CQC report explained · a residential care home
What the CQC found at Sycamores
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some risks to people's health and welfare were not properly assessed, reviewed or managed. Inspectors also found unsafe moving and handling, medicine problems and some cleaning and storage concerns.
- Effective?
- Good
- This question was not inspected during this focused inspection. The previous rating was used when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused inspection. People and relatives said staff were kind and considerate.
- Responsive?
- Good
- This question was not inspected during this focused inspection. People and relatives were involved in care discussions and relatives could attend meetings.
- Well-led?
- Requires improvement
- Quality checks and audits did not reliably identify or correct problems. Inspectors also found limited evidence that lessons from other inspections had been put into practice.
What inspectors found, June 2023
Rated Requires Improvement; inspectors found risks, medicines and quality checks were not always managed safely.
This was an unannounced focused inspection after concerns about care standards and records. Inspectors visited on 24 May 2023 and reviewed activity up to 30 May 2023. They spoke with people, relatives, staff and health professionals, and checked care, medicine, risk and quality records.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. Inspectors found that some health and safety risks were not properly assessed or reviewed. Medicines were not always given or stored safely, and staff did not always use wheelchairs safely.
There were also positive findings. People said they felt safe and that staff were kind. There were enough staff on shift, call bells were answered promptly, and people were supported to make choices. The rating fell from Good at the previous inspection, published on 2 April 2020.
Staff availability
Inspectors found enough trained and suitable staff on shift. Staff responded promptly when people used their call bells.
“When people rung their calls bells for assistance, staff were on hand to support them with limited delay.” from the report
Kind support
People and relatives said they felt safe and described staff as kind and considerate.
“People and relatives told us they felt safe living at Sycamores.” from the report
Choice and involvement
People were supported to make choices and relatives could be involved through meetings and care information.
“People were supported to have maximum choice and control of their lives” from the report
Response to concerns
The management team responded positively to the issues raised during the inspection and planned actions to address immediate risks.
“Following our visit, actions had been planned to address some of the immediate risks to people's health and welfare.” from the report
Risk records and moving people
seriousSome risk plans did not reflect people's current needs. Inspectors saw staff move people in wheelchairs without footplates on four occasions, creating an unnecessary risk of injury.
“We observed 4 occasions during our visit when staff did not follow safe practice when transferring people around the home.” from the report
Medicines
seriousOne person did not receive two prescribed medicines for at least 24 days. Inspectors also found problems with medicine storage, cream records, guidance for medicines given when needed, and crushing medicines.
“People did not always receive their medicines as prescribed.” from the report
Quality checks
seriousAudits and improvement plans did not reliably identify or follow up problems. Similar issues had appeared in other homes, with limited evidence that lessons had been learned.
“The provider's systems and processes were not always effective to drive improvements through effective governance and quality assurance.” from the report
Cleanliness and storage
needs fixingCommunal areas were clean, but some bedroom furniture and equipment needed deeper cleaning. Continence wear was stored on bathroom floors, creating an infection control risk.
“However, some items of furniture and equipment required further deep cleaning and continence wear was stored on the floor in people's bathrooms which was an infection control risk.” from the report
- 01What has been changed to make sure wheelchair footplates are always used when people are transferred?
- 02How do you now check that medicines are given as prescribed, including medicines given twice daily and creams?
- 03How are expired, wrongly stored or incorrectly recorded medicines identified and removed?
- 04How are current risks, including skin damage, diabetes and distressed behaviour, recorded and reviewed?
- 05What actions have been completed from the CQC action plan, and how is the manager checking that improvements last?
This was a focused inspection of Safe and Well-led only; the other key question ratings carried over from the previous inspection when calculating the overall rating. This explanation was written from the published report of 21 June 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, March 2021
Sycamores was inspected but not rated; inspectors were assured that infection prevention and control measures were in place.
This was an announced, targeted inspection on 23 February 2021. It checked how the home was preventing and controlling infections during the coronavirus pandemic.
Inspectors were assured that visitors, admissions, testing, PPE, social distancing and shielding were managed safely. They also found an outdoor visiting pod, supported arrangements for people unable to socially distance, and cleaning and hand hygiene measures.
The home was inspected but not rated. This means the inspection did not give an overall quality rating or a full rating across all five areas of care.
Safe visiting
An outdoor visiting pod was available by appointment, with cleaning and visits coordinated by a visitor facilitator.
“An outdoor visiting pod was available on an appointment basis.” from the report
Support with distancing
People who could not socially distance were given extra support, including use of a specific lounge area that was then cleaned.
“People who were unable to socially distance were given extra support to minimise the risk of infection being spread.” from the report
PPE and cleaning
Staff were observed using PPE correctly. The home used a two-stage cleaning process and kept separate cleaning equipment on each floor.
“A two stage cleaning process was used throughout the home to ensure areas were cleaned and then sanitised.” from the report
Hand hygiene training
Staff training used a special lotion to show areas missed during handwashing. This was intended to help staff improve their technique.
“As part of staff training in hand hygiene, a special lotion was used to highlight any areas missed by inefficient hand washing techniques.” from the report
Inspectors raised no specific concerns in this report.
- 01Are the outdoor visiting pod and appointment arrangements still available, and how is the pod cleaned between visits?
- 02How are people who cannot socially distance supported now, and how are the areas they use cleaned?
- 03How do you check that staff continue to use PPE correctly and follow hand hygiene procedures?
- 04How are people and staff tested for infections, and what would happen if there were an outbreak?
- 05Are the two-stage cleaning process and separate cleaning equipment on each floor still being used?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic; the service was inspected but not rated and the report does not assess all areas of care. This explanation was written from the published report of 31 March 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 Sycamores
4 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- April 2020Goodstayed GoodSafe: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 2011.
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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