We carried out a review of the data available to us about Lyons Gardens on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lyons Gardens, you can give feedback on this service.
We found the following examples of good practice.
Family and friends could visit people who lived at the service in line with current guidance. However, most family and friends chose to visit their relative, friend outside of the service. If family and friends wanted to visit the service, they would need to have completed a rapid COVID-19 test, prior to visiting and had their temperature checked. There would be gaps between visits to reduce the risk of people encountering other visitors, staff or other people from the service. Visitors would also be required to wear the supplied PPE (personal protective equipment).
External health and social care professionals and visitors had to show their vaccination status, complete a rapid COVID-19 test, just before visiting and had their temperature checked. They also had to wear the correct PPE before entering.
Staff supported people to use computer tablets and phones to video call and/or communicate with family and friends. This promoted people’s social well-being. There was a business contingency plan in place to help with any staff absences due to staff leaving the service, being unwell or self-isolating due to COVID-19. Emergency planning had been requested to support staff by the registered manager. This meant there would be a temporary stop to emergency placements.
People had their temperature checked twice a day to monitor their health. Anybody remaining at the service for over a month had a COVID-19 swab test. Staff were tested for COVID-19 twice a week and had rapid COVID-19 tests daily. This was because agency staff and staff from sister homes were being asked to support shifts. This had been risk assessed. Staff had their temperature checked when they started their shift and again during their shift.
Staff were observed to be wearing their PPE correctly including face masks. Staff did not appear to be fiddling with their face masks when worn. Staff were bare below the elbow and were wearing a minimum amount of jewellery with long hair tied up that promoted good infection control.
The service had a registered manager in post. 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.
This inspection was carried out on 30 October 2017 and was an unannounced inspection. At the last inspection on 14 December 2015, the service was rated as Good. At this inspection we found the service remained Good.
There were enough staff available to support people’s individual needs. Staff were knowledgeable about how to report suspicions of harm and poor care practice. Pre-employment checks were in place to make sure that new staff were deemed suitable to work with the people they were supporting. People were assisted to take their medicines as prescribed and medicines were safely managed.
The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. Staff were able to demonstrate an adequate understanding of the MCA to ensure that people did not have their freedom restricted in an unlawful manner. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
People had individualised health, care and support plans in place which recorded their needs. These plans prompted staff on any assistance a person may require and how they would like the support to be given. Individual risks to people were identified and assessed by staff. Plans were put into place to minimise these risks as far as practicable to enable people to live as safe and independent a life as possible.
People were assisted to access a range of external health care professionals and were supported to maintain their health and well-being. People’s health and nutritional needs were met.
People who used the service were cared for by staff in a kind and respectful way. Relatives were given the opportunity to be involved in the setting up and review of their family members’ individual support plans. Staff supported people to maintain their interests and links with the local community.
Staff were trained to provide effective care which met people’s individual support and care needs. Staff were supported by the registered manager to maintain and develop their skills through training. The standard of staff members’ work performance was reviewed by the management through supervisions and appraisals. This was to make sure that staff were competent and confident to deliver the care required.
The registered manager sought feedback about the quality of the service provided from people and/or their relatives. There was an on-going quality monitoring process in place to identify areas of improvement required within the service. Where improvements had been identified, actions taken to reduce the risk of recurrence were recorded.
The registered manager confirmed that since they had been in the role, the CQC was informed of the majority of incidents that the provider was legally obliged to notify them of.
Lyons Gardens is registered to provide personal care for up to 11 people. People living at the home live with a learning disability and autism. The home offers respite care and also for people requiring an emergency admission for temporary care. At the time of our visit there were six people living at Lyons Gardens.
This comprehensive inspection took place on 14 December 2015 and was unannounced.
A registered manager was in post at the time of the inspection. They had been registered since 31 May 2015. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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 were kept safe and staff were knowledgeable about reporting any incident of harm. People were looked after by enough staff to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service. People were supported to take their medicines as prescribed and medicines were safely managed.
People were supported to eat and drink sufficient amounts of food and drink. They were also supported to access health care services and their individual health needs were met.
The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA] and the Deprivation of Liberty Safeguards [DoLS] and to report on what we find. The provider was acting in accordance with the requirements of the MCA so that people had their rights protected by the law.
Assessments were in place to determine if people had the capacity to make decisions in relation to their care. When people were assessed to lack capacity, their care was provided in their best interests. In addition, DoLS applications had been made to the supervisory body and the provider was following the conditions of authorised DoLS.
People were looked after by staff who were trained and supported to do their job.
People were supported by kind, respectful and attentive staff. Relatives were given opportunities to be involved in the review of their family members’ individual care plans.
People were supported with a range of hobbies and interests that took part in and out of the home. Care was provided based on people’s individual needs. There was a process in place so that people’s concerns and complaints were listened to.
The registered manager was supported by a team of managerial and care staff. Staff were supported and managed to look after people in a safe way. Staff, people and their relatives were able to make suggestions and actions were taken as a result. Quality monitoring procedures were in place and action had been taken where improvements were identified.
As part of this inspection we observed activities taking place, spoke with four people who used the service, three relatives of people who used the service, the home's manager and three members of care staff. We also reviewed records relating to the management of the service which included four care plans, daily records, staff records and quality assurance monitoring records.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
Is the service safe?
People who used the service indicated that their social and health care needs were met in a safe and appropriate way. People also felt safe because they had confidence in the staff members and they also engaged well with them, without any reservations.
Family members of people who used the service said that they felt their relative was kept safe when they had stayed at Lyons Gardens because they were well looked after.
Health and safety risk assessments had been carried out and measures were in place to minimise these, to keep people safe.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care services. While no applications have needed to be submitted, proper policies and procedures were in place and under review. Relevant staff have been trained to understand when an application should be made, and how to submit one.
Equipment was available to safely support people's individual needs. Members of staff were trained to safely support people with their equipment.
There was a sufficient number of staff employed to provide people with safe and appropriate care as planned and also to meet people's changed level of needs as required.
Is the service effective?
People's choices and decisions about their support and care were respected and valued. People told us that they were actively consulted, including people's representatives, about their support and care.
Procedures were in place, but people's care records needed to be more detailed regarding mental capacity assessments. This would then ensure that where people who may not have had the mental capacity to understand complex information would have their support and care needs met in their best interests, and reasons for this to be recorded. People who were considered not able to understand complex information were represented by people who were legally appointed to do so.
People were supported to engage in meaningful activities. One of the people using the service told us that they took part in helping with domestic duties and, with staff support, was aiming to make an evening meal for other people to share. Another person told us that the care and support was, 'Brilliant.' They also told us that they were enabled to continue with their educational courses, whilst temporarily living at Lyons Gardens.
The standard of support and care had enabled main carers to continue in their role of looking after their relative at home in the community. This was because their relative spent time at Lyons Gardens away from home, allowing their main carer to have a break. The aim of some of the people's support and care also enabled people to move on to more independent living.
Is the service caring?
Relatives of people who used the service told us that members of staff were kind, caring and considerate. Our observations noted that members of staff interacted with people who used the service in an attentive way including providing individual care and attention to people they were looking after.
People who we spoke with and who we observed indicated that they liked the members of staff and liked how they were being looked after. They were laughing, smiling and were settled.
Is the service responsive?
People's needs, choices and personal preferences had been assessed and were under review. Members of staff demonstrated to us how they respected people's choices and decisions about their support and care. One of the people who used the service told us that they wanted to become more confident and independent when travelling in the community, and they had been enabled to do this.
People's individual social care needs were responded to. People were supported to engage in meaningful social and recreational activities. They were also supported to maintain contact with their friends and family members, where this support was needed.
Is the service well-led?
Members of staff told us that they had the training and support to safely do their job, which they said they enjoyed.
People, including members of staff and family members of people who used the service, were provided with opportunities to make suggestions and comments to improve the quality of people's support and care.
We received positive comments in respect of the leadership and management of the home. People, including staff members and a social worker, had noted improvements in the standard and quality of the service, since the change of leadership in the home during 2013.
A completed application, to register the home's manager, has been submitted for the CQC to consider.
After this inspection the provider wrote to us and said that it had completed all of the necessary improvements.
At our inspection of 23 October 2013 we spent time with three people who used the service. They told us that the service provided a comfortable and safe setting in which to receive support. They also said that staff were kind, caring and trustworthy. One of them said, "Staff are sound' and then smiled at a member of staff who was next to them.
At this inspection we found that the recruitment and selection procedure had been strengthened so that all of the necessary security checks on staff had been completed. This helped to ensure that people were always supported by suitably qualified, skilled and experienced staff.
We saw that staff had consulted with people who used the service (and their relatives) about the support to be provided.
People said or showed us that they received all of the health and personal care they needed. Records confirmed that assistance had been provided in a safe, reliable and responsive way.
We found that people were protected against the risk of unsafe or unsuitable premises. The accommodation was step free and it had the right equipment.
Records showed that some security checks had not been completed on staff. This reduced the reassurance people could have that only suitable and trustworthy people were employed in the service.
The provider's quality assurance system was not robust with checks being regularly completed to ensure people were supported in a consistent and safe way.
People received the care and support they required to improve their health and well-being. Care records were written in detail and provided clear guidance to staff members. The person we spoke with said staff always supported them with their care needs. They confirmed that they had a choice of what they ate and they were involved in buying food for the service. We observed that arrangements were in place to ensure people's religious and cultural nutritional needs were met appropriately.
There was information available for people if they wanted to contact the local authority regarding safeguarding or if they wanted to make a complaint. Staff members were able to explain their role in reporting any allegations of abuse and where the service's procedures were located. The person we spoke with stated they would be able to tell one of the staff members if they were not happy, but they had not needed to do this.
Medicines were stored appropriately and accurate records were kept to show the number brought in, taken out and administered during each person's stay at the service.