This inspection was carried out on the 27 June 2016 and was unannounced.Lynton House is registered to provide accommodation and personal care for up to eight people. People living at the service had a range of learning disabilities. Some people had physical disabilities and occasionally required support with behaviours which challenged.
Downstairs there was a kitchen, dining room and lounge. The eight bedrooms were split over three floors and there were several bathrooms. At the time of the inspection there were eight people living at the service.
Historically there had been a long standing, established registered manager at the service. They no longer worked at the service and this had been a big change for both staff and people. The practice team leader was currently acting as manager and there was not currently a registered manager in place. 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 practice team leader said that the lack of the registered manager had been difficult for people to come to terms with. They were focussed on providing high quality care but did not have the time to work with staff directly or carry out formal audits on the quality of care or documentation. A best interest meeting had taken place and staff had not recorded this so there was no record of the process or decision made. People, their relatives and people involved in the service had been surveyed in 2014 to ask their opinions on the service. Feedback had been positive, but no further feedback had been sought.
The Care Quality Commission (CQC) was informed of important events within the service, in line with current legislation.
Staff were supported to carry out their roles. There was a plan in place to ensure all staff had a one to one meeting with the practice team leader by the end of June 2016. Staff had received the training they needed to carry out their roles.
The provider was a Christian charity and people’s faith was important to them. They regularly attended Church and people told us they liked to read their bibles and attend Communion. People were fully involved, in a meaningful way, in developing and shaping the service. There was a culture of openness and inclusion with everyone taking a role in the running of the service. Everyone took part in some way in the cooking, cleaning and in regular resident’s meetings.
Staff knew how to recognise and respond to abuse. The practice team leader told us there had been no safeguarding issues and the local authority safeguarding team confirmed this was the case. They understood their responsibilities and who to report concerns to.
Risks relating to people’s health and well being had been assessed and action was taken to minimise them. Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. Regular fire drills were undertaken and people and staff knew what to do in the event of an emergency.
There was enough staff to meet people’s needs. People were able to do the activities they wanted and attend all of their appointments. Before staff started working at the service all the necessary checks were carried out to ensure staff were suitable to work with people.
Medicines were stored appropriately. People received their medicines when they needed it and were encouraged to be as independent as possible when taking their medicines.
All staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). One DoLS application had been made as the person was unable to leave the service without assistance. People were able to live their lives the way they chose.
People were supported to prepare and eat healthy and nutritious food. People were seen and assessed by a speech and language therapist (SALT) when they needed support to eat and drink safely. People attended a variety of healthcare appointments and staff supported people to be as independent as possible. People had seen improvements in their health. One person had lost weight and another person was able to mobilise more.
People and their relatives spoke positively about the support they received. They said staff were kind and caring. Staff treated people with respect and dignity. People decorated their rooms in the way they wanted and their loved ones could visit whenever they wanted.
People were involved in writing their care plans and risk assessments. They received the care they needed, in line with their wishes. People were actively involved in the local community and regularly attended Church and various local clubs. They enjoyed the company of staff and each other and were happy and relaxed in their home.
There had been no recent complaints. People and their relatives told us they were in regular contact with staff and felt they could raise any issues if they arose.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full report.