Lyndhurst Park Nursing Home

Lyndhurst Park Nursing Home provides personal and nursing care for up to 27 people. The service is provided in accommodation over two floors. At the time of the inspection, 24 people were living at the home.

We found the following examples of good practice.

Staff had access to supplies of personal protective equipment (PPE), and they had received training to ensure they used this correctly. PPE was available on every floor and was disposed of safely. We observed staff following correct protocols when changing PPE and posters were displayed around the service to provide reminders about this. This showed staff were committed to maintaining high standards in infection prevention and control, and to keeping people, staff and visitors safe.

People’s families had been kept up to date about changes and risks at the service. When face to face visits were not possible, people had been supported to keep in contact with friends and family using phone and video calls and some window visits had taken place. A plan was in place to safely restart visits in line with government guidance. Families had been informed that they would be required to wear PPE and have an on-site rapid coronavirus test before they could enter the service.

The service was clean and well maintained and procedures throughout the building helped control the risk of cross infection. During the outbreak of coronavirus at the service, one member of staff had been tasked with specifically cleaning all high touch points on a continuous basis. Rooms were regularly disinfected using a fogging machine to distribute a very fine mist which lands on all surfaces to sanitise them. Staff were clear about how to safely use this equipment.

The staff team were committed and knew people well. Staff had been challenged by the recent outbreak at the service, but they were positive and committed to working at the service. They told us they felt safe with the systems in place at the service. The provider had offered different shift and working patterns to support staff’s health and wellbeing. Staff accessed testing as required and all had received their first vaccination against Covid-19.

When people received a positive coronavirus test, they were supported to have a high calorie diet and extra fluids. This meant they had the best opportunity to boost their nutritional intake and build strength to help them recover from illness.

Lyndhurst Park Nursing Home is a nursing home that provides accommodation with nursing and personal care for up to 27 people. When we visited, 25 people lived there.

People’s experience of using this service and what we found:

People were supported by staff that were caring, compassionate and treated them with dignity and respect. Staff understood the needs of the people they supported and their communication needs. Staff spoke positively about the people they supported, and we made positive observations.

Risks of abuse to people were minimised because staff understood safeguarding reporting processes. Staff were confident any reported matters would be addressed by the provider. The registered manager had an oversight of current and historical safeguarding matters and communicated with external agencies when needed.

There were effective systems that ensured the service was safe. Health and safety checks, together with effective checks of the environment were completed. People, their relatives and staff commented positively on the number of staff on duty to support people and the provider operated safe recruitment procedures.

People were supported by trained staff who performed their roles competently. Staff were supported through supervision and appraisal. Staff at the service worked together with a range of healthcare professionals and followed professional advice and guidance when needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff understood the Mental Capacity Act 2005 and applied the principles of the Act when performing their role.

People’s records were personalised, and staff knew the history and background of people. There were systems to ensure care was responsive. People's concerns and complaints were listened and responded to. People has escalation plans relating to end of life care decisions.

People and their relatives gave us positive feedback about the quality of care people received. The feedback on the leadership of the service and the registered manager was positive. There were quality monitoring systems operated by the provider.

The provider had failed to inform the Care Quality Commission of all notifiable incidents as required by law, as a result we have rated the ‘Well Led’ key question as Requires Improvement.

Rating at last inspection (and update): The last rating for this service was Requires Improvement (published August 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Lyndhurst Park 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.

Lyndhurst Park accommodates 27 people in one adapted building. At the time of our inspection there were 24 people living there with two people admitted during our inspection.

There was a registered manager at the service. 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.

People who lived at the service and their relatives were complimentary about the care and the staff. They felt staff knew them well and delivered effective and kind care. They told us they were happy living at the home and enjoyed the food. Relatives told us they were confident their loved ones were safe and well cared for. Relatives told us that they felt the service was particularly good at making it feel like home.

We found shortfalls in the management of medicines during our inspection and we identified this was a breach of regulations. The registered manager took steps to address these quickly, however this was a breach of regulations at the time of our visit.

We found some areas within the home needed maintenance. The provider told us they would address these immediately.

The provider’s systems had not identified the shortfalls in ordering and storage of medicines.

The home was clean and smelt fresh throughout, however the provider had not identified some infection control risks. We have made a recommendation about this.

The provider had failed to display their most recent rating on their website.

The provider had a consistent staff team with very low turnover. Many of the staff had worked at Lyndhurst Park for many years. This had a mostly positive impact in that it created a stable caring environment. People’s choices and preferences were respected, although these had not been entered on the new electronic records system yet.People received care from staff who knew them well. Staff morale was good, and staff felt supported and worked well as a team. However, the longevity of the provider and staff team meant that shortfalls were not always noticed as everyone was used to the environment and to working in a particular way.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Lyndhurst Park Nursing Home is registered to provide accommodation and nursing care for up to 27 people including people who require respite care. The home specialises in the care of older people. Some people at the home have complex needs or dementia and as a result have limited communication skills. At the time of our inspection there were 27 people living at the home. The home is a large building over two floors. There are communal lounges, a dining room and an indoor pond.

The home had 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. They worked alongside the provider to manage the home on a daily basis.

People and relatives told us they felt safe. We found improvements could be made with some of the medication procedures in the home. Nurses knew people’s administration preferences. However, staff did not have guidance for people who needed medicines ‘as required’, medicines were not always stored securely and some medicine administration seen was not safe.

Staff had a working knowledge of infection control.

The provider and staff understood about Deprivation of Liberty Safeguards (DoLS) and the process to follow to make sure people’s human rights were respected. People who lacked capacity had decisions made following the code of practice.

Quality assurance systems did not identify all concerns found on the inspection. There were limited records to demonstrate learning from issues found by the management. When shortfalls had been identified they had not always resolved them.

A safe recruitment procedure was not always being followed because staff had not always received complete checks before starting to work with people.

Staff knew how to recognise and report abuse. They had received training in safeguarding adults from abuse and knew the procedures to follow if they had concerns. However, one concern found had been raised with the local authority.

Staff were supervised informally and had annual appraisals. They told us they received enough training to meet most people’s needs.

People were supported by sufficient staff to enable them to take part in a range of activities according to their interests and preferences. There was a low staff turnover which meant people received consistent care and support. The registered manager and provider were currently recruiting more staff because they had identified people’s needs were changing.

People's health care needs were monitored and met. Staff and the registered manager made sure people saw the health and social care professionals they required and implemented any recommendations made which people agreed to.

Staff supported and respected the choices made by people. People’s cultural and religious diversity was respected. People had a choice of meals, snacks and drinks and most people told us they enjoyed the food. People who required special diets received them and staff understood about special diets to meet people’s care and health needs.

There were systems in place to manage complaints and the registered manager and provider demonstrated a good understanding of how to reduce the likelihood of them.

People and their relatives thought the staff were kind and caring and we observed positive interactions. People’s privacy and dignity was respected by staff.

Staff had good knowledge about people’s needs. Their care plans contained information about end of life care choices which helped to ensure best practice for people when nearing the end of their life. The needs of the people were reflected in their care plans.

We found one breach in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People were able to comment directly on their care so we spent time speaking with them and their relatives.

We saw that staff treated people with consideration and respect. Staff were able to recognise when people wanted assistance and responded promptly.

People's care needs were delivered in line with their individual care plan. We saw that people looked at ease with staff. Staff were clear about their role to protect people and involve them in day to day decisions. Staffing levels met people's needs.

People we spoke with said 'the staff are very kind' and 'I like it here the staff are lovely'.

We also spoken with relatives who said 'the staff are very kind'.

We spoke with staff who said they felt supported and enabled to do their jobs well.