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Care Home: Sycamore Court

  • Magpie Lane Little Warley Brentwood Essex CM13 3DT
  • Tel: 01277261680
  • Fax: 01277202028
  • Planned feature Advertise here!

  • Latitude: 51.589000701904
    Longitude: 0.30399999022484
  • Manager: Ms Sonia Ellen Harrington
  • Price p/w: ~
  • UK
  • Total Capacity: 39
  • Type: Care home only
  • Provider: Southern Cross Healthcare (West) Limited
  • Ownership: Private
  • Care Home ID: 15251
Residents Needs:
Old age, not falling within any other category

Latest Inspection

This is the latest available inspection report for this service, carried out on 27th January 2010. CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Sycamore Court.

What the care home does well Prospective people wishing to live at Sycamore Court are assessed prior to admission so that the management and staff team are able to meet the individual`s needs. Staff working at the home, have a good rapport with individual people and demonstrated a reasonable knowledge and understanding of peoples care needs. Visitors to the home are made to feel welcome and staff morale at the home is good. Many members of staff have been employed at Sycamore Court for some considerable time, providing stability and continuity of care to the people who live there. The quality of meals provided at the home for residents is good and people`s comments in relation to meals provided were positive and are recorded within the main text of the report. People live in a home which is comfortable, safe and homely for their needs. The home was observed to be clean, tidy and odour free at the time of the site visit. There is a quality assurance system in place so as to seek the views of residents and their representatives, staff and other stakeholders about the services and facilities provided at the home. A good range of social activities is provided for people and caters for the varying needs of people in the home. People are assured that any complaints or areas of concern are taken seriously by the management team of the home and acted upon. Where safeguarding alerts are raised and initiated, there is evidence to show that the management and staff team of the home are proactive so as to ensure positive outcomes for people and that they are protected from possible harm and/or abuse. The main medicines storage areas are secure temperature controlled to maintain the quality of medicines in use. There is a safe and robust system in place to ensure that recruitment procedures within the home ensure people`s safety and wellbeing. Staff training in core areas is up to date. What has improved since the last inspection? When people are prescribed medicines on a "when required" basis there is guidance for the use of such medicines. So the requirement made about this on our last inspection has been met. We also made a requirement on our last inspection that there must be adequate supplies of medicines for the continued treatment of residents. On this inspection we did not find that any resident`s medicines had run out and so this requirement has been met. Risk assessments are more detailed and in general terms there are risk assessments in place for the majority of identified risks. What the care home could do better: There must be a record of all medicines kept in the care home and the record of when medicines are disposed of must be accurate and up to date. The temperature of the fridges used to store medicines should be recorded as the maximum and minimum reached, the current temperature and then be re-set for the next recording period. Systems must be put in place to ensure that care staff are given information about a prospective person`s care needs prior to them being admitted to the care home. An `interim` care plan must be devised detailing the person`s care needs and any identified risks to their health and wellbeing. Key inspection report Care homes for older people Name: Address: Sycamore Court Magpie Lane Little Warley Brentwood Essex CM13 3DT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Michelle Love     Date: 2 7 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Sycamore Court Magpie Lane Little Warley Brentwood Essex CM13 3DT 01277261680 01277202028 sycamorecourt@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Southern Cross Healthcare (West) Limited care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Sycamore Court is a purpose built, two storey building situated in a rural location outside Brentwood/Warley and within easy access of A127 and M25. The home provides accommodation for 39 older people on two floors, in 39 single en-suite rooms. Other facilities include 4 lounges and separate dining areas. In addition the home benefits from a specially equipped hairdressing salon. A passenger lift provides access to all levels within the home. There are large open grounds with excellent views across the local countryside and a patio area with seating. Car parking facilities are available to the side of the property. The home is not serviced by any public transport. Brentwood station is approximately 3 miles away and the nearest bus stop is advised as approximately a 40 minutes walk. The weekly fees range from £453.11 to £855.71 per week. Care Homes for Older People Page 4 of 30 Over 65 39 0 1 7 0 8 2 0 0 9 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection. The visit took place over one day by one inspector and lasted a total of 8 hours, with all key standards inspected. Additionally progress against previous requirements and recommendations from the last key inspection were also inspected. In addition a pharmacist inspector examined medication practices and procedures. We did not ask the organisation to complete an Annual Quality Assurance Assessment (AQAA). This is a self assessment document, required by law, detailing what the home does well, what could be done better and what needs improving as they had already submitted this prior to the inspection in August 2009. Information within the AQAA was used in the key inspection report of August 2009. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. Additionally a partial tour of the premises Care Homes for Older People Page 5 of 30 was undertaken, residents, relatives and members of staff were spoken with and their comments are used throughout the main text of the report. The manager, administrator and other members of the staff team assisted the inspector on the day of the site visit. Feedback on the inspection findings were given to the manager and operations manager. The opportunity for discussion and/or clarification was given. Care Homes for Older People Page 6 of 30 What the care home does well: What has improved since the last inspection? When people are prescribed medicines on a when required basis there is guidance for the use of such medicines. So the requirement made about this on our last inspection has been met. We also made a requirement on our last inspection that there must be adequate supplies of medicines for the continued treatment of residents. On this inspection we did not find that any residents medicines had run out and so this requirement has been met. Risk assessments are more detailed and in general terms there are risk assessments in place for the majority of identified risks. Care Homes for Older People Page 7 of 30 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are assessed and assured that their needs can be met. Evidence: There is a formal pre admission assessment format and procedure in place, so as to ensure that the staff and management team are able to meet the prospective persons needs. Admissions are not made to the home until a full needs assessment has been undertaken. In addition where appropriate, supplementary information is provided by the persons Placing Authority or Primary Care Trust. Records also showed that formal assessments are completed in relation to dependency, moving and handling, pressure area care, nutrition and continence. As part of this site visit the care files for two people admitted since the last key inspection to the home in August 2009 were examined. Records showed that a pre admission assessment was completed for each person by the manager and prior to their admission to the home. There was evidence to show that the information Care Homes for Older People Page 10 of 30 Evidence: recorded was informative and detailed. In addition the pre admission assessment for both people recorded the rationale for their admission and records showed that arrangements and opportunity were given for the prospective person and/or their representative to visit the home prior to admission. We spoke with one of the residents case tracked and they confirmed that the admission process had been smooth. We were also made aware by the manager that a new admission to the home was expected on the day of the site visit. Records showed that a pre admission assessment was completed by a Team Leader and additional information had been sought from the persons placing authority. We spoke with 2 members of staff on duty and enquired if either of them had been given any information about the prospective person due to be admitted to the home. Both members of staff confirmed that the only information they had received was that a new resident was to be admitted that day. Comments included we have not been given any information as yet. Consideration should be given to put appropriate systems in place so that staff working at the home have information about a prospective person in a timely manner and in advance of the person being admitted. A copy of the homes Statement of Purpose and Service Users Guide was readily available within the main reception area of the home. This provides information about the homes aims and objectives, facilities and services. On a tour of the premises we noted that people who live at the home had a copy of the homes Service Users Guide. Care Homes for Older People Page 11 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care needs of individual people are clearly recorded detailing their specific needs and how these are to be met by the home. Evidence: There is a formal care planning system in place to help staff identify the care needs of individual people and to specify how these are to be met by staff who work in the home. In addition to the care plan, formal assessments are completed in relation to manual handling, nutrition, pressure area care and dependency levels. Of those people case tracked, each person was observed to have a plan of care and these were devised from information undertaken as part of the pre admission assessment and from other associated information provided by other stakeholders. As part of the inspection process we looked at 4 peoples care files (2 in full and 2 in relation to specific healthcare needs). Records showed that since the last key inspection to the service in August 2009, positive steps have been taken by the manager and other members of the management team to address previous identified shortfalls relating to care planning, Care Homes for Older People Page 12 of 30 Evidence: risk assessing and delivery of care by staff. The care needs of individual people are now more clearly recorded and provide a reasonable level of detail of the actions and interventions required by care staff to ensure that all aspects of their health, personal, emotional and social care needs are met. Each care plan was seen to be written in plain language and was easy to understand. The manager confirmed that care plan audits by the management team of the home continue to be undertaken however the frequency of these has reduced. There was evidence to show that care plans are more person centred however care must be taken to ensure there is more evidence of residents and/or their representatives involvement in the process and evidence that their personal preferences and wishes have been included. While we recognise the above improvements, care must be taken to ensure that all of the individuals care needs are recorded, that where information is linked and/or recorded in several places within the care file the same information is recorded and where there is a change of care needs the care plan is updated and reflective of the new information. The records for one person recorded them as having experienced a stroke in the past and this resulting in them having a one-sided weakness, difficulties with communication and poor mobility. No care plan was in place relating to this and the impact this has on their activities of daily living. Staff spoken with confirmed the resident as having poor mobility and difficulties with communication but appeared unaware that they had previously had a stroke. The pre admission assessment and placing authority assessment for one person made reference to them experiencing acute Urinary Tract Infections (UTI) and experiencing pain in their legs. No plan of care was recorded for either area. The same persons care plan also detailed they require encouragement to eat and are at high risk of poor nutrition. Daily care records consistently recorded them as eating very little however this was not updated within their plan of care and no risk assessment had been completed. We requested to see the support plan for the person due to be admitted to the home on the day of the site visit. Records showed that no interim plan of care had been completed. While we acknowledge the prospective resident was not admitted to the home on the day of the site visit as planned, had the admission occurred as the manager and staff had expected, no care plan was in place and no information had been given to staff as to how to meet the persons care needs. Consideration needs to be given by the manager and management team to put in place appropriate systems to manage this better for the future. Records showed that people living at Sycamore Court continue to have access to a range of healthcare professionals and services as and when required. These include District Nurse Services, GP, Optician, Dentist, attendance at hospital appointments, Care Homes for Older People Page 13 of 30 Evidence: Parkinsons Nurse and Dietician. Of those people case tracked, professional visitors records were available outlining visits/appointments and the outcomes of interventions provided. On the day of the site visit residents were observed to receive treatment/care from a healthcare professional or care staff in the privacy of their room. A letter from the homes GP to the manager recorded I have nothing but praise for your staff and this really pleases me. On a sad note we lost [name of resident] today. The care, dedication and compassion showed by all staff members during their last few days are beyond compare. We spoke with several residents and they confirmed that their care needs were met and that staff were kind. Other comments included staff are very good, they know what makes me tick. Relatives spoken to felt that the staff communicated with them well and contacted them at home when there were any issues. Relatives also said that the quality of the service had improved over recent months. Staff interactions with people who live at the home were observed to be much improved and positive. Where support and assistance was provided by staff in relation to individuals personal care, this was conducted with respect and sensitivity. In addition staff presence within the lounge areas was more prevalent so as to provide support and assistance in a timely manner. We looked at the practices and procedures for the safe storage, use and recording of medicines. The majority of medicines are stored securely for the protection of residents but we found some creams in peoples rooms which were not locked away and for which there was not a record made that they were in use. Some of these were also out of date. The main medicines storage areas are temperature controlled to maintain the quality of medicines in use and the temperatures are monitored and recorded regularly. The temperatures of the fridges used to store medicines are also recorded regularly but only the current temperatures are recorded not the maximum and minimum reached as recommended on our last inspection. This remains a good practice recommendation. We looked at the records made when medicines are received into the home, when they are given to people and when they are disposed of. In general these were in good order, but we found that the record of disposal of a medicine was not made when the medicine was given to a person who returned home. The records made when medicines are given to people were of a good standard and demonstrate that people receive their medicines as prescribed. Given the lack of recording of medicines in peoples rooms, and the discrepancy in the disposal record we have made a requirement for these records to be maintained accurately so to be able to account for Care Homes for Older People Page 14 of 30 Evidence: all medicines in use. We watched medicines being given to some people during lunchtime and this was done with a good standard of professional practice and with regard to peoples dignity and personal choice. Some people are prescribed medicines on a when required basis and we found guidance for the use of such medicines. So the requirement made about this on our last inspection has been met. We also made a requirement on our last inspection the there must be adequate supplies of medicines for the continued treatment of residents. On this inspection we did not find that any residents medicines had run out and so this requirement has been met. The staff training matrix submitted by the manager on the day of inspection, showed that all staff who administer medication have up to date medication training. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Sycamore Court have their social care needs met and receive a varied diet. Evidence: An activities co-ordinator is employed at Sycamore Court for 35 hours per week Monday to Friday, however we were advised that these hours are flexible to cover weekends, evenings and special events. The activities co-ordinator said that residents are more motivated and keen to participate in activities than on previous occasions. In addition we were advised that care staff are more motivated to assist and get involved with some activities. An activities programme is in place for each day and includes forthcoming events. A copy of the programme is pinned to a notice board on both the ground and first floors. We were also advised that a copy of the programme is provided to each person within the home. More thought should be given to make this more user friendly e.g. larger print and in a written and pictorial format so as to aid people who have poor sensory impairment or whose cognitive ability is beginning to deteriorate and to consider producing a daily list of activities rather than a full weeks record as this could be confusing for some people. Care Homes for Older People Page 16 of 30 Evidence: Records showed that people living at Sycamore Court are given the opportunity to participate within a varied schedule of activities. Records showed that activities on offer include bingo, 1-1 sessions with individual people in their rooms, cookery club, quizzes, religious observance, film afternoons, gentle keep fit, scrabble, dominoes, coffee mornings, therapeutic art classes, massage and visits by external entertainers. Residents spoken with confirmed that they were happy with the range of activities provided. On the day of the site visit several people during the morning were observed to enjoy a cookery session where bread pudding was made. This was followed by a glass of Baileys Liqueur prior to the lunchtime meal. In the afternoon 10 people were observed to enjoy an art session (Guidelines to Art) with an external instructor and volunteer. The aim of the session is to enable all participants to be individually creative and to produce an individual piece of artwork that they can be proud of. One resident was overheard to say to the manager unprompted Id sooner do that than fall asleep. Other residents were overheard to express surprise at their own abilities and to congratulate one another on the end result. We spoke with the tutor and they confirmed that residents are enthusiastic and appear to look forward to each art class. From discussion with the activities co-ordinator and residents, few trips to access the local community are planned however there have been trips to Harry Ramsden Fish and Chip Restaurant and visits to a local theatre. There is an open visiting policy at the home whereby visitors can see their member of family and/or friend at any reasonable time. There was evidence to show that people living at the home are actively encouraged and supported to maintain friendships and relationships. Relatives spoken with confirmed they can visit the home at any time and are always made to feel welcome when they visit. Relatives visiting the home were observed to have a good relationship with staff and members of the management team. People spoken with who live at the home confirmed they are enabled to maintain friendships with others and to see members of their family when they choose. The lunchtime and teatime meals were observed during the site visit on both the ground and first floors. At the time of our arrival the menus detailing the choices of meals available for that day were not displayed and staff spoken with were unable to clarify the choices available. The tables were nicely laid with tablecloths, condiments, glasses, vase of flowers and serviettes. The dining experience for people at the home during both the lunchtime and teatime meals was observed to be organised, calm and positive. People were noted to receive their meal in a timely manner and where people require assistance and/or support to eat their meal, this was provided by care staff in a respectful and sensitive way. Throughout the day people were observed to have Care Homes for Older People Page 17 of 30 Evidence: drinks readily available and to be given a choice. The chef advised that following consultation with the residents and from discussion with the management team of the home it was agreed that the menus would be changed so that people in the home receive home cooked meals. The chef and manager confirmed that this has proved very positive. Comments from residents about the quality of meals provided were positive and included the food is very good, the food is alright, I manage to find something I like and no complaints. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and there are robust systems in place to ensure peoples safety and wellbeing. Evidence: A copy of the complaints procedure is displayed in a prominent place and further information is recorded within the Service Users Guide. On inspection of the complaints log, there has been one complaint since the key inspection of August 2009. The complaint related to meals not up to standard. An appropriate record of the complaint was recorded and there was evidence to show that appropriate steps had been taken by the manager to address the issue. This has resulted in a menu club being formed whereby people who live in the home can discuss with the manager and chef future menu ideas. Residents spoken with confirmed they feel comfortable to raise issues and/or concerns to staff or a member of the management team. In addition relatives spoken with also confirmed that they were able to raise concerns and were confident that the manager would effectively address any matters raised. Records of compliments were also available and comments included A sincere message of thanks to you and all the staff and Thank you so much for all the help and support you gave me during my short-stay and thank you for making me feel so welcome. I am very grateful to you all. Care Homes for Older People Page 19 of 30 Evidence: Since the last key inspection there have been no safeguarding alerts or referrals. Staff spoken with were able to demonstrate a good understanding and awareness of safeguarding procedures and said that should an issue arise information would be passed to the senior person in charge, deputy manager or manager. On inspection of the staff training matrix this shows that 84 of staff have up to date SOVA (Safeguarding of Vulnerable Adults) training. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a safe, well maintained and comfortable environment which meets their needs. Evidence: A partial tour of the premises was undertaken. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The home environment continues to be maintained, decorated and furnished to a good standard and is both homely and comfortable. Furnishings and fittings were domestic in nature and were of a good quality and were in keeping with the environment. There is sufficient communal space and this refers specifically to a large lounge, small lounge and dining room on each floor. There are sufficient bathing and communal toileting facilities available which enable immediate access and these are fitted with appropriate aids and adaptations. On the day of the site visit the premises were seen to be clean, tidy and odour free. Minor health and safety issues were highlighted and the manager made aware at the time of the site visit. This refers specifically to the cleaners cupboard on the ground floor being left unlocked and a bottle of bleach being easily accessible to residents. Additionally a bottle of floor cleaner was noted to be stored in the small kitchenette on the first floor. In addition we noted there was no lighting on one stairwell which is also a designated fire escape. When discussed with the manager and the homes Care Homes for Older People Page 21 of 30 Evidence: operations manager we were advised that this had been faulty for the past week. We were also advised that this has been an on-going problem since 3/12/2009 and the homes estates department are aware of the issue. We must be notified in writing within 7 days of receiving this report as to whether or not the problem has been rectified. A maintenance person is employed at the home Monday to Friday. We did not look at the homes maintenance records as these were seen to be up to date and satisfactory at the last key inspection to the service in August 2009. The laundry was seen to be well organised. Residents spoken with said that overall they were satisfied with the homes laundry system. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained and in sufficient numbers to support the people who use the service. Evidence: The manager confirmed that staffing levels at the home remain at 1 senior member of staff and 2 members of care staff between 08.00 and 20.00 and 1 senior member of staff and 1 member of care staff between 20.00 and 08.00 each day. The managers hours are supernumerary to the above figures, the deputy manager receives one supernumerary shift per week and an administrator is employed Monday to Friday between 10.00 to 18.00. In addition to the above, ancillary staff are employed and these include a chef, housekeepers and domestic staff. On inspection of 4 weeks staff rosters, records showed that the above figures have been maintained. We checked the staff roster on the day of the site visit and this reflected accurately the staff on duty. The staff rosters showed minimal usage of agency staff. The deployment of staff on the day of the site visit was observed to be much improved, staff were observed to engage and interact with people in the home more frequently, people were provided with personal care in a timely manner and actions by staff were seen to be positive and not solely based around tasks and/or routines. Care must be taken to ensure that staff have appropriate days off and are not working excessive hours. This refers specifically to one member of staff who was Care Homes for Older People Page 23 of 30 Evidence: rostered to work 12 continuous days on duty, of which 11 days were 12 hour shifts. The manager confirmed that no new staff have been employed to the home since the last inspection. Three staff files were reviewed at random including the managers file, to check the recruitment process in the home. In general terms two out of three of the files were seen to be in good order with all relevant checks and documentation in place. However we found that other than training records and evidence of supervision, the only records available for the manager were a photograph, proof of identification and a Criminal Record Bureau (CRB) check. We discussed this with the operations manager and were advised that it is company policy for all managers information to be held at the organisations head office. They were advised that where the decision has been made to hold records centrally, a proforma should be held on the file in the home detailing the date an application form was received, the date written references were received, confirmation that the person is fit to undertake their role and confirmation that all records have been seen. The staff training matrix provided to us by the manager showed that the majority of staff working at the home have up to date training in core subject areas e.g. manual handling, fire safety awareness, health and safety, food and hygiene, infection control, safeguarding, emergency first aid and nutrition awareness. It also details that 74 of staff have attained training relating to pressure area care, 78 have had care planning training, 84 have attained challenging behaviour training and dementia awareness training. Records also showed that out of 23 members of care staff, 8 have achieved NVQ Level 2 and 3 staff have attained NVQ Level 3. At the current time 5 members of staff are undertaking NVQ Level 2 and 4 members of staff are undertaking NVQ Level 3. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a home that is run in their best interests. Evidence: The manager has many years experience in caring for older people and has been managing Sycamore Court since November 2007. The manager has completed the Registered Managers Award and undertaken a variety of training in both core and specialist subject areas. Relatives and residents spoken with were positive about the manager and the improvements made. The manager confirmed following the site visit that they have submitted an application to be formally registered as manager with the Care Quality Commission. Evidence showed that on a day-to-day basis the home is generally well run and provides positive outcomes for the people who live at Sycamore Court. Relatives spoken with confirmed they had confidence in the organisation and management team of the home to ensure good care practices were adopted and that there were positive Care Homes for Older People Page 25 of 30 Evidence: outcomes for people who live in the home. It is positive that since the last key inspection to the service in August 2009 further improvements have been made to ensure positive outcomes for people and all outstanding statutory requirements, statutory requirements made at that inspection and recommendations have now been met. From evidence of staff supervision records and from discussion with staff, staff working at the home are receiving regular supervision in line with the recommendations as detailed within the National Minimum Standards. The organisation have several ways of monitoring the quality of the service provided at Sycamore Court. These include monthly Regulation 26 visits, monthly audits undertaken by the manager and an outcome audit that is based on the National Minimum Standards and Care Homes Regulations for Older People. The manager confirmed that a recent audit in November 2009 was completed by the organisation and this concluded that the home was achieving a good level of compliance to meeting not only the Care Homes Regulations for Older People but meeting the organisations aims and objectives. Minutes of resident/relatives and staff meetings were available for review and showed that the manager was actively encouraging people to comment on the home, care provided and care practice issues. At the last key inspection to the service there was evidence to show that the views of people who live at the home, their relatives, staff and other stakeholders are sought about the quality of the service provided at Sycamore Court. The manager told us that in December 2009 surveys were forwarded to peoples relatives. At the time of the site visit the home had received 8 completed surveys. The majority of comments recorded were seen to be positive and included In my judgement my relative is as happy as possible and likes Sycamore Court and the staff, My relative has been very happy at Sycamore Court. The care staff are excellent (although sometimes under great pressure due to staff shortages) and I know they are very happy at Sycamore Court and I am grateful to all the staff. The only negative comments recorded related to one relative feeling there was on occasions an unpleasant odour in the home from wet incontinence pads and on occasions these were left in their member of familys en-suite. Corporate health and safety policies and procedures were observed to be in place within the home. The staff training matrix showed that all staff have updated health and safety training. Accident records were reviewed and noted to be completed well. Where appropriate, we had been notified under Regulation 37 of the Care Standards Act 2000 of any deaths, illness or other significant events. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 There must be record of all medicines kept in the care home and the record of when medicines are disposed of must be accurate and up to date. This will ensure the home can account for all medicines in use. 19/03/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 7 Ensure staff are made aware at the earliest opportunity of prospective peoples care needs. Ensure that all of a persons care needs are clearly recorded and that an interim plan of care for prospective people due to be admitted to the care home is drawn up prior to their admission or at the earliest opportunity (emergency admission). Consider devising the activity programme in larger print and/or pictorial format so that people in the home can make an informed choice as to the activities they wish to participate in. Page 28 of 30 3 12 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 4 5 19 29 Ensure that all areas of the home environment are safe for people who live in the home. For those people that have their recruitment records held centrally, sufficient evidence must be maintained within the home to show that all records as required by regulation have been sought and confirmed by a member of the organisation. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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