Archived: Lynbrook

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

The care service had 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.

Risks to people were assessed and centred on the needs and rights of each individual and were designed to promote people’s independence.

There were enough skilled and experienced staff on duty to meet people’s needs. Recruitment systems were robust, so helped the employer make safer recruitment decisions when employing new staff. New staff had received a comprehensive induction into how the home operated and their job role. This was followed by regular training updates, supervision and specialist training to meet the needs of the people using the service.

People’s needs had been assessed before they moved to the home and we found they, and if required, their relatives had been involved in planning care. Care files reflected people’s care and support needs, choices and preferences and these were accurate and up to date.

There was a strong person centred and caring culture in the home. Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual. The vision of the service was shared by the management team and staff.

People felt safe living in this home and staff supported them to stay safe in the local community. We saw that people who lived in the home were comfortable with the staff who worked there, with a supportive working relationship.

Systems were in place to protect people from the risk of harm. Staff were knowledgeable about safeguarding people and were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified risks to people and management plans to reduce the risks were in place to ensure people’s safety.

Staff supported people in line with the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Systems were in place to ensure people received their medications in a safe and timely way from staff who were appropriately trained. More robust monitoring of medication had been introduced since our last inspection.

There was an open and transparent culture where measures were put in place from lessons learnt from incidents or errors so that they were less likely to happen again. Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were very well managed and organised.

People were supported to maintain good health because they had access to appropriate health care services. They were supported to eat and drink sufficient to maintain a balanced and varied diet.

Relatives of people who used the service told us they were very happy with how care and support was provided at the home. They spoke positively about the staff and the way the home was managed.

The management structure in the home had been strengthened since the last inspection, including the appointment of a new registered manager. This had led to improvements in the service, such as with care planning and the thoroughness of audits. Staff morale, team work and communication were good and the staff team were very positive about the changes.

The registered manager and staff we spoke with were passionate about ensuring effective quality monitoring to continually improve the service and the wellbeing of people they supported.

Staff conveyed enthusiasm about the ethos of the home and said they were committed as a staff team to make a difference to people’s lives. A visiting health care professional told us, “The staff team are fully on board with a positive pro-active approach. People’s well-being and engagement has improved dramatically recently with this refocus of approach.”

Lynbrook provides accommodation and personal care for up to four adults with a severe learning disability and/or autism. At the time of the inspection there were four people living at the service.

Most bedrooms and facilities at the home are located over one floor. However, there is one bedroom on the first floor. There is a kitchen, a lounge and a conservatory which is used as a dining room. All bedrooms are single occupancy and one bedroom is ensuite. A bathroom and appropriate toilet facilities are available. There is a secure garden to the rear of the property.

At the time of our inspection there was a registered manager at the service who had been in post since 2013. 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.

At our last inspection on 20 January 2014, the provider was compliant will all of the standards that were reviewed at the time.

Relatives told us they felt people living at the service received safe care. The staff we spoke with had a good understanding of how to safeguard vulnerable adults from abuse and what action to take if they suspected abuse was taking place.

We saw evidence that staff had been recruited safely. Relatives and staff were happy with the staffing levels at the service and we found that there were enough staff on duty to meet people’s needs. Staff felt well supported. They received an appropriate induction, regular supervision and could access training when they needed it.

There were appropriate policies and procedures in place for managing medicines and relatives were happy with the way people’s medicines were managed. People were supported with their healthcare needs and were referred appropriately to a variety of healthcare services. A local healthcare professional who visited the service told us the staff were able to provide good care for people with very complex needs.

The relatives we spoke with were happy with the care provided to people living at the home. One relative told us, “We’re happy with the care. The staff are well trained”.

We observed that people’s needs were responded to in a timely manner and saw evidence that their needs were reviewed regularly. We saw staff treating people with patience, kindness and affection. Relatives told us the staff who supported their family members were caring. One relative said, “The staff are very caring. I feel [my relative] is well looked after there”.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The service had taken appropriate action where people lacked the capacity to make decisions about their care. Relatives told us they were involved in decisions about their family member’s care. They felt that staff respected people’s privacy and dignity and encouraged them to be independent.

Relatives were happy with the food provided at the home and we observed people being supported appropriately with their meals. People took part in a variety of activities within the home and staff supported people to go out into the community regularly.

The registered manager requested feedback about the service from relatives and acted on the feedback received. Relatives and staff felt the service was managed well and they felt able to raise any concerns. We observed staff and the registered manager communicating with people and each other in a polite and respectful manner.

The service had a statement of purpose which focused on providing people with person centred care which reflected their needs and abilities. We saw evidence that this approach was promoted by the registered manager and staff. The registered manager completed a variety of audits which were effective in ensuring that appropriate levels of care and safety were achieved and maintained at the home.

We observed staff speaking politely with people who used the service, using various methods of communication to ensure people understood what was being asked of them.

We looked at all four care records and found they included relevant health and personal information. Documentation was up to date with any changes recorded.

We spoke with a relative who told us, 'Some staff work well with my X but others are less experienced. X is well cared for in the main, he is happy and I would not want to move him whilst he is happy'.

The premises were clean and warm and maintenance records up to date. Emergency equipment was checked regularly and fire exits were unobstructed. There was, however, no suitable room for staff sleep over arrangements and some staff members were reluctant to undertake sleep over duties because of this.

There were adequate numbers of staff on duty and they had received appropriate induction and training for their employment.

A complaints procedure was in place, accidents and incidents were reported appropriately and audits and checks were carried out regularly.

We found that recruitment and training of staff gave them the knowledge to look after people with complex conditions.

Two family members we spoke with said that they were involved in the assessment and placement of their relatives. Comments included, "I am satisfied with the care given at Lynbrook" and "It seems all right at the home".

Two staff members we spoke with said, "I like working here. I enjoy it because I have looked after this person into adulthood.

There have been ups and downs but overall he has improved" and "I enjoy working here. I feel we are well supported".