Sydmar Lodge

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.

The five questions we ask about services and what we found