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Inspection Summary


Overall summary & rating

Good

Updated 29 November 2017

Lynfield is a residential home for up to nine people with a learning disability. People living there need support with behaviour that could challenge the service. There is a large shared dining area, sitting room and people also have access to a hydrotherapy pool. When we inspected, nine people were living there.

At the last inspection in August 2016, the service people received at the home was rated as good over all. However, there was one breach of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. This related to staff understanding of how to support people who may lack capacity to make informed decisions about their care. This meant that the service was not as effective as it should be.

At this inspection, we found that improvements had been made and there was no longer a breach of regulations. People received an effective service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The registered manager ensured they took appropriate action to protect people’s legal rights where they were subject to restrictions that were essential for their safety. Staff were alert to each person’s way of communicating so they could support people in making decisions. They understood how they needed to involve others where appropriate, to help assess people’s understanding. They knew that, where people could not make an informed decision about their care or treatment, any actions they took had to be in people’s best interests.

Staff supported people competently and effectively. They had a clear understanding of the care and support each person needed and of the importance of delivering this in a consistent way. Where some staff had not updated training in a timely way, the provider’s representative was taking action to ensure this improved. They were aware that supervision to discuss staff performance and development needs had slipped from the expected frequency. They were reviewing this to ensure improvements were made but staff said they felt well supported and people using the service were not affected.

People had a choice of enough food and drink to keep them well, and staff support in this area if they needed help. Staff monitored people's health and wellbeing and sought professional advice promptly when people needed this.

The service continued to be safe. Staff understood their roles in protecting people from the risk of harm or abuse and how to report any concerns or suspicions. Staff could explain how they followed guidance for minimising risks to people and there were enough of them to support people safely. Recruitment processes contributed to protecting people from the employment of staff who were unsuitable to work in care. Staff also supported people safely with their medicines.

Staff had developed warm and compassionate relationships with people. Relatives valued the family atmosphere this had created. Staff respected people's privacy and intervened in a discreet way when they needed to. They understood how people indicated anxiety or distress so they could try to establish what was wrong.

Staff were aware of people's preferences and their likes and dislikes. They supported people to keep in touch with their family and with professionals who could support them with planning their care. People’s representatives were confident that, if they needed to, they could make a complaint and have their concerns investigated and addressed.

There was stable and consistent leadership within the home, contributing to good staff morale and teamwork. There were regular checks to see what improvements could be made to ensure a good quality service. They were confident that the management team would act to address any concerns about poor practice that might place people at risk.

Further information is in the detailed findings for this report.

Inspection areas

Safe

Good

Updated 29 November 2017

The service was safe.

People were protected from the risk of harm or abuse as far as practicable and staff were aware of the importance of reporting any concerns.

Staff understood risks to people's safety and followed guidance about minimising these.

There were enough staff to meet people's needs and recruitment processes contributed to protecting people from the employment of unsuitable staff.

Staff supported people to manage their medicines safely.

Effective

Good

Updated 29 November 2017

The service was effective.

Staff had an improved awareness of how to promote the rights of people who lacked capacity to make specific, informed decisions.

Staff were skilled and competent to meet people’s needs. Where staff had not renewed training promptly and supervision had slipped, this was being addressed.

People had a choice of enough food and drink to keep them well and staff sought advice from professionals about people’s health and wellbeing.

Caring

Good

Updated 29 November 2017

The service was caring.

Staff had developed positive and caring relationships with people.

People were involved in making decisions about their care as far as practicable, with support from their families, staff and health or social care professionals.

Staff understood the importance of promoting people's privacy, dignity and independence.

Responsive

Good

Updated 29 November 2017

The service was responsive.

Staff understood people’s preferences and tailored their support to meet the individual needs of each person.

People’s concerns were recognised and there was a robust system for dealing with complaints they or their representatives made.

Well-led

Good

Updated 29 November 2017

The service was well-led.

Systems for monitoring the quality and safety of the service worked well in identifying where improvements should be made. They also identified when there was any slippage from the expected timescales for improvement so they were addressed.

There was consistent and stable leadership, which had fostered good team work and morale. This contributed to people receiving consistent, good quality care.