We carried out a review of the data available to us about Sydmar Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Sydmar Lodge, you can give feedback on this service.
The service is registered to provide accommodation and personal care for up to 57 people, although the registered manager told us the maximum practical occupancy was 50. There were 45 people using the service at the start of this inspection. The service specialises in dementia care and is operated by a small independent provider that bought the company shortly after the last inspection.
The service had a registered manager, which 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.
This was a comprehensive inspection, to make sure the service was providing care that is safe, caring, effective, responsive to people's needs, and well-led.
The inspection was brought slightly forward due to two separate cases of information of concern about the service being conveyed to us. This information included suggestions of poor personal care, poor cleanliness, poor nutritional support, and understaffing resulting in people not being attended to. However, we found the service was upholding standards in all areas.
At our last inspection of this service, in February 2017, we found two breaches of legal requirements. These were in respect of safe care and treatment, and good governance. The service was rated ‘Requires Improvement.’ The provider completed an action plan to show what they would do and by when to improve the key questions of ‘Is it Safe?’ and ‘Is it Well-Led?’ to at least good.
At this inspection, we found the necessary improvements had been made. There was better communication in support of the effective care of people, and care records were consistently up-to-date. Risks associated with the prevention of Legionella were now being properly managed, and professional passenger lift maintenance was occurring. However, we have recommended the provider review national guidance on upholding health and safety in care homes and embed procedures relating to this.
We found the service was providing people with care and support that enabled them to have a good quality of life. Staff and managers responded to people’s individual needs, preferences and routines. We saw people always being treated respectfully and in a friendly and caring manner. There was consistently positive feedback about the approach of staff, and that they knew people well as individuals.
Most people using the service praised it highly. A typical comment was, “I think the standard of care here is very good. I can recommend this care home to other people.”
All the relatives and representatives we spoke with commented positively on the service. One said, “I believe Sydmar can be rightly very proud of the services it is offering. There is a very special atmosphere at Sydmar created by very kind and caring staff and a real family environment.” People’s visitors were welcomed at any time of the day.
We found the twice-daily activity programme to be outstanding in its breadth and depth. It engaged people well, was at times highly original, and was attuned to involving everyone using the service including those who tended to stay in their rooms. People’s past interests were explored in order to set up opportunities for them pursue them again. For example, one person was supported to go swimming, an activity they had once regularly enjoyed.
The service had strong links with community healthcare professionals, which particularly helped people to receive prompt and effective healthcare support. Community professionals praised how the service worked with them to enable high quality care of people. One told us that Sydmar Lodge provided an invaluable service which they would have no hesitation recommending to anyone. It was evident the service went to great lengths to keep people’s health and welfare under review, and acquire support from the most appropriate healthcare professionals to increase the chances of good outcomes for people. The service also supported people at the end of their life to have a comfortable, dignified and pain-free death.
The service was very capable at supporting people to eat and drink well. Good attention was paid to helping people enjoy the mealtime experience set in a restaurant-style environment. There was effective oversight of people’s nutrition and hydration, with dietitian advice sought and acted on where needed. The service found creative ways to support people at nutritional risk.
The service was strong at ensuring people received personalised care that was responsive to their needs, preferences and routines. It promoted a Jewish ethos but welcomed people of all faiths. Many Jewish customs and celebrations were therefore practiced at the service, which people and their representatives fedback positively about.
The new provider had invested well in the physical environment. Many areas of the premises had been redecorated, and there was ongoing work to complete this with minimal disruption to people using the service. Good standards of cleanliness were maintained regardless.
The service monitored people’s personal safety in a variety of ways to help minimise the risk of accidents occurring or health and welfare concerns developing. This was supported by staffing levels being kept under review, to help ensure people’s needs were consistently met. The service also followed procedures to keep people safe from abuse, and respond accordingly should any allegation of abuse occur.
Medicines were properly and safely managed. We made a few good practice recommendations which the service promptly addressed.
The service ensured staff received comprehensive training and good support to deliver effective care to people. There was good team work in support of this.
There was a positive working culture at the service in support of providing people with high quality care. The service was quick to respond to any concerns raised or suggestions made. The registered manager and the deputy kept up-to-date with good practice recommendations, worked co-operatively with local services, and provided clear leadership and governance of the service. This helped to ensure that everyone involved in whatever capacity worked with appropriately caring and responsive approaches in their interactions and support of people using the service.
Sydmar Lodge is registered to provide accommodation and personal care for up to 57 people, although the registered manager told us the maximum practical occupancy was 48. There were 48 people using the service at the time of this inspection. The service specialises in dementia care and is operated by a national care company.
The service had a registered manager, which 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 and their relatives generally reported overall satisfaction with the service. For some, improvements could be made but it was still “eight out of ten.” Others were very satisfied and full of praise.
There was good feedback about improved management of the service under the new registered manager. However, we found some concerns around how the service ensured that people received high quality care. There were some weaknesses in terms of service-wide communication in support of the effective care of people and with ensuring accurate care records.
We also found that professional safety advice was not always adhered to. Risks associated with the prevention of Legionella were identified in July 2016 but had not been addressed at the time of this inspection. Proper maintenance of one passenger lift was only being completed at the time of the inspection.
Whilst people felt safe in the service, some did not think there were enough staff. We saw an occasion where one person had to wait a while for their request to be addressed. The registered manager told us she was introducing a documented system of checking response times to call-bells as a result of this inspection, and we have recommended that people’s feedback in relation to staffing availability be considered.
Despite these concerns, there was much good practice taking place at the service. People at the service had a strong collective voice that helped influence how the service was run. This included through regular house meetings, and being asked to contribute towards staff recruitment and development decisions. Due to ongoing feedback about the quality of meals provided by the in-house catering service, the service arranged for a number of people to meet with members of the catering service’s senior management team. This had helped to make improvements to people’s experience of meals.
The service provided an extensive range of activities and entertainers that many people enjoyed. People were enabled to maintain and develop connections with the local community, visitors were made very welcome, and there were weekly trips out using the service’s minibus. The service even had its own choir.
The service promoted a Jewish ethos but welcomed people of all faiths. A number of Jewish customs and celebrations were therefore practiced at the service. There was ongoing training of staff on these matters by a Jewish staff member.
Community healthcare professionals provided strong praise of the service and staff capability. People received good support with healthcare and nutrition, and their medicines were safely managed.
There were established systems of assessing risks to individuals and taking action to prevent harm. People’s care plans had been recently improved on and so better reflected their individual needs and preferences and the care that they received. This was a significant achievement for the service.
There was much praise of how committed and kind staff were. The service had many staff who had worked there for a long time, and was not using agency staff. There was good training and support of staff. The service demonstrated strong commitment to checking and supporting staff to have caring approaches to people. It was evident that many staff and managers had developed great fondness for people using the service.
There was clear evidence of service-wide improvement being facilitated through the new registered manager’s approach. In particular, the culture at the service was more open, inclusive and empowering, to both people using the service and the staff supporting them. The service was aiming at high quality care and was increasingly providing it.
There were overall two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.