Sycamore Hall

Updated 11 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. This was a comprehensive inspection.

The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury. This incident is subject to a Coroner’s and safeguarding investigation after which we will consider any next steps. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of falls from moving and handling equipment. This inspection examined those risks.

This inspection took place on 1 and 3 November 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted them to be present on these days to provide us with the information we needed.

Inspection site visit activity started on 26 October and ended on 6 November 2017. It included reviewing the information we held about the service, speaking to people who used the service, staff and professionals.

We visited the office location on 1 and 3 November to see the manager and office staff; and to review care records and policies and procedures. An expert-by-experience carried out telephone interviews to seek the views of people who used the service and their relatives. On day two, the adult social care inspector visited the provider’s office and the service at Kirkwood Hall. An expert by experience also visited Kirkwood Hall and spoke with people who used the service and their relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Both experts had experience of caring for older people or people with disabilities.

Before our inspection, we looked at information we held about the service such as notifications we had received from the provider. A notification is information about important events which the service is required to send us by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan the inspection.

As part of this inspection, we visited five people within their own homes and spoke with nine people and one relative when we visited the extra care services. We spoke with three people who used the service and eight relatives via the telephone.

We spoke with the manager, four team leaders and three care and support workers. We spoke with managers who were responsible for the maintenance of the premises and three health and social care professionals for their feedback on their experiences of the care provided.

We looked at eight people's care records, three staff recruitment and training records, meeting minutes, medication administration records, audits and a selection of records relating to the running of the service which included the providers quality assurance audits.

Updated 11 January 2018

We carried out this announced inspection 1 and 3 November 2017.

Sycamore Hall provides personal care to people in their own homes. The service also provides personal care to people living at Kirkwood Hall in Leyburn. Both services are carried on and managed from the Sycamore Hall location.

The service can be provided to adults over 18 years, older people, people living with dementia or mental health difficulties, physical disabilities, autistic spectrum disorder or people with sensory impairments. At the time of our inspection, the service was providing care for 44 people.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

People using the service at Sycamore hall lived in apartments. The Kirkwood Hall facility had apartments and bungalows that were situated in the grounds.

Sycamore Hall has a room reserved for people from the community who need additional support following discharge from hospital or to prevent them from being admitted to hospital. Kirkwood Hall has two of these rooms. These are known as step up / step down beds. Health professional's work alongside staff to ensure people who require this level of support have their needs met.

The service did not have a registered manager. The previous registered manager left in May 2017. The manager in charge of the service had applied to be registered.

At the last inspection, the service was rated good. At this inspection, we found the service remained good.

People were protected from harm by staff that recognised the signs of abuse and were confident to raise concerns. Care plans and risk assessments were in place and there was enough staff to safely provide care and support people.

There were safe recruitment processes to prevent unsuitable staff working with vulnerable people. The administration of medicines was well managed and people received support from health professionals when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Arrangements were made for people to see health professionals when they needed to and to have a healthy balanced diet to promote their wellbeing.

The care and support people received was person centred to meet individual needs. Staff were kind, treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights as their choices and preferences were respected.

People’s independence was promoted and they were supported to have maximum choice and control of their lives.

The service was well-led. Staff said the management team were approachable and supportive and there were good working relationships with health and social care professionals. The safety and quality of support people received was monitored and the provider completed quality assurance audits to drive continuous improvement of the service.

Feedback systems were in place where the views of people and relatives were sought. People were given information on how to raise a complaint should they choose to do so.

Further information is in the detailed findings below.