Lyndale Nursing Home

Lyndale Nursing Home is a care home which provides residential and nursing care and is registered to support up to 25 older people. At the time of our inspection, the service was providing care and support to 23 people. Accommodation is over three floors, with a large garden to the rear.

People's experience of using this service and what we found

At the last inspection we found the safety of people’s care was compromised. The registered manager had implemented an action plan to address the breaches of regulation and recommendations made at the last inspection, and had made improvements to all aspects of the service.

People living at Lyndale Nursing Home benefited from a service which was safe and well-led.

Regular safety checks of the environment helped ensure the home was a safe place in which to live. Risks to people were identified, managed and mitigated to help keep people safe from the risk of harm. Staff followed best practice guidance in relation to infection prevention and control to help minimise the risk of COVID-19 and other infections.

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 were looked after by dedicated staff, who were motivated to provide safe, high quality and individualised care and support. People and their relatives told us how staff were caring and kind. People received appropriate care and support in line with their needs, and documentation around people's care and support helped evidence this.

The registered manager had worked hard to make the required improvements, this demonstrated their commitment to driving improvements in the safety and quality of person-centred care. The registered manager was aware of their regulatory responsibilities and obligations.

The service worked in partnership with a wide range of healthcare professionals and external services, to ensure people had access to care and support appropriate to their needs, and to prevent unnecessary admissions to hospital.

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 (report published 26 August 2022). 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 carried out an unannounced focused inspection of this service on 26 July 2022. A breach of legal requirement was found in relation to safe care and treatment. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this inspection to check they had followed their action plan and to confirm they now met legal requirements.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lyndale Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lyndale Nursing Home is a care home which provides residential and nursing care and is registered to support up to 25 older people. At the time of our inspection the service was providing care and support to 22 people. Accommodation is over three floors, with a large garden to the rear.

People’s experience of using this service and what we found

Although people and their relatives told us they felt the home was a safe environment in which to live, some regular safety checks of the environment had not been undertaken.

Although we were assured people were receiving appropriate care and support in line with their needs, documentation around people’s care and support was not always fully completed accurately. We have made a recommendation about this.

Although training records indicated that some staff had not completed mandatory refresher training such as health and safety and fire awareness, staff knew people well enough to care for them in a safe way.

Since our last inspection, a new registered manager had been appointed. They had already identified our concerns through auditing processes and had timely and robust actions in place to address them. This demonstrated their commitment to further driving improvements in the safety and quality of person-centred care. The registered manager was aware of their regulatory responsibilities and obligations.

Risks to people were identified, managed and mitigated to help keep people safe from the risk of harm. Staff followed best practice guidance in relation to infection prevention and control to help minimise the risk of COVID-19 and other infections.

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 were looked after by dedicated staff, who were motivated to provide safe, effective and high-quality care and support. A relative told us, “It’s not just for show here, it’s genuinely caring care, the gold standard, it’s exactly what a care home should be, caring and a real home from home.”

The service worked alongside a range of healthcare professionals and external services, to ensure people had access to care and support appropriate to their needs.

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 the service was good, (report published on 9 March 2018).

Why we inspected

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.

We received concerns in relation to levels of risk/harm to service users from potentially poor manual handling practices. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lyndale Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 a breach in relation to safe care and treatment at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

Lyndale is nursing home which provides accommodation and nursing care for up to 25 people. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were 20 people living at the home.

Accommodation is located over three floors; there is a shared lounge located on the ground floor, a passenger and stair lift to the upper floors as well as a large garden to the rear of the building and a car park at the front.

At the last inspection, which took place on 20 and 21 October, 2015 the home was rated ‘Good’.

At this inspection we found the service remained ‘Good’ and continued to meet all of the essential standards.

There was a registered manager at the time of the inspection. A registered manager is 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.

During this inspection we reviewed care plans and risk assessments. We found that they contained relevant, consistent and up to date information in relation to the support needs of people who were living at the home. Care plans were person centred and reflected people’s individual wishes, choices and preferences.

Medication management systems were in place. Medication was only administered by staff who had received the appropriate training. Regular medication audits were taking place and people received all medication which was prescribed to them.

The home operated within the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We reviewed information in relation to capacity assessments and processes which needed to be in place to make decisions in a person’s best interest. Staff had received the necessary MCA/DoLS training. Peoples care plans and risk assessments contained current information in relation to their capacity and the restrictions which were in place.

Recruitment processes were safely and effectively managed. The necessary recruitment checks had been completed, suitable references had been sought and Disclosure and Barring System checks (DBS) were in place for all staff. DBS checks ensure that staff who are employed to care and support people are suitable to work within a health and social care setting.

We reviewed staff training, learning and development opportunities the registered provider had in place. We found that staff were supported in their roles, completed the necessary training and were also provided with specialist training in order to effectively carry out their duties.

We reviewed how people’s nutrition and hydration was supported. Peoples’ preferences, likes and dislikes were well known amongst the staff team, kitchen staff were familiar with specialist dietary needs and people were supported with a choice and variety of food and drink provided. People were nutritionally assessed and risk assessment tools were in place to safely and effectively monitor people’s health and well-being.

There was a formal complaints policy in place. People informed us that they knew how to make a complaint if they ever needed to. At the time of the inspection there were no complaints being investigated.

Safeguarding and whistleblowing procedures were in place. Staff were able to explain their understanding of what ‘safeguarding’ and ‘whistleblowing’ meant and the actions they would take in order to protect people who were receiving care.

The home operated an ‘open door’ policy. The culture was supportive, kind, caring, compassionate and respectful. People living at Lyndale, staff and relatives we spoke with all provided us with positive feedback about the quality and standard of care being provided.

We reviewed health and safety audit tools and infection prevention control procedures which were in place. We found that people were living in a safe, clean and well maintained environment. Audit tools and checks were regularly being completed and the standard and quality of the environment was being monitored and assessed.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who lived at the home, their relatives, staff providing support and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found there was sufficient staff on duty to meet the needs of the people who were living at the home. Systems were in place to check the environment was safe. Arrangements were in place to monitor accidents and incidents on a monthly basis.

The home protected the rights and welfare of the people in accordance with the Mental Capacity Act (2005). At the time of the inspection nobody who lived at the home was on a Deprivation of Liberty Safeguards (DoLS) plan. Some of the staff team had attended DoLS training.

Is the service effective?

People were satisfied with the care and said their needs were being met. Everybody we spoke with was pleased with the care and support they received. They said staff arranged for them to see a health professional, such as a doctor or dentist if they needed it. Care plans were in place for each person. Care plans were reviewed each month to ensure they were current.

People told us they were satisfied with the food and menus. Any suggestions about changes to the menu were listened to and acted upon.

Is the service caring?

People told us the staff were approachable and responsive if they needed support with a task or activity. One of the people living there said, 'The nurses and carers are all friendly and kind to me.'

Throughout the day of the inspection we observed care and nursing staff engaging with people in a positive, respectful and individualised way. Staff had a good knowledge of each person's needs.

Is the service responsive?

People were involved in decisions about their care and they or a family member had signed a care plan agreement. They told us they had access to recreational and social activities, including activities within the home and trips out to the local community.

Is the service well-led?

The home had systems in place to regularly monitor the quality and safety of the service provided. People who lived at the home and their relatives had the opportunity to provide feedback about the home by completing an annual questionnaire. Meetings were held annually at the home so people could mention any concerns they had and suggest how the service could be improved.

Staff we spoke with said they felt well supported by management. They told us they received good quality training and had an appraisal/supervision every six months.

People who were living there told us there were plenty of staff on duty each day and they received very good care. One person said, 'I can only praise the staff. They are so caring and know what they are doing.' Relatives told us they were very happy with the care and were confident in the ability of the staff team to provide a high standard of care.

Assessments and care plans were in place for each person and were regularly reviewed to take account of people's changing needs. People were aware of their care needs and care plans were signed by either the person or their relative/representative. We heard from people who were living at the home that a programme of recreational and social activities was in place, including trips outside of the home.

Arrangements were established to monitor the safety of the environment. A complaints procedure was displayed in the foyer and any complaints received were responded to in an effective and timely way. Appropriate measures were in place for the recruitment of new staff.