We carried out a review of the data available to us about Lynncare 2000 Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lynncare 2000 Limited, you can give feedback on this service.
Lynncare 2000 Ltd is a residential care home providing personal care to seven people with learning disabilities at the time of the inspection. The service can support up to eight people.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support:
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. Environmental risks, medicines administration and individual risk assessments were in place to ensure people were safe. Staff were recruited safely and in line with the provider's policy.
Right Care:
The prevention and control of infection was managed safely. People received personalised care from staff who knew them well and ensured their rights and dignity were promoted and protected. Risk assessments were detailed, and staff understood their role in keeping people safe. Staff received specific training in how to support people with learning disabilities and autistic people.
Right Culture:
Oversight of the home and processes used to monitor the quality and safety of people had improved since the last inspection. The registered manager promoted a positive culture where support and care of people was the highest priority. People showed they were happy with the care they received. The registered manager and staff worked with other professionals to achieve good outcomes for people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 26 October 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Lynncare 2000 is a residential care home providing personal care to seven people with learning disabilities at the time of the inspection. The service can support up to eight people.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support:
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. Some environmental risk, aspects of medicines management and individual risk assessments required improvement to ensure people were safe. Action was taken to address this. Staff were recruited safely and in line with the provider’s policy.
Right Care:
The prevention and control; of infection was not always managed safely and the wearing of personal protective equipment needed to be improved. People received personalised care from staff who knew them well and ensured their rights and dignity were promoted and protected. Risk assessments required more detail, but people were safe, and staff understood their role in maintaining this.
Right Culture:
Oversight of the home and processes used to monitor the quality and safety of people needed to be improved however the registered manager promoted a positive culture where support and care of people was the highest priority. People showed they were happy with the care they received. The registered manager and staff worked with other professionals to achieve good outcomes for people.
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 28 December 2019).
Why we inspected
We received concerns in relation to staffing, administration of medicines and the culture of the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. 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.
The provider took immediate action to make improvements to mitigate any risks to people.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to assessing risk to people and the oversight and management of this at this inspection.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
¿ People were supported to maintain contact with people who were important to them which included making telephone calls. The registered manager spoke frequently with people’s family members to keep them up to date on their relative's wellbeing.
¿ A 'visiting pod' had been created in the rear garden to facilitate safe visits in line with current guidance.
¿ Risks associated with staff using public transport to and from work had been reduced because the provider had paid for staff to travel in taxis.
¿ Cleaning schedules had been increased and additional audits had been implemented to monitor cleanliness and staff compliance with the provider’s infection control policy.
Further information is in the detailed findings below.
Lynncare 2000 is a residential care home providing personal care to eight people at the time of the inspection. The service can support up to eight people.
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 service was a large home domestic style property. It was registered for the support of up to eight people. Eight people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People were protected from the potential risk of abuse or harm from enough staff who knew how to identify and report any concerns. Staff knew people’s risk which had been assessed and reviewed to maintain safe care. People’s medicines were safely administered, recorded and stored by competent staff. The environment was kept clean and staff used gloves and aprons to prevent the spread of infections. The registered manager learned from any accidents and incidents, which had been recorded and shared with staff.
People’s needs were continually assessed and reflected best practice advice from other health and social care professionals. Staff were trained and supported to care for people at the home. People enjoyed their meals and were involved in menu planning, shopping and cooking. The decoration of the home had been chosen by people and reflected their personalities. 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.
People had lived in their home for many years and had developed friendships and relationships with the staff and management team. Staff were able to recognise people’s preferences and routines and when best to offer support and guidance. People spent time In the lounge and conservatory or on their own, in their rooms. Privacy was maintained and people had access to their bedrooms and bathrooms as needed. Staff were considerate of people’s independence and knew when people were able to do things on their own.
People’s care needs had been recorded and reviewed and reflected their current care and support needs. People and where agreed family had been involved and their views and choices included to meet personal preferences. People had a variety of things to do both in and out of the home. There were many community based opportunities which had been developed and run by the registered manager.
People had contributed to the running of their home, had been listened to in meetings and individual monthly meetings. The suggestions and ideas from both people and staff had been acted on. People’s care and support had been monitored as systems and process were in place. The registered manager was part of the team, knew people well and had oversight of people’s needs and wishes and advocated for them to try new things and fore fill their life long ambitions.
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 8 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
Lynncare 2000 Limited provides care for a maximum of eight people. At the time of our inspection there were eight people who lived at the home. These people were younger adults or older people who required care and support with their mental health, learning disabilities or autistic spectrum disorder.
The service had a 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 registered manager was also the provider and had been at the service since 2003, registered since August 2011.
Care plans contained information for staff to help them provide personalised care, were up to date and accurately reflected people’s care needs. People were involved in reviews of the care provided with their keyworkers.
People told us they felt safe living at the home. Staff had a good understanding of what constituted abuse and knew what actions to take if they had any concerns. Staff were effective in identifying risks to people’s safety and in managing these risks.
There were enough staff to care for the people they supported. Checks were carried out prior to staff starting work to reduce the risks of unsuitable staff working at the service. Staff received a comprehensive induction into the organisation, and a programme of training to support them in meeting people’s needs effectively.
People and relatives told us staff were caring and had the right skills and experience to provide the care required. People were supported with dignity and respect and people chose how they spent their time. Staff encouraged people to be independent.
People received medicines from trained staff, and medicines were administered safely.
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 were supported with their nutritional needs and were involved in preparing meals where possible. People were assisted to manage their health needs, with referrals to other health professionals when required.
People had some activities to keep them occupied with day trips out and holidays, and staff supported people with their individual interests.
People knew how to complain and were encouraged to share their views and opinions about the service they received. There were formal opportunities for people and relatives to feedback any concerns through surveys.
People and relatives were positive about the management of the service. Staff told us the management team were approachable and responsive, and they could raise any concerns or issues with them. There were formal opportunities for staff to do this at team meetings and individual meetings.
There were processes to monitor the quality of the service provided. There were other checks which ensured staff worked in line with the organisation’s policies and procedures. Environmental checks were completed and staff knew the correct procedures to take in an emergency.
We carried out this inspection on 8 July 2015. The inspection was unannounced.
Lynncare 2000 is registered for a maximum of eight people offering accommodation for people who require nursing or personal care. People using the service require care and support to manage their mental health, learning disability or autistic spectrum disorder. At the time of our inspection there were eight people living at the service.
A requirement of the service’s registration is that they have a 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A registered manager was in post.
People told us they felt safe at the home. Staff knew about safeguarding people and what to do if they suspected abuse. People were protected from harm as medicines were stored securely and systems ensured people received their medicine as prescribed. Checks were carried out prior to staff starting work at the service to make sure they were of good character and ensure their suitability for employment.
There were enough staff to meet people’s needs but there had been a high turnover of staff recently, which put pressure on existing staff to support people, some of whom had high level needs.
Staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLs). When there were concerns about people’s capacity to make decisions, we saw decisions had been made in their best interests.
Staff completed training to do their jobs effectively, in order to meet people’s care and support needs. Staff were encouraged to continue to develop their skills in health and social care. Staff told us they felt supported by the management team so they could carry out their roles effectively.
People’s nutritional needs were met and there was a variety of food available. Snacks and drinks could be accessed when people required these. People enjoyed taking part in organised activities, and many people chose to go out either individually or with care staff, and pursue their own interests.
People told us the management team were approachable and the registered manager knew the staff and people at the service well. We saw systems and checks made sure the environment was safe for people that lived there and that people received the care and support they needed. However, the management team did not always notify us of changes at the service, to enable us to monitor changes or concerns effectively. People knew how to complain if they wished and told us they did not have any concerns about the service they received.
People told us staff were caring. We saw people were treated as individuals and had their preferences and choices met where possible. Staff showed dignity and respect when providing care and all the people we spoke with were positive about the staff. Relatives were encouraged to be involved in supporting their family members where possible.
Is the service safe?
People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
People who use the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements. CQC monitors the operations of the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act. The provider had appropriately submitted DoLS applications and were awaiting a response to the applications. We saw that staff were provided with training in safeguarding vulnerable adults from abuse. Proper policies and procedures were in place.
People were cared for in an environment that was safe, clean and hygienic. There were enough staff on duty to meet the needs of people living at the home and a management team was available on call in case of emergencies.
Staff personnel files contained information required by the Health and Social Care Act. This meant the staff employed were suitable and had the skills and experience to support people living in the home.
Is the service effective?
Relatives of people using the service told us they were happy with the care and support provided. One relative told us they were: 'Really happy with care provided'. The two people using the service we were able to speak with told us they were happy. The external support workers we spoke with told us they found people were well supported by the provider. Staff had received training to meet the needs of the people living at the home.
We saw evidence that assessments were used in planning care and support to people who used the service. This meant that people using the service were protected against risks of inappropriate care.
Is the service caring?
We saw that people were supported by staff who were kind and caring towards them. Relatives of people we spoke with told us that people were well cared for. One person who uses the service told us: 'People here kind'.
Is the service responsive?
People's needs were assessed before they moved into the home. Each person was allocated a key worker. Records confirmed people's preferences, interests and diverse needs had been recorded and care and support that had been provided that met their needs. People had access to activities that were important to them and were supported to maintain relationships with relatives.
Is the service well led?
We saw that staff, relatives, people using the service and external health and social care professionals were asked for feedback and that any identified needs or wishes were responded to and acted on. The provider ensured that monthly audits of various aspects of the service's operations were undertaken and we saw records which showed that where any concerns were identified processes were in place to address them.
Staff told us that they were clear about their roles and responsibilities. One staff member told us: 'We're a good team, good atmosphere, all get on well together'. We saw evidence of staff receiving regular supervision, training and support and attending regular staff meetings. We saw that the service had robust contingency, emergency planning in place to ensure that people using the service always had their needs met.
Most of the people living in the home could not tell us how they felt about living there. We watched how care workers supported people to see if they were happy and comfortable living in the home. We saw people looked happy and comfortable.
We saw people had access to social activities appropriate to their needs. A relative we spoke with was positive about the care being provided. They told us they were in regular communication with the home and were involved in their relative's care.
People were dressed in appropriate clothing and were able to move around the home with no restrictions placed on them.
We spoke with two care workers. They told us they had access to regular training and supervision to make sure they met the needs of people safely and effectively.
We found some of the care records were not accurate or easy to follow to determine if people's needs were being met consistently.
We saw that people looked happy and comfortable in the home. We saw that people were smiling for the majority of the time. They were dressed in clothing that fitted them well. They were able to move around the home with no restrictions on them.
We spoke with two care workers, two relatives and two professionals involved with the home. The relatives were very happy with the care being provided. They told us that they had no worries about the people living in the home. They felt that people's needs were being met in a caring, sensitive and professional way.
Care workers told us that they gave people choices; they had no concerns about the home, received training to help them carry out their roles and felt supported by the manager.
One professional told us that the felt the home worked in a way that treated people as individuals. They found that the service worked very well with families and other professionals to ensure that people's needs were met. Another professional told us that the home liaised well with medical professionals and sought advice about how to meet people's individual needs. They felt there were choices in the home but they were quite basic choices.