Lindley Grange Care Home

Lindley Grange Care Home is a residential care home providing personal and nursing care to up to 45 people. The service provides support to people across 2 floors who require nursing care and to people living with dementia. At the time of our inspection, there were 38 people using the service.

People's experience of using this service and what we found

The provider had systems in place for the reporting and management of accidents, incidents, complaints and safeguarding concerns. Risks were assessed and managed by staff. Staff recruitment procedures were followed, and a tool was used to determine staffing levels. People's medicines were managed safely. Staff worked with healthcare professionals to support people's needs.

Managers were visible within the service, providing staff with direction and support. The service promoted a person-centred culture. Interactions between people and staff were positive and engaging. We received positive feedback from a visiting professional. The premises were clean and infection control measures were being followed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 15 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lindley Grange on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lindley Grange Care Home is registered to provide accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury for up to 45 older people.

At the time of our inspection there was 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.

Protocols for the use of as and when required medicines were not always in place. The registered provider had identified this in a recent audit and action was taken to remedy this during our inspection. Not all staff responsible for the administration of medicines had an up to date assessment of their competency. However, medicines were mostly found to be stored appropriately and administered as prescribed.

Audits and monthly reviews had been completed. The registered provider had an overall home improvement plan.

The registered provider gathered feedback from people and relatives using a number of methods. Complaints were appropriately managed and information from satisfaction surveys had been analysed and feedback was on display.

There were sufficient numbers of staff to meet people’s needs. We saw staff provided timely assistance when this was needed. Rotas showed staffing cover was provided as identified by the registered provider who regularly reviewed people’s dependency levels.

Staff were seen to be attentive to people’s needs and quickly intervened to de-escalate situations where people demonstrated behaviour which may challenge others. Staff were familiar with people’s care needs and preferences. People’s privacy and dignity was respected.

Care plans were sufficiently detailed which meant staff had access to relevant information in order to provide effective care. However, the involvement of people and their representatives in the planning of their care was not always evident in the care plans we looked at. A programme of activities was taking place and we saw good recording of people’s involvement.

Risks to people had been identified, assessed and reviewed and least restrictive practices were in place. The registered manager analysed accidents and incidents and records demonstrated appropriate action was taken in response to lower risks to individuals.

People were enabled by staff to receive timely support from healthcare professionals where this was needed. A visiting health professional was complimentary about the care provided at Lindley Grange.

Training records showed staff were up to date with their training needs. Although individual and group supervisions were taking place, we recommended the recording of individual supervision be strengthened. The registered manager told us they would address this immediately.

The mealtime experience was found to be positive, although due to the layout of the building, there was limited dining space.

Staff felt they worked well as a team and told us leadership in the home was strong as the registered manager was approachable and listened to them.

Fire safety checks were regularly carried out and the building was maintained as required. Some furnishings in the home looked dated.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who lived at the home, their relatives, staff members and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by staff. People told us they felt safe.

Systems were in place to make sure managers and staff learn from events such as accidents, incidents and concerns. This reduces the risks to people and helps the service to continually improve. The home had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had been trained to understand when an application should be made, although some training was undertaken more than 2 years ago.

The service was safe, clean and hygienic. Equipment was well maintained.

The registered manager set staff rotas, taking people's care needs into account when making decisions about staff numbers. This helped ensure people's needs were able to be met.

Is the service effective?

There was an advocacy service available. This meant people could access additional support, when required.

People's care records were assessed with their involvement and with relatives and other professionals' involvement, where possible and appropriate.

Is the service caring?

People were supported by kind and attentive staff. We saw care assistants showed patience and gave encouragement when supporting people. People we spoke with said staff were kind and caring.

People living at the home and their relatives completed satisfaction surveys and any actions identified were addressed by the provider.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities at the home. On the day of our visit we observed people getting involved with singing, painting, dominoes and crafts.

People, or relatives of people, knew how to complain if they were unhappy. People we spoke with said the manager was approachable. We spoke with staff members, who said the manager was approachable. One member of staff we spoke with told us; 'We can talk to the manager. She's very open to suggestions and is more than willing to try new things'.

Is the service well-led?

The service worked well with other agencies and services to make sure people received the most suitable care. This included multi-agency work with the local authority and Care Quality Commission.

The service had quality assurance systems in place and, where shortfalls were identified, action plans were put in place and addressed promptly. As a result, the quality of the service was being maintained and, much of the time, improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home. Staff were also aware of audits and observations carried out by the manager to monitor and improve service provision. This helped to ensure people received a good quality service.

We found some issues around training for staff.

Before people received any care or treatment they were not always asked for their consent. We have judged that this has a minor impact on people who use the service, and have told the provider to take action.

We found care and treatment was planned and delivered in a way that ensured people's safety and welfare.

Staff had received abuse awareness training and procedures were in place to respond appropriately to any allegation of abuse.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

During our visit we observed that there seemed to be enough staff available to respond in a timely manner to people who required assistance. There were enough qualified, skilled and experienced staff to meet people's needs.

They commented to us positively about the opportunities now provided for them and other relatives to meet together with the managers and staff to offer their views on the development of the service. They said 'This was a positive step in the right direction'.