Archived: Lyndridge Care & Support

The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’, which is help with tasks related to personal hygiene and eating. Where they do receive personal care we also take into account any wider social care provided

Some people supported by Lyndridge Care and Support did not require support with personal care, but did need support with enabling activities such going out and shopping. We do not inspect this aspect of service provision.

Lyndridge Care and Support provide personal care to older people living in 10 supported living houses. At the time of inspection there were around 60 people living in these houses. People had their own bedroom or in the case of couples, shared a bedroom. People in each house shared communal areas including sitting rooms and dining rooms. Staff were present in all the houses throughout the day and night, although in six houses staff slept in while on duty at night. Some houses had an office where staff were able to work and store records related to the service. On this inspection we visited seven of the 10 houses where older people lived.

Lyndridge Care and Support also provide personal care to people with a learning disability living in six supported living houses. We did not visit any of these houses on this inspection. We also did not visit any people receiving personal care who lived in their own homes.

The inspection took place over six days; two inspectors visited the offices of the provider and one supported living house on 20 February 2018. One of the inspectors visited five supported living houses on the 8, 13 and 22 March 2018. A pharmacy inspector visited five supported living houses where some or all of the people received personal care on 28 March 2018. On the 4 April 2018 the inspector returned to the provider’s offices to meet with senior staff and the provider.

The inspection was prompted in part by notification of an incident where a person sustained a serious injury and died later in hospital. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident.

However, we also received information after the incident which indicated there may be possible risks to other people. There were potential concerns about staffing levels, poor care, staff training, the privacy and dignity afforded to people. This inspection examined those risks. We did not find evidence to support these allegations at the time of our inspection.

The first day of inspection was unannounced. All subsequent days were announced as we needed the provider to check with people whether they were happy for us to visit and talk with them. Where people did not have capacity to make that decision, the provider checked with the person’s legal representatives whether they agreed, on the person’s behalf, for inspectors to visit the person’s home, speak with them and review their care records.

At the last inspection in July 2016, the service was rated Good. At this inspection, we found the service remains Good in all five key areas.

The provider of Lyndridge Care and Support had also registered with the CQC as the manager of the service. A registered manager is a person who has registered with the CQC 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.

The registered manager was supported by a team of senior managers called development managers. Development managers were responsible for overseeing the work in three or more supported living houses. Each house had a manager. House managers were responsible for the day to day running of the house, ensuring there were sufficient staff; supervising the staff and monitoring the quality and safety of the service provided. This information was fed back to development managers and the registered manager as part of the quality assurance and governance systems. The service had a service improvement plan. There was evidence that actions on the plan had been completed; the plan was monitored and updated at regular intervals.

Where incidents and accidents occurred, these were investigated and, where necessary action was taken to reduce the risk of similar incidents or accidents occurring again.

People living in the supported living houses said they were happy with the care they received. Comments included “Really good”; “Very happy here” and “Staff are lovely, they help me whenever I need it.” Our observations of interactions between staff and people confirmed this. Care plans were person centred and included background information provided by the person and their family. Staff knew people well and were able to describe the care and support each person needed.

Staff had been recruited safely and underwent a comprehensive induction which provided them with the knowledge and skills required to deliver effective care. Staff refreshed their training at regular intervals to ensure they remained up to date. Staff were supervised and appraised by managers and supported to undertake qualifications and additional training to meet people’s individual needs.

There were sufficient staff to meet people’s needs. Staff said they had enough time to work with people without rushing. Staff sought advice from health and social care professionals appropriately. Where a change in a person’s care was recommended, care plans were updated accordingly. 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 support this practice.

There was a complaints policy and procedures. No complaints had been received in the previous 12 months.

Further information is in the detailed findings below

Lyndridge Care and Support provides personal care for adults of all ages. Most of the people live in shared, supported living houses in Okehampton, Crediton, Hatherleigh and surrounding areas. They also provide care to two people living in their own homes in Okehampton.

The provider has administrative offices in Okehampton. The provider is also the registered manager. 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.

The service had previously been inspected in May 2014 and had met all the standards inspected.

At the time of our inspection, 84 people were being supported with personal care by Lyndridge Care and Support. Of these 9 people were younger adults and 76 were older adults.

People said staff were “lovely” and they considered them to be friends. One person said “staff always do whatever they can to make me happy.” We observed staff and people chatting and laughing together. Staff knew people well and took this into consideration when supporting them. People were encouraged and helped by staff to stay in touch with their family and friends. This included taking people to meet their loved ones if that was easier for them. Key events such as birthdays were celebrated.

Staff recognised the importance of respecting people and treated them with dignity. For example staff described how they helped people with personal care, at all times ensuring their dignity and privacy was maintained. Staff had had training about the Mental Capacity Act(2005). Staff understood the need to consider people’s capacity to make decisions. Where there was a concern about a person’s ability to make a decision, staff described how they would work with the person, their family and health and social care professionals to come to decide what was in the person’s best interests. Staff understood their responsibility in terms of safeguarding vulnerable adults. They were able to describe what actions they would take if they had concerns that someone was being abused.

Care records contained risk assessments and care plans which were regularly reviewed and also updated when a new concern arose. Risk assessments took into account people’s ability and focussed on how to manage the risks in a positive way. People were supported to receive their medicines safely by staff who had been trained to administer medicines. Medicines were stored and disposed of safely.

People were encouraged to get involved in activities of their choice, both as an individual and as part of a group. Activities included gardening, attending reading groups, cooking and trips out. People were also supported to remain as independent as possible and develop life skills. For example people were encouraged to get involved in household tasks if they chose. People were also accompanied on occasions by staff to go on holiday. People were supported to have a healthy, nutritional diet. People said they enjoyed the food and were able to choose what to eat and drink. People said there were always alternatives if they did not like a particular meal.

People said they knew how to complain, although people we spoke with said they had never had to. Six complaints, which had been received in the last year, had been responded to and dealt with to the complainants’ satisfaction.

There was a registered manager who was also the provider. The registered manager understood their responsibilities, including providing information to the Care Quality Commission as necessary.

The registered manager was supported by a team of six senior managers, called development managers. Each development manager was responsible for looking after a group of staff who provided care in supported living homes, where a number of people receiving services from Lyndridge lived.

There were regular staff meeting, where staff said they could make suggestions and raise concerns. The provider also undertook regular surveys of people, their families as well as health and social care professionals. Actions to improve the service were planned and carried out.

There were sufficient staff to support people without being rushed. The registered manager and senior staff used a tool to determine safe and effective staffing levels. This tool took into account the skills and experience of staff.. Staff were recruited safely and undertook an induction when they first joined Lyndridge Care and Support. Staff had initial training on subjects relevant to their role. This included mandatory topics such as fire safety and food hygiene as well as specific training to support people’s needs, such as diabetes and epilepsy. Training was refreshed from time to time to ensure staff remained up to date with their skills and knowledge. Staff were also supported to complete nationally recognised qualifications.

There were regular checks and audits of the service and its functions. These included medicine administration audits. Where issues were identified, action plans were drawn up to improve the service.