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Inspection report

Date of Inspection: 22 May 2014
Date of Publication: 1 August 2014
Inspection Report published 01 August 2014 PDF


Inspection carried out on 22 May 2014

During a routine inspection

We consider all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

�Is the service safe?

�Is the service effective?

�Is the service caring?

�Is the service responsive?

�Is the service well led?

This is a summary of what we found.

Is the service safe?

People�s care plans reflected their individual needs. All care plans we looked at had risk assessments that included: Moving and handling, falls and safeguarding. The care plans were reviewed on a monthly basis. All staff received handovers at the start of their shift. This ensured staff were kept up to date with any changes to people�s needs.

We looked at medication and we saw that staff did not reconcile medication that was dispensed, for example: PRN medication is given when required and recorded on the individual MAR sheet. There is no reconciliation of what has been dispensed and what should be left. That meant medication could go missing and would not be noticed.

Is the service effective?

People told us that they were happy with the care that had been delivered and their needs had been met. It was clear from our observations and from speaking with staff that they had a good understanding of people�s care and support needs.

People had signed consent forms in their care plans. Staff we spoke to understood the importance of consent. One member of staff said, �They can choose what they want and when they want to do it.� One person said, �Staff always knock on my door even when it is open. They always communicate what they are doing, and they support me to do what I can.�

Staff supervision had been completed but appraisals had not been started. Training was now being sourced. Staff had recently received training for moving and handling and medication. There were planned dates for safeguarding of venerable adults and health and safety training.

Is the service caring?

People were supported by kind attentive staff. They spoke to people in a polite and respectful way. We observed good interaction between staff and people who used the service. One person said, �Staff are very caring.� Another person said, �You are cared for and I am really happy here.�

Is the service responsive?

All service users had pre-assessments to ensure the home could meet there needs. Their care plans were regularly reviewed and people�s needs were assessed and documented. The care plans we saw were all person centred. There were lots of activities for people that included: Bingo, scrabble, flower arranging, table games and quizzes.

Is the service well led?

There was no registered manager at Lyndon house. The temporary manager at the date of our inspection was still the registered manager of another location in Richmond.

There had been no feedback surveys sent out to relatives, advocates, staff or healthcare professionals such as GPs and nurses since October 2011. This meant people�s views had not been sought.

Monthly resident meetings and staff meetings had been started in April 2014. We spoke to some staff who said they did not feel supported by the manager and that communication was poor.

All care plans we looked at had relevant information and risk assessments, and these were reviewed monthly.