Lindau Residential Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment of this key question we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. Care plans were person centred and included individual preferences, likes, dislikes and favoured routines. However, care plans were not always updated and clear. For example, the care plan for a person recorded they should drink between 2.5 and 3.5 litres of fluid within a 24-hour period. Records showed this was not happening and when discussed with the registered manager they confirmed it was unlikely the person would attain this daily target as stated. The care plan had not been reviewed and updated to reflect this. Another person’s care plan recorded them as living with epilepsy that could impact on their wellbeing and safety. Although known triggers were identified, the type of seizures was not recorded. The registered manager stated the types of seizures were unknown to the service and all health professionals. The care plan had not been updated to reflect this and to advise staff to monitor for specific types off seizure such as tonic-clonic and absence seizures.

Staff knew people well. They described their likes, dislikes and preferences and we observed people responding well to staff. Staff described how they supported people at their own pace. People told us their care and support was person centred, they had consistent staff that knew them well. A person told us, “I prefer to have a shower. If the staff can’t support me in the morning, I can always have one in the afternoon, later in the day, or the next day. That is fine with me.” Another person said, “The staff are really here for my emotional, mental and psychological support. I really can’t emphasize that enough.”

Relatives told us their loved ones received personal care to meet their needs and were supported to dress appropriately. A relative said their loved one, “She has her hair combed flat, she is waiting to have it permed, it is always clean and she’s never in dirty clothes.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Information was shared with staff during handover regarding any changes to people’s health or care needs. The service worked with other health professionals involved in people’s care. A healthcare professional told us the service was, “Very proactive in identifying changes in health. They do the training we ask, work with us and follow advice. Priority is the residents and they are good at arranging medicines for new residents.”

Staff told us how they supported people and their relatives. Relatives told us they felt staff supported people with appointments and communicated well with GPs and health specialists to ensure people received continuity of care. A relative told us, “[Loved one] arrived one day, the day after they [staff] picked up that mum had a UTI (urinary tract infection). They have been brilliant.” A person told us, “Lindau Residential Home saved me. They (staff) look after me well and I don’t want to leave here.”

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. There was a lack of dementia friendly signage and way marking around the service to direct people to communal areas. There was no dementia friendly signage on doors such as toilets, bathrooms and shower rooms. On day 2 of the assessment the management team printed out written way marking signs and placed these around the service as a temporary measure until dementia friendly signage had been ordered and delivered. Staff were aware of people’s individual communication needs for example, people who may have hearing or visual impairments. There were some notice boards around the service which had some easier to read information on display. The registered manager told us easy read information was available if anyone needed it.

Staff shared how they provided information and communicated with people. For example, a staff member told us, “We did have a lady who died recently who we used cards to help her make choices and someone else used a whiteboard.” They also picked up on people’s nonverbal communication such as facial expressions, eye movement or use of hands (thumbs up or down).

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

We observed good practice from staff in relation to listening and involving people with their care and making decisions. The registered manager shared with that they held meetings with people on a regular basis. Updates about the service were also shared at these meetings. A person told us, “We do have meetings for the residents.” A relative said, “They have residents’ meetings. They talk about the food, and what people want to eat. They always explain what is going on.”

People and their relatives were sent surveys about the service. Feedback was positive. The service displayed a ‘Have your say’ board in the lounge which showed that people had asked for things and what the service had done about the request. For example, people wanted home cooked food and now this happens. People had requested a visit from the ponies. The ponies had visited, and information showed they would be coming back.Staff surveys had been sent and most of the feedback from staff had been positive.

People were offered informal opportunities to feedback about the service. The management team spent time walking round the service daily and chatting with people. Most people knew who the registered manager was. People and relatives told us they could talk to the registered manager if they needed to.

People were supported with medical appointments and follow up appointments. We observed people receiving visits from healthcare professionals during the assessment visit. People’s care records showed that they had received medical help. Relatives told us their loved ones has visits from healthcare professionals. Staff gave us examples of when they had recognised people were not acting in their usual manner and the action they took. Staff were knowledgeable about how to recognise signs of deterioration and staff said they would report health changes to senior staff on duty or the management team. People were supported to maintain contact with their friends and families. We observed people receiving visits from friends and families during the assessment. People were able to access the garden when the weather was nice; this was secure and had plenty of seating areas to enable people to access fresh air.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider had a clear policy in place in relation to equality, diversity and inclusion. The provider set out information in their statement of purpose, ‘It is the underlying principle of Lindau Care Home’s aim to provide an exceptionally high level of care and to ensure that each resident is treated with the utmost respect, their privacy protected, and dignity preserved. Our goal is to support individuality and independence and to encourage you to exercise choice in all aspects of your care. We manage our home to create a pleasant environment where people are happy to live, also where staff feel motivated and valued.’ We observed that all the staff were passionate about the people they were caring for, and people’s care and support was tailored to their own needs and wishes. A staff member said, “I enjoy working there, I take residents out and I find the job really rewarding.” Another staff member told us, “Lindau is the best place for residents and staff. One day I will move to Lindau if I need to.”

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. The provider had systems and processes in place to understand the diverse health and care needs of people living at the service. Some people had a DNACPR (Do not attempt cardiopulmonary resuscitation) form in place. This is an advanced decision not to attempt CPR. It is not about other treatments or care. Some people had ReSPECT (Recommended Summary Plan for Emergency Care Treatment) forms in place. A ReSPECT form records a person's wishes about a range of care and treatments.

End of life care plans were as comprehensive as the person wanted it to be and plans were clear in cases where people had chosen not to discuss this element of their care. The service provided some care to people at the end of their lives. Staff told us that they worked closely with the local hospice and community nurses to ensure people had effective support and pain relief to ensure people had dignified, pain free deaths. Medicines were available to keep them as comfortable as possible. Staff told us they had attended training to support people at the end of their life. A staff member said, “We have frailty nurses that come and do end of life syringe drivers, we have tried to contact the hospice for [Person]. They have not been out but will do if [Person] requests this.”

The service had received thank you cards from relatives of people who had passed away. A card read, ‘Thank you for the care, love, compassion respect and dignity shown to [person] whilst she was with you. You all made a difficult time much more bearable. She truly enjoyed her stay and it was wonderful to see a spark in her eyes joining in activities and especially Christmas.’