Lynden Hill Clinic

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Staff did not always have access to the most important and current information first.Care plans did not have details and guidance regarding how people preferred their care and what was important to them. For example, we noted one person did not want to be disturbed until certain a time in the morning, but this was not acknowledged and acted on.The service did not offer any activities to people because the registered manager told us this was “not a nursing home”. However, this did not demonstrate people’s social needs were considered to avoid social isolation. People did not have access to activities to promote and support their independence, wellbeing, and positive outcome as part of their stay. This did not demonstrate care and treatment was centred around people, their needs and wishes.During the assessment, people told us they were happy staying at the service. They said, “[Staff] make sure that you are good. They come with a wheelchair at the right time. Very well thought through” and “Very much person-led. Individually led. What your needs are and what help you want. It is not imposed on you and it is offered and it is there. This is my main purpose for coming here.”Staff told us how they supported people to make choices, maintain preferences and wishes such as meals, spend their time or when to receive personal care.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.Staff used an enquiry form to gather some information before admissions. However, this did not always work effectively to support the admission process as part of joined-up care, as people were often asked repetitive questions at a time they were already overwhelmed with change. This meant people’s care and treatment was not always delivered in a way that met their needs including those with protected characteristics under the Equality Act 2010 and those at most risk of a poorer experience of care.Care plans did not include information to guide staff on how to escalate concerns about people’s risks. The registered manager and the staff did not ensure referrals to external services included details of any known risks, and the outcomes and recommendations from professionals were recorded. The provider did not have systems in place to monitor and review people’s care needs and to escalate concerns to external services. The service did not establish partnerships with the local authority or other agencies to continuously review and improve the quality of care they delivered.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s care records did not contain guidance in relation to how they would prefer information to be presented to ensure information was accessible, safe and secure and supported their rights and choices.People told us they did not know how or where to access their all health and care records so they could decide which personal information can be shared with other people. Therefore, people did not always receive information in a timely way so they could be assured it met best practice standards, legal requirements and was tailored to individual need.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.We reviewed information about complaints and how they were dealt with. It was not clear if full investigations were carried out into each issue or concern raised. The provider had a complaints policy in place defining the process including contacting the local authority for advice and guidance to manage any complaints that included harm or risk of harm to people. However, the registered manager was not able to provide evidence how the complaints were consistently investigated and addressed, including any lessons learned or improvements identified that could be shared with staff. There was no clear evidence if people received the information regarding the outcome and how their complaint or feedback was used to make improvements if necessary. Some responses given to people did not always demonstrate the registered manager or staff understood and acknowledged people’s issues.Some staff noted they did not receive much information regarding complaints that could support any learning. This meant the registered manager was not able to monitor themes from complaints and measure the impact to people, staff and the service.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Physical premises and equipment were not always made accessible. People were not always given support to overcome barriers to ensure equal access. For example, one person was staying at the service and due to their physical needs, they were not able to use equipment such as their bed or a wheelchair. The provider had the information about the person before the admission. However, they did not ensure these things were planned before accepting the person therefore, providing care and treatment that put the person at risk of harm. A number of staff raised this as a concern but there was no clear evidence how this was managed to ensure they provided care and treatment in line with the person's expectations. People told us they had access to therapies and the equipment they required to keep them mobile and comfortable. However, neither the provider nor the registered manager gathered or used people’s feedback and other evidence to actively identify if any of the people were more likely to experience barriers or delays in accessing their care and then seek to review and improve the process as and when needed.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. There was no specific structure of gathering such information so the provider could measure people’s experiences and outcomes. People were not always empowered to give their views about their experience to ensure they had positive experience while using the service or how the service could apply learning if something did not go well, as neither the provider nor the registered manager gathered or used people’s feedback.People told us they had not experienced any discrimination or inequality while using the service.“[Staff] respect my human rights. I have not experienced any discrimination or inequality” and “I have not experienced any discrimination or inequality here. I don’t think so.” People felt the staff supported them in a timely and respectful way. Some added, “Nothing went wrong since I came here. I’ve got this bell I ring and very seldom wait anything like 5 minutes. If they are going to be longer, they always come and tell you and apologise” and “Yes, [staff] come here quickly, there might be a slightly longer delay of a few minutes. Yes, they do everything.”

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future. Due to the service being for respite and rehabilitation there were no people accessing the service that may require end of life care.Some people told us they had a plan for physiotherapy exercises that would benefit them for greater independence and fewer care interventions. However, care records did not include detailed information on people’s wishes and any important information regarding a specific treatment or intervention, to ensure staff were able to provide timely support as and when needed, if people’s condition suddenly deteriorated. Records lacked personalised detail regarding what was important to people.