Sycamores Care Home Enter and View Report

Approach Used
6 Authorised Representatives arrived at the home unannounced, which means that no-one knew we were coming. We spoke to The Duty Manager and Care Team Manager, 1 Lifestyle Coordinator, 8 members of staff, 10 residents and 3 relatives and observed the care being given in the communal areas of the home, including the period over lunch.

Summary of findings

• Staff are clear about their roles, appear to be properly trained. We were informed there was a low staff turnover.
• Relatives told us that staff at the home manage challenging behavior well.
• The home has a positive focus on activities.
• A smart phone records system is used, which means relatives can see a record of the care being given at any time using an app on their phone. Staff and relatives told us that they liked this system.
• Staff reported that there is an emphasis on improving communication.
• New staff told us that they had a good induction.
• We saw residents at the home given drinks, snacks and fruit outside of normal mealtimes.
• Residents were happy to talk to us.
• Residents were dressed appropriately for the time of year.
• There is a system that records response times for staff to answer call bell alerts. We observed that 1 call bell was not plugged in and 2 pull cords were tied back.
• Some residents reported that a recent upsurge in the use of agency staff had a negative impact on their care.
• 3 residents said they would like to go out more.
• The lift had been broken on and off for 2 weeks although maintenance men completed the repair on the day we visited.
• The projector in the cinema room was not operable.

Recommendations
• Try and limit the use of agency staff when possible
• Routinely check call bells are plugged in and pull cords are accessible
• Put a comments and suggestions box in the reception area
• Continue the improvements in communication that were reported by staff.
• WCS Care support the maintenance of the garden
• Carry out a programme of redecoration/maintenance inside and outside the building

Response from the Registered Manager:
• The home did use more agency during March due to staff using up annual leave before the next financial year. We have also recruited 5 new carers. This also means we have a pool of bank carers to cover staff when they are on leave and training. We did use more agency that month but this has now significantly reduced to only 2 agency in the last 3 weeks.
• The home has just reviewed their interview process and induction passport which is now being rolled out. The focus is to ensure staff get a thorough induction and feel confident in their new roles.
• You observed 1 call bell was not plugged in and 2 pull cords were tied back. Duty managers are expected to complete daily walkabout at the start of each of their shifts. Part of their walkabout is to observe that residents have access to call bells, assistive technology is in place and pull cords aren't tied back. We are in the process of creating a prompt sheet for the duty manager walkabouts. I will add this check onto the prompt sheet.
• The projector in the cinema room was not operable. The projector is operable but we have had to take it out of action because one of our residents keeps entering the room and dismantling it. We are in the process of redecorating the room and turning it into a relaxation room / quiet lounge. This way there isn't any equipment that can be damaged. We will move the cinema equipment into another lounge area. This lounge is being redecorated on Tuesday 21st May 2019.
• The home doesn't have a Dementia unit. Staff are linked to floors for consistency but also have to be flexible and work across the home to meet the needs of the residents and ensure we have the correct skill mix across the floors.
• The actions from this report will be added to our Service Improvement plan. We do have a decoration plan being put into action at the moment. No timescales have been put in place yet but the small lounge is being redecorated this week and the misted windows are being replaced.