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Inspection Summary


Overall summary & rating

Good

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 po

Inspection areas

Safe

Good

Updated 18 October 2018

The service was safe.

People were safe as staff were attentive to their needs and there were few incidents. Staff recognised potential signs of abuse and knew what action to take.

Risk management was focused on the individual and staff knew how to support people safely.

Staffing levels were appropriate to meet people�s needs and medication was administered in accordance with guidelines.

Effective

Good

Updated 18 October 2018

The service was effective.

Staff received supervision and training, and people were supported appropriately with nutrition and hydration.

The environment had improved significantly and had been developed in line with people�s current and future needs.

Further embedding of knowledge was needed around the requirements of the Mental Capacity Act 2005 although people�s consent was always sought.

Caring

Good

Updated 18 October 2018

The service was caring.

People were supported by helpful, caring and kind staff who focused specifically on the person.

People were happy and settled, and took part, where ever possible, in deciding how their needs would be met.

Privacy was respected and dignity promoted at all times.

Responsive

Good

Updated 18 October 2018

The service was responsive.

People�s records were person-centred and showed people had been involved in choosing what they did each day.

The service had received no complaints in 2018 but many compliments.

Well-led

Good

Updated 18 October 2018

The service was well led.

The home was run by a registered manager who showed passion and enthusiasm for people, and had a vision to improve people�s quality of life. This was mirrored by other members of the management team which provided day to day support.

Quality assurance systems had improved and show good insight into how problems were considered and positively dealt with.

There was evidence of wider engagement in the community for people.