This comprehensive inspection took place on 10 and 24 May 2018. The first day was unannounced. We told the service we would be visiting on the second day.

This is the first inspection of the service under a new provider and is rated Requires Improvement overall.

At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to staffing and governance. You can see what action we told the provider to take at the back of the full version of the report.

The Sycamores Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Sycamores Nursing Home accommodates a maximum of 15 people in one adapted building who require nursing or personal care and support with their mental health needs. At the time of our inspection there were 15 people living at the service.

The home did not have a registered manager. 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 previous registered manager left the service in July 2017.

Staff were not receiving regular supervision and appropriate training to ensure they could meet the needs of people using the service.

The provider did not have a robust system to monitor the quality of service provided. Actions that had been identified were not followed up to ensure they had been completed. The provider had not consulted people about the quality of service.

People’s risk assessments needed to be updated to reflect their current needs and records needed updating to show person centred care was being provided.

Checks on the safety of the building had been completed, but had not identified that some of the windows were unsafe. During the inspection action was action taken to make the windows safe.

The manager had managerial responsibilities for The Sycamores Nursing Home and another larger home which impacted on the clinical lead and their ability to meet the demands of their role. We have made a recommendation that the provider reassessed the deployment of staff at the service.

The service held meetings to check people’s health needs were met, but this lacked oversight from the provider. We have made a recommendation about the provider ensuring the manager is supported with the clinical governance of the service to ensure care and treatment is in line with current best practice guidelines.

Medicines were administered safely and people told us they felt safe with the staff who supported them. Staff received training in how to safeguard people and understood what action they should take to protect people from abuse.

There were enough staff to meet people's needs and pre-employment checks were undertaken to ensure their suitability to work with people.

People were supported by kind and caring staff who were committed to providing a good service. Staff asked people for their consent before offering support and treated people with dignity and respect. People were supported to make choices about their day to day lives and had access to health professionals when needed.

People and their relatives told us they felt welcome at the service and felt able to raise any concerns with the manager or staff.