Lynde House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People received safe care from managers and staff who had developed a positive learning culture within the care home. Managers understood the importance of reporting safety concerns and learning lessons when things went wrong. Systems were in place to support staff to report and record safety concerns and events when they arose. Any safety concerns or incidents that did occur were investigated and any lessons learnt were shared with staff and used to continually improve the service and keep people safe.

The provider worked with people and healthcare partners to establish and maintain safe.

systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Managers gathered information about people’s individual needs and wishes, and risks to their safety, prior to them using the service. This information was used to develop person-centred care and risk management plans which were shared with staff to help them provide safe and appropriate care to people from the moment they started living at the home. Managers and staff worked closely with the relevant external health and social care professionals and bodies to make sure care plans and risk assessments reflected people’s current needs and wishes.

The provider worked with people to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe living in the care home and with the staff who supported them there. A person said, “I feel very safe here. The staff are all lovely and they really do look after us here.” An external care professional added, “The residents are kept safe at Lynde House and I am confident any allegations of abuse or neglect are dealt with rapidly and thoroughly.” Managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “I would not hesitate to immediately report any concerns I might have about people being abused here to the managers.” Managers made timely safeguarding referrals when required and worked with the relevant partners to ensure people were safeguarded from further risk.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The service was working within the principles of the Mental Capacity Act (MCA) 2005. Staff involved people in their care, offering choices and respecting people’s decisions. An external care professional told us, “I have never seen a staff member not ask for people’s consent.” Mental capacity assessments were completed with people and others involved in their care. Where people did not have the capacity to consent to their care, managers and staff held best interests’ decisions and liaised with those that had legal authorisation to make decisions on people’s behalf. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We found managers and staff liaised with the relevant local authorities to ensure appropriate Dols arrangements were in place to ensure people’s safety. Managers and staff confirmed they had received Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLs) training.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Systems were in place to ensure risks to people were routinely assessed, monitored and reviewed. People’s care records contained current and sufficiently detailed information about potential risks to their safety and how these risks should be prevented or appropriately managed. For example, a risk management plan for a person identified as being at high risk of choking was now sufficiently detailed and easily accessible to staff. In addition, people’s risk assessment and management plans were now being reviewed at more frequent intervals and updated accordingly to reflect any changes in people’s needs.

Managers and staff were fully aware of the potential risks people might face and the steps they needed to take to prevent or safely manage them. An external care professional told us, “Staff have a very good understanding of risks and decisions are made proactively to try to manage them.” A member of staff added, “The risk management plans we have are very detailed and easy to follow, so we all know how to keep people safe and minimise risk in the first place.” Staff remained vigilant to people’s whereabouts and were visibly present throughout this assessment.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The premises were kept free of obstacles and hazards. Managers assessed potential health and safety risks people might face and plans were in place to mitigate risks posed by the care homes environment. Safety systems and equipment were maintained and serviced at regular intervals, so that they remained in good order and safe for use. Staff understood the importance of maintaining a safe environment for people. Staff told us they had clear guidelines available to help them deal with emergencies, including individualised plans to evacuate people in the event of a fire.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider operated safe recruitment practices and only fit and suitable staff were employed to work at the care home.

Staffing levels matched the staff duty rota on the day of our site visit. Where people had been assessed as requiring one-to-one staff support we observed this was in place. Staff were visibly present on each of the units throughout this assessment and were quick to respond to people’s questions and requests for support. For example, we saw several instances of staff responding promptly to people who had activated their call bell alarm. People told us the care home was adequately staffed. A person said, “Staff come as quickly as they can when you call them.” Another added, “Staff can be busy sometimes, but I always manage to find someone when I need them.” The service did not use any agency staff to cover staff shortfalls. This meant people were supported by permanent staff who were familiar with their needs, preferences and daily routines.

Staff were well-trained to meet people’s individual needs, in line with their choices and preferences and encouraged to continually improve in their role. A person told us, “The staff are always so cheerful and seem so well-trained and good at their job.” Staff received a mixture of e-learning and in-person practical and theoretical training. This was routinely refreshed as frequently as staff required it including, competency-based assessments. The training of new staff included a comprehensive induction programme.

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff had regular individual and group meetings with their fellow peers and line managers. A member of staff told us, “We have regular supervision and performance appraisals meetings with your line manager.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People lived in a clean, hygienic environment. Staff followed current best practice to reduce the risk of infections spreading. A person told us, “The home is always kept spotlessly clean.” An external care professional added, “The care home is always clean, odour free and well-maintained.” Staff were provided with relevant training to help them prevent and control the risk and spread of infection in the care home. They had access to resources and equipment to help them reduce infection risks and used this appropriately, which included adequate supplies of personal protective equipment [PPE]. Staff appropriately maintained cleaning and food safety records to provide a clear audit trail of measures taken to reduce infection risks at the service. The provider’s infection prevention, control, and food hygiene policies and procedures were current and reflected national guidance.

The service did make sure medicines met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. However the service did not always follow internal policies relating to medicines.

Medicines systems were well-organised and safely managed. Medicines stocks, balances and records showed people consistently received their prescribed medicines as and when they should. An external care professional told us, “Given the number of patients and the number of different medications being administered, some drug errors do occur from time to time. However, they [provider] uses these episodes to learn and improve.”

Care plans included detailed guidance for staff about how people needed and preferred their medicines to be administered. Staff received relevant training and their competency to continue managing medicines safely was routinely assessed. Staff demonstrated a strong understanding of handling-controlled medications and how to store these. The service did not always follow the internal medications policy relating to dealing with medication incidents. The service did however provide assurance on inspection relating to this and have robust measures in place from lessons learnt outcomes. The service was able to demonstrate regular checks of staff’s practice to ensure they remained competent and safe to administer and manage medicines.