This inspection took place on 1 May 2018 and was unannounced. At the time the CQC had received a notification of an incident involving the use of oxygen. The inspection did not examine the circumstances of the incident, but examined those risks and other potential risks to people.

Sycamore Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Sycamore Court is purpose built, and was taken over in 2015 by Tradstir Limited. This is the second inspection since the service was taken over by the new provider. Residential and nursing care is provided, across three units, for up to 40 older people with increasing physical frailty, many living with dementia or other mental health needs. Long term care and respite care is provided. There were 34 people resident at the time of the inspection.

At the last inspection on 7 March 2017 the service was rated overall Requires Improvement. At this inspection we found the service remained overall Requires Improvement. At the last inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because we found robust audit systems maintained and embedded in the running of the service to ensure the quality of the service had not been completed. An external company had also been used to audit in the service. However, action plans to address the issues highlighted had not been developed. We could not identify how the provider monitored or analysed the information received to look for any emerging trends or make improvements to the service provided. Regular health and safety checks of the building had not been maintained and not all risk assessments had been completed. Records were not fully accessible for senior staff to refer to and ensure essential checks of the building and services had been carried out. We also found areas in need of improvement. Training records were not fully up-to-date, so it was not possible evidence all staff had completed the essential training to support them in their roles. Staff told us they felt well supported by the senior staff who were accessible. However, feedback and records showed us that not all the staff had received regular individual supervision or appraisal. A new electronic care planning system had been introduced into the service, and people's care plans were in the process of being reviewed and transferred from the paper records onto the new system. This process had not been fully completed and care plans were between both systems, and some reviews had fallen behind. It was not possible to fully evidence peoples current care and support needs and any risks that had been identified were being met. People's nutritional needs were assessed and recorded. However, where people were being supported with their fluid intake, records had not been fully completed to inform care staff. Activities for people particularly for those people who stayed mainly in their own rooms were still in need of development. The provider sent us an action plan as to how these issues would be addressed. At this inspection we found significant improvements had been made to address all the issues raised. However, not all the issues had not been fully addressed, or had time to be fully embedded in the practice of the service and were still in need of improvement.

There was a new registered manager for the service. 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. The registered manager was also the registered manager for another of the provider’s services l

This inspection took place on 7 March 2017 and was unannounced.

Sycamore Court is purpose built, and was taken over in 2015 by Tradstir Limited. This is the first inspection since the service was taken over by the new provider. The service provides residential and nursing care, across three units, for up to 40 older people with increasing physical frailty, many living with dementia or other mental health needs. Long term care and respite care is provided. There were 20 people resident at the time of the inspection.

There was a registered manager for the service. 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.

Staff told us it had been a significant period of change with a new provider taking over the service, difficulties in recruiting staff and a number of staff changes. The registered manager told us for a long period they had been without a deputy manager and clinical lead for the service. This had meant process and systems had not been fully developed and embedded in the service as quickly as they had planned. However, one had recently been recruited and work had already commenced to start to address this. Staff also spoke of changes and improvements which were now starting to be implemented since the deputy manager had started to work in the service. There were also a lot of refurbishment works being carried out to the building, which had led to areas of the building not in use and people being moved out of their rooms for a period whilst the work was being completed. This was due to be completed shortly. Staff spoke of the passenger lift had been out of action for a significant period of time which had been difficult to manage and had restricted the movement of people around the service. One the day of the inspection one unit was closed for refurbishment and only half the beds were filled.

We found regular auditing by senior staff in the service to ensure the quality of the service had not been completed or regularly maintained and embedded in the running of the service. People had been able to feedback on the care and support they had received. An external company had also been used to audit in the service. However, action plans to address the issues had either not been drawn up or actions had not been taken to address the issues highlighted. We could not identify how the provider monitored or analysed the information received to look for any emerging trends or make improvements to the service provided. This is an area which requires improvement.

People received care in an environment that was clean and tidy. However, regular health and safety checks of the building had not been maintained and not all risk assessments had been completed. Records were not fully accessible for senior staff to refer to and ensure essential checks of the building and services had been carried out. This is an area which requires improvement.

Senior staff monitored people’s dependency in relation to the level of staffing needed to ensure people’s care and support needs were met. Feedback from people and staff was that there was usually enough staff to meet people’s care and support needs. One member of staff told us, “This is generally a good place to work, we pick up lots of skills here. The place has potential and is designed for a certain type of care. We all sing from the same hymn sheet with similar aspirations and expectations.” Another member of staff told us “It’s really good I’m quite happy the staff are doing a very good job.” Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. However, training records were not fully up-t