Lyndale

Updated 18 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 22 and 23 August 2018 and was unannounced on the first day. The inspection team consisted of two adult social care inspectors on the first day, and one on the second.

Before the inspection we requested a Provider Information Return (PIR) which was returned to us. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We checked information held by the local authority safeguarding and commissioning teams in addition to other partner agencies and intelligence received by the Care Quality Commission.

We spoke with six people using the service and one of their relatives. In addition, we spoke with six staff including two support workers, the care co-ordinator, the general manager, the registered manager from the linked home and the registered manager who was also the provider.

We looked at four care records including risk assessments in depth and other sundry records three staff files including all training records, minutes of resident and staff meetings, complaints, safeguarding records, accident logs, medicine administration records and quality assurance documentation.

Updated 18 October 2018

The inspection of Lyndale took place on 22 and 23 August 2018 and was unannounced on the first day. The previous inspection in April 2017 had found two breaches of the Health and Social Care Act 2008 Regulations in relation to safe care and treatment and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions, safe, effective, responsive and well led, to at least good. We received this and checked on this inspection to see if improvements had been made.

Lyndale 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. Lyndale accommodates 18 people in one adapted building. On the days of the inspection there were 17 people living at Lyndale, two of whom were on respite. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post and they were available during the inspection. 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.

People were safe as staff knew them very well, and there were detailed, individualised risk assessments in place. The staff team was stable with an in-depth knowledge of people living at the home and they were able to describe and show how they supported people in their preferred manner.

Medication administration was safe and followed all required guidance, and infection control practice was also proficient. There were few incidents within the home but where these had occurred, there was evidence of reflection and analysis to minimise the likelihood of reoccurrence.

The registered manager and senior management team demonstrated understanding of key regulation and guidance, and supported people to be as independent as possible. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People needing assistance with nutrition and hydration received this from competent staff and staff also were vigilant in observing for the smallest of changes in people’s wellbeing, requesting extra support where necessary. Staff received supervision and training and were competent in supporting people effectively. Staff were also very clear this was people’s home and they were there to enable. They worked well as a team.

There had been a considerable programme of environmental improvements since the last inspection and this had resulted in a usable, accessible outdoor area for people to use independently and also internally building work ensured easier access for those becoming physically frailer.

People were comfortable and affectionate towards staff and we observed some very positive interactions between people. Emotional support was offered to people who were feeling low in mood in a sensitive and discreet manner. Records showed people took an active role in choosing what and how they did things. Privacy was respected at all times and people encouraged to change clothing or seek support with personal care when needed.

Care was delivered as people requested it. People had choice as to how to spend their days and every effort was made to accommodate their wishes. People were keen to share their positive experiences of living at Lyndale.

Concerns were dealt with promptly, and people were supported with issues outside of the immediate control of the home. There was full consideration of each issue and action taken to remedy the situation. The home had received many compliments from people living in the home, their relatives and external professionals.

There was limited evidence of end of life decision making but this had been approached wherever possible with people. The home had utilised all previous contacts to ensure wishes were recorded as much as possible.

Lyndale provided support and care for people in a relaxed and friendly atmosphere. It was evident this was people’s home and high quality support was key. There was a strong focus on outcomes, whether in terms of environmental changes or people’s health and wellbeing, both mentally and physically.

There had been significant improvements to the quality assurance systems which ensured effective scrutiny over all aspects of life at Lyndale, and because it was shared between the senior management team, a transparency and confidence to challenge was evident. There was evidence of integration in the community through different activities and with different services, promoting partnership working at each opportunity.