Lyndhurst Lodge Residential Home Limited

We found the following examples of good practice

As part of their business continuity plan, Lyndhurst Lodge Residential Home ‘twinned’ itself with another local care home. The registered managers shared resources and guidance and supported each other during the pandemic.

To provide more outside space for people and visitors to meet safely, two wheelchair-accessible patios with seating and umbrellas were created. The provider purchased new washable easy chairs and overbed tables for people’s bedrooms.

Extra permanent staff were employed to help ensure people’s needs were met if staff needed to isolate. Staff pay and conditions were improved to reward staff for their loyalty.

When people couldn’t see their families, due to COVID-19 restrictions, staff did their best to compensate. An activities co-ordinator was employed for 30 hours a week to provide one-to-one activities and care staff spent more time interacting and socialising with people.

Lyndhurst Lodge Residential Home is located in a residential area of Ashby-de-la-Zouch and is registered to provide accommodation and personal care for up to 19 older adults. At the time of our inspection, there were 19 people living at the service, some of whom were living with dementia.

At our last inspection in May 2016, the service was rated as 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 on-going 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.

Staff had a good understanding of how to protect people from the risk of abuse and safeguarding procedures to be followed. Risk assessments were in place to manage potential risks for people and staff were clear on the measures they needed to take.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out which helped ensure that suitable staff worked at the service. There were sufficient numbers of staff deployed to keep people safe and their needs were met in a timely manner.

Staff had the skills, knowledge and support they needed to meet people's needs. Staff demonstrated that they knew people well.

Staff received regular support and supervision. This helped them to reflect on their practices and identify areas of personal and professional development.

People were supported to have enough to eat and drink and people had access to healthcare to enable them to maintain their health and well being.

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 treated with kindness, dignity and respect. Staff spent time getting to know people and their specific needs and wishes.

People and, where appropriate, their relatives, were involved in care planning and were able to contribute to the way in which care was provided. Information in care plans supported staff to provide personalised care and was regularly reviewed to ensure it reflected people's current needs.

A process was in place which ensured people could raise any complaints or concerns. These were acted upon promptly and used to drive improvements in the service.

The provider had systems in place to monitor the quality of the service. People, relatives and staff were supported to share their views about the service and this feedback was used to develop the service to ensure people received good care.

The service was last inspected on 2 December 2014. During the last inspection the provider was found not to be meeting five regulations. These were in relation to assessing and monitoring the quality of the service, meeting people’s nutritional needs, involving people in the service, staffing and ensuring that people had consented to care and treatment. We asked the provider to implement changes to ensure that they met the regulations. At this inspection we found that the necessary action had been completed and improvements had been made.

Lyndhurst lodge is a 19 bedded residential home for older people, some of whom have dementia. One the day of our inspection there were 17 people using the service.

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.

People were protected from harm. People told us they felt safe and that there were enough staff available to meet their needs. There was a recruitment policy in place which the registered manager followed. We found that all the required pre-employment checks were being carried out before staff commenced work at the service.

Risks associated with people’s care were assessed and managed to protect people from harm. Staff had received training to meet the needs of the people who used the service. People received their medicines as required and medicines were managed and administered safely.

People’s independence was promoted and staff treated people with dignity and respect. People were supported to follow their interests and engage in activities.

People were supported to make decisions about the care they received. People’s opinions were sought and respected. The provider had considered their responsibility to meet the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager was clear of their role in ensuring decisions were made in people’s best interest.

The registered manager had assessed the care needs of people using the service. Staff had a clear understanding of their role and how to support people who used the service as individuals.

Staff knew people well and treated them with kindness and compassion.

People enjoyed the meals provided and where they had dietary requirements, these were met.

Systems were in place to monitor the health and wellbeing of people who used the service. People’s health needs were met and when necessary, outside health professionals were contacted for support.

People were supported to follow their interests. Information about planned activities were displayed within the home.

Staff felt supported by the registered manager. The registered manager supervised staff and regularly checked their competency to carry out their role. People who used the service felt they could talk to the registered manager and were confident that they would address issues if required. Relatives found the registered manager to be approachable.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

We found that although nobody using the service was under a Deprivation of Liberty Safeguard (DoLS) at the time of our inspection, appropriate applications had been made by the service in the past. However, people's mental capacity was not being considered by the service.

We found that people were being cared for in premises which were being maintained to ensure their safety. We found the premises to be safe and secure for people. However, we did not find the premises to be in a clean and hygienic state at the time of our inspection.

People's risks associated with their care were being managed effectively and people were being cared for by adequate numbers of staff.

Is the service effective?

People were involved in their care planning and delivery on an on-going basis. People's individual likes and dislikes were detailed within their care plans and staff understood people's care needs. However, care plans did not always contain the relevant information and accurate records were not being held for people.

People's health needs were being monitored and the relevant health professionals were involved in their care.

People told us that they liked living at the home. One person told us, 'I'm happy with everything.' Another person said, 'The food is beautiful.'

Staff did not have adequate training to effectively meet the needs of people using the service. There were gaps in staff training in relation to safeguarding vulnerable adults and infection control, amongst others.

Is the service caring?

We observed staff to treat people with respect and maintain their dignity. Staff were kind and compassionate towards people. Staff knew the people they were caring for and we saw that people's personal histories were detailed in their care plans.

People were able to express their views about how the service was run through regular meetings and people were asked about how they wanted their care to be delivered to them. One person using the service told us, 'Anything you want them to do they'll do it for you.'

Is the service responsive?

There had been no mental capacity assessments carried out for people who may have lacked the capacity to consent to their care. People's consent was not being obtained at the service and therefore it was not clear how people were agreeing to their plan of care.

People had access to some activities and did not appear to be at risk from social isolation. There were systems in place to obtain people's views about how the service was being run.

People's individual needs were assessed on a regular basis, however, some people's care records were in need of review and updating and some records held for people were not being adequately kept.

Is the service well-led?

There had been a recent change of manager at the home and the current manager had submitted an application to us, the CQC, to become registered at the service. The service was found to be continuing to fail to meet the requirements detailed in this report. We have asked the current manager to make the required improvements within a short timeframe due to continued failings at the service.

We found that although some quality assurance processes were now in place and being carried out effectively, staff training and infection control was not being monitored and addressed at the service. Staff required training in a number of areas and the home was not found to be clean or hygienic at the time of our visit.

Staff, relatives and a visiting professional spoke positively about the new manager in place at the service and told us that this had made a positive difference to how the service was being run.

We spoke with the registered manager, the provider and three members of staff working at the home as part of our inspection.

We saw that care plans were in the process of being revised and that they had been updated to reflect any risks associated with people's care. However, some of the staff we spoke with told us that they were not familiar with the content of these care plans. The care plans did not always reflect what was being delivered in practice.

We found that some action had been taken to minimise the risks associated with infection, however, further improvements were required in the recording and management of this.

We found that improvements had been made in relation to the premises in which people were living. We found that there was a lack of management checks in place at the home and that there were no systems in place to ensure the premises were safe or that people were protected from the risk of infection on an ongoing basis.

Staff had been recruited in line with legal requirements.

We visited the home on two separate occasions in order to assess the service. During the two days we spoke with five people who used the service and six members of staff working at the service, including the registered manager. We also spoke with a visiting health professional and the relatives of two people who used the service.

Most of the people using the service were happy with the care they received at the home. One person told us that they were concerned about the levels of cleanliness and said staff did not have time to meet people's needs. They said: "They're all over-worked. They've not got time to see to you."

Staff told us there were not enough staff working at the service. One staff member said: "We've told the owners we don't have enough staff but they've said they don't have the money to pay for them." The staff we spoke with said they did their best to meet people's care needs.

We found further concerns during our visit in relation to infection control at the home and found there to be insufficient checks carried out by the registered manager to ensure the quality of the service.