Archived: The Sycamores Nursing Home

The Sycamores Nursing Home is in two adjoining Victorian houses which have been converted to provide accommodation for 15 people with a mental health illness. It is situated in the Harehills area of Leeds close to the busy junction of Harehills Lane with Roundhay Road and a range of local amenities. There is a small garden and courtyard parking area to the rear of the building. The facilities are spread over four floors and there is no lift access.

At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe in the home and we saw there were systems and processes in place to protect people from the risk of harm. Staff had a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe. People were protected against the risks associated with medicines because the registered provider had appropriate arrangements in place to manage medicines safely.

We found people were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. Robust recruitment and selection procedures were in place. Staff received the training required to meet people’s needs and had attended supervision meeting, however, these were not carried out in line with the registered provider’s policy.

Staff said people were supported to make decisions and where people did not have the capacity decisions had to be in their best interests. The registered manager told us there was no one living at the home that was subject to a Deprivation of Liberty Safeguards authorisation.

People were provided with a choice of food and drink options ensuring their nutritional needs were met and people’s mental and physical healthcare needs were monitored as required which included appropriate referrals to health professionals when required.

There was opportunity for people to be involved in a range of activities within the home or the local community. People were able to choose how and where they spent their time.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. Staff had good relationships with the people living at the home. Staff knew how to respect people’s privacy and dignity. People were supported to attend meetings where they could express their views about the home.

The service had good management and leadership. The management team investigated and responded to people’s complaints, according to the registered provider’s complaints procedure. People we spoke with did not raise any complaints or concerns about living at the home. There were effective systems in place to monitor and improve the quality of the service provided, however, action plans were not always up to date.

We considered all the evidence we had gathered under the outcomes we inspected. We gathered evidence to help us answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Is the service safe? -

We found there were sufficient staff on duty to meet people's needs throughout the day and night. When necessary the service used bank staff to cover absences. People we spoke with told us there was always someone to help them when they needed support.

In the care plans we looked at we saw people had risk assessments which covered areas of potential risk such as road safety, self-medication and behaviours that challenge. When people were identified as being at risk, their plans showed the actions required to manage these risks.

There were procedures in place to guide staff on the actions to take in response to medical emergencies.

People's best interests were managed appropriately under the Mental Capacity Act (2005). The manager understood their responsibilities under the Deprivation of Liberty Safeguards. We did not observe any restrictions to people's liberty.

The home was clean, safe and hygienic and people we spoke with told us they had no concerns with the cleanliness of the home.

Is the service effective? -

People had an individual care and support plan which set out their needs. We found people and/or their representatives were involved in the assessment and planning of their health and care needs. This meant people could be assured their individual care needs and wishes were identified and planned for.

The home had good working relationships with other healthcare professionals and worked closely with them to make sure people's needs were met. The input of other healthcare professionals involved in people's care and treatment was clearly recorded in their care records.

Is the service caring? '

People we spoke told us the staff were helpful. One person said, 'It's good living here, they help me.'

We found the care staff we spoke with demonstrated a good knowledge of people's needs and were able to explain how individuals preferred their care and support to be delivered.

We found the atmosphere within the home was calm, warm and friendly and we saw staff approached individual people in a way which showed they knew the person well and knew how best to assist them. People had their privacy and dignity respected.

Is the service responsive? '

People's needs were assessed before they moved into the home. We saw people's care records had information about people's individual needs and preferences.

People had access to a range of day to day activities and were consulted about the types of activities they wanted to take part in. People also were able to maintain their links with the local community.

Is the service well led? '

At the time of our inspection the service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

The service was well led with an approachable management team and a positive and open working atmosphere.

People told us they had confidence in the manager and they were approachable and listened to what they had to say. We saw the home held meetings for people who used the service to give them the opportunity to share their views and make suggestions for improvements to the service.

The staff we spoke with said they enjoyed working at the home. They said they worked well as a team and felt supported by the manager. One person said, 'It is a really nice place to work.'

We found the service had an effective system in place to identify, assess and manage risk and there was a system in place should people wish to make a complaint.

There were sufficient staff to meet people's needs and they were competent and knowledgeable. Quality audits were robust in identifying areas for improvement and action plans were implemented when necessary.

People told us the staff were respectful and listened to their views. They were supported to increase their confidence and where appropriate prepare for more independent living. They were involved in community activities and many were able to go out and travel independently.

Care and support plans were personalised and included detailed assessments of people's needs and any risks to their health and welfare. Each person had a named nurse who was responsible for coordinating their support and reviewing their needs.

There were clear arrangements to obtain and store supplies of medication. Administration of medication was properly recorded and medication procedures were regularly audited.

The staff told us they were well supported and helped to carry out their role. They said they had regular supervision and an annual appraisal. Their training and development needs were assessed and they were encouraged to undertake further qualifications relevant to their role.

People's views about the service were listen to and changes were made to improve the service. There was an annual programme of audits through which the provider was able to monitor the quality of the service.