Lyndhurst House

Updated 24 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector.

Service and service type

Lyndhurst is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. As the service was small and people could be out we gave a short period of notice to ensure the availability of the manager, staff, and people living at the service during the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

During the inspection we met all three people currently living in the service. People were unable to tell us about their experiences, so we used the short observational framework for inspection (SOFI) SOFI is a way of observing care to help us understand the experiences of people who could not talk to us.

We spoke with three members of support staff in addition to the registered manager. Prior to inspection we contacted six health and social care professionals. We received positive correspondence from one relative.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the operational management of the service, including quality audits.

After the inspection

We continued to seek clarification from the registered manager and provider to validate evidence found. We looked at additional recruitment information, activity planners, daily records which were sent to us. We spoke with two further relatives and we were contacted by two professionals who had visited the service.

Updated 24 October 2019

About the service

Lyndhurst House is registered to provide accommodation and personal care for up to four people who have a learning disability in one adapted building. At the time of the inspection, two people lived at the home all the time and one-person shared time between the service and their family home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

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

People’s safety could be compromised by staff not fully following approved strategies for managing escalations in behaviour. Staff were not always communicating their concerns about issues affecting people to the registered persons, and the registered manager did not have oversight of some records. The quality monitoring and assurance system was not used robustly to provide an accurate overview of what was happening in the service.

Staffing levels were satisfactory to provide good levels of care. There was a safe system of recruitment in place. Medicines were stored and managed safely.

There were effective systems to assess the needs of people prior to admission. 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. Staff understood How the Mental Capacity Act 2005 (MCA) impacted on their support of people and how people could be helped to make decisions.

Staff received an appropriate range of induction and training to undertake their role. Peoples health needs were supported, and staff alerted and involved relevant health professionals when necessary. People were provided with a varied menu that met their dietary needs and preferences.

Staff showed kindness and compassion and promoted and protected people’s privacy and dignity. Staff were supporting people to live full lives, have a community presence and develop independence skills at a pace to suit them.

Care plans were detailed and provided staff with information about people’s individual support needs and guided staff in how they should deliver support.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 17/02/2017)

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. The provider acted to mitigate these risks during, and following the inspection. We will check if these actions have been effective when we next inspect. Please see the Safe and Well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.