Sydmar Lodge 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 service is registered to provide accommodation and personal care for up to 57 people, although the registered manager told us the maximum practical occupancy was 50. There were 45 people using the service at the start of this inspection. The service specialises in dementia care and is operated by a small independent provider that bought the company shortly after the last inspection.

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 w

This was an unannounced inspection that took place on 21 and 28 February 2017. At the last inspection in May 2016, we checked on the provider’s progress with ensuring safe medicines management and found that this was sufficient.

Sydmar Lodge is registered to provide accommodation and personal care for up to 57 people, although the registered manager told us the maximum practical occupancy was 48. There were 48 people using the service at the time of this inspection. The service specialises in dementia care and is operated by a national care company.

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.

People and their relatives generally reported overall satisfaction with the service. For some, improvements could be made but it was still “eight out of ten.” Others were very satisfied and full of praise.

There was good feedback about improved management of the service under the new registered manager. However, we found some concerns around how the service ensured that people received high quality care. There were some weaknesses in terms of service-wide communication in support of the effective care of people and with ensuring accurate care records.

We also found that professional safety advice was not always adhered to. Risks associated with the prevention of Legionella were identified in July 2016 but had not been addressed at the time of this inspection. Proper maintenance of one passenger lift was only being completed at the time of the inspection.

Whilst people felt safe in the service, some did not think there were enough staff. We saw an occasion where one person had to wait a while for their request to be addressed. The registered manager told us she was introducing a documented system of checking response times to call-bells as a result of this inspection, and we have recommended that people’s feedback in relation to staffing availability be considered.

Despite these concerns, there was much good practice taking place at the service. People at the service had a strong collective voice that helped influence how the service was run. This included through regular house meetings, and being asked to contribute towards staff recruitment and development decisions. Due to ongoing feedback about the quality of meals provided by the in-house catering service, the service arranged for a number of people to meet with members of the catering service’s senior management team. This had helped to make improvements to people’s experience of meals.

The service provided an extensive range of activities and entertainers that many people enjoyed. People were enabled to maintain and develop connections with the local community, visitors were made very welcome, and there were weekly trips out using the service’s minibus. The service even had its own choir.

The service promoted a Jewish ethos but welcomed people of all faiths. A number of Jewish customs and celebrations were therefore practiced at the service. There was ongoing training of staff on these matters by a Jewish staff member.

Community healthcare professionals provided strong praise of the service and staff capability. People received good support with healthcare and nutrition, and their medicines were safely managed.

There were established systems of assessing risks to individuals and taking action to prevent harm. People’s care plans had been recently improved on and so better reflected their individual needs and preferences and the care that they received. This was a significant achievement for the service.

There was much praise of how committed and kind staff were. The service had many staff who had worked there for a long time, and was not using agency st