This inspection took place on 24 August and 26 September 2017 and was unannounced. This was the first inspection of the service following a change to the provider’s registration.

Sycamore Lodge provides personal and nursing care to a maximum of 45 people. It is situated in the town of Ashby on the outskirts of Scunthorpe. There are bedrooms and bathrooms on two floors, which can be accessed by a passenger lift or stairs. There is a range of communal areas including a conservatory and a number of lounges.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 understood their responsibility to protect people from abuse or harm. They knew they must report potential issues to the management team, local authority or to the CQC, which helped to protect people.

Staffing levels provided met people’s needs and were kept under review. Risks to people’s health and wellbeing were identified and were monitored by staff to help minimise the risk present to people’s wellbeing.

Staff completed training in a variety of subjects on a regular basis to help to develop and maintain their skills. Supervision and appraisal was provided to staff to support them and identify any training or performance issues.

People’s dietary needs were monitored and special dietary needs were catered for. Choices of food and drink were provided and alternatives were offered if people did not like what was on the menu. Advice was sought from relevant health care professionals to ensure people’s nutritional needs were met.

People made decisions for themselves and consented to receive their care and support. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked mental capacity and important decisions needed to be made, this helped to protect people's rights.

People were cared for by caring attentive and kind staff who went the extra mile to provide people with high quality care. Caring support was provided to people’s relatives and visitors. Very positive comments were received about how caring the staff were.

People received exceptionally compassionate end of life care, which was very positively promoted at the service. People received exceptionally compassionate care which was planned in advance with them. We received exceptional comments about this support from people's relatives. The staff excelled to provide innovative ways of ensuring people achieved their last wishes in their life. The provider, registered manager and staff took pride in supporting people and their relatives at this time to ensure people felt well cared for and supported.

Activities were provided and people were encouraged to maintain their hobbies and interests.

A complaints procedure was in place for people and their relatives to use. Issues raised were acted upon straight away.

People’s views about the service were asked for informally on a daily basis by staff or formally through surveys.

On the first day of our inspection we found some environmental issues were present for example; the sluice required cleaning, some window restrictors needed fitting and a stairwell required a brighter light. A noise operated door guard on the kitchen door had to have the battery changed to ensure it worked if the fire alarm was activated. These issues were acted upon immediately and were resolved before we left the service. Checks were put in place and audits were undertaken to prevent these issues from occurring again. Audits were undertaken to monitor the service.

The provider and registered manager had an ‘open door’ policy in place and there was an on call system in operation, which allowed people, their r