.
The overall rating was Requires Improvement. Safe, responsive and well-led were rated Requires Improvement, while effective and caring were rated Good. The provider told CQC about improvements made after the inspection, but CQC planned to monitor progress and return to check the changes.
Kind and respectful staff
People said staff were kind and supportive. Inspectors saw calm, respectful care, including staff spending time with people who were distressed.
“We observed staff being calm, respectful and caring towards people.” from the report
Enough staff
Inspectors found enough staff to meet people's needs and keep them safe. People said they did not have to wait for care.
“There were enough staff to meet people's needs and keep people safe.” from the report
Staff training and support
Staff received induction, training and competency checks. They had meetings and handovers to discuss people's needs and changes.
“People were supported by staff who had the training, skills and experience they needed.” from the report
Good infection control
The home was clean and had systems for cleaning, laundry, clinical waste and COVID-19 precautions. Staff and visitors used protective equipment and took regular tests.
“There were systems to help prevent and control the spread of infection.” from the report
Bedrail safety
seriousSome bedrails were not safely assessed or protected. Wide gaps and unsecured bumpers created a risk of people becoming trapped or harmed.
“The space between the rails was wide and presented a risk of the person becoming trapped.” from the report
Medicines management
seriousSome medicines and oxygen cylinders were not stored securely. Some time-specific medicines were not given at the prescribed time, and guidance for some as-required medicines was missing.
“Medicines were not always safely managed.” from the report
Care plans lacked detail
needs fixingOne recently admitted person's care plan was incomplete. Other plans did not always give enough personal information about oral care and future wishes.
“Not all care plans had enough personalised information.” from the report
Checks did not find problems
seriousThe home's audits had not identified the bedrail, medicine and care-plan issues. This meant the provider's quality checks were not working effectively enough.
“These had not always identified risks.” from the report
Limited activity variety
minorPeople had group and individual activities and could maintain contact with families. However, some people wanted more variety, and some community and external activities had stopped during the COVID-19 pandemic.
“Some people wanted more variety in activities.” from the report
- 01What has been done to reassess every person's bedrails and fit or secure the required bumpers?
- 02How are medicines now stored, and how do you make sure time-specific medicines are given at the prescribed time?
- 03Are as-required medicine protocols now complete for every person who needs them?
- 04How have care plans been updated to include personal information about oral care, preferences and future wishes?
- 05What checks are now in place to make sure these problems are found quickly and kept under review?
This was the first planned inspection since the service registered with the current provider and covered all five key questions, including infection prevention and control; the previous Good rating was under a different provider in 2018. This explanation was written from the published report of 17 December 2021 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 Lodge
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2021Requires improvementdown from GoodSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- April 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2020
Registered with the Care Quality Commission on 10 March 2020.
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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At least 100 live-in carers within about an hour of Ealing
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,300 a week. 77 can care for a couple. 11 years' experience on average.
“I can truly say that Peter always put Dad at the centre of everything and I know that they found a great friendship in difficult times.”
“She has an unusual combination of kindness and firmness, is quite unflappable, physically strong, extremely savvy”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.