Lyles House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff were recruited safely, with the correct checks being made to ensure they were suitable for their role. Staff had a thorough induction and completed ongoing training. The environment and equipment was regularly checked for safety. Risks relating to people's care needs had been identified and assessed thoroughly. Medicines were managed safely and staff had received appropriate training and competency checks. The service was working to embed improvements since our last assessment to ensure long term sustainability.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives told us they would raise any issues or concerns with the management team, and felt confident these would be addressed in a timely way. We saw that the management team had dealt with concerns appropriately through reviewing records.

The management team at the service regularly reviewed incidents, including complaints, and took action to learn lessons where things went wrong. The management team shared staff meeting minutes with us, which showed incidents had been reflected upon and plans implemented to drive improvement.

Records of incidents were reviewed by the manager on a monthly basis to spot trends and themes. Incidents were shared within the staff team for the purpose of learning and reflection. The service had a service improvement plan in place which detailed plans for ongoing improvements, however this was not up to date at the time of our assessment. The manager was aware this needed to be reviewed.

People and their relatives told us communication between services was smooth, and that Lyles House made referrals to healthcare professionals as necessary. One family member told us staff had made arrangements for their relative to a variety of external services regularly since moving to Lyles House. They told us ‘They’ve seen the doctor, had new glasses arranged, the chiropodist comes in and the hairdresser, they’ve also had their nails painted.’

The manager told us how the service worked closely with other professionals to ensure people received the care they needed. For example, the service made sure a staff member was always available to assist healthcare professionals when they visited the home. This meant information could be sought and shared quickly and accurately between the different services.

We spoke with a visiting GP, who told us the service communicate with them about their patients regularly and effectively.

Records reflected that the service had sought support from specialist services, such as speech and language therapy (SALT) and dietitians appropriately. People's preferences around whether staff accompanied them to these consultations were reflected within care plans.

People told us they felt safe living at Lyles House. One person said ‘I do feel safe. Staff walk about, and if I ring they come quickly – always’. A relative told us they felt confident to take their first holiday in 17 years since their family member moved to Lyles House. ‘They said to me don’t worry, go on holiday. They really do look after [relative].’

Where safeguarding concerns had been raised at Lyles House, the management team were knowledgeable about these, and took action to investigate promptly. Leaders demonstrated in depth understanding of what constituted a safeguarding concern. Training provided to staff had been complimented by follow up discussions in staff meetings and supervisions with managers.

We observed care to be provided in a way which was safe and in line with best practice guidelines. We observed staff working in a way which promoted safety, and risk assessments in place to safeguard people were adhered to. Leaders promoted a culture of transparency, and encouraged staff to report incidents to enable further investigation where necessary. Information signposting people to external help from the local authority safeguarding team was displayed.

Staff and managers had received training in safeguarding. Concerns of a safeguarding nature were investigated, recorded, and actions taken. The service were transparent with incidents and worked co-operatively with local safeguarding teams and social workers as necessary.

Relatives of people living at the service felt involved in their family members care, and felt the home managed risks appropriately. ‘I sat with the owner and we went through the care plan, each month we go through how [relative] is doing and the staff get to know more about [relative]. They really do listen.’ Where people's care needs placed them at increased risk of falls, people using the service felt the home took appropriate action to keep them safe.

Care plans had been created in conjunction with the person using the service and their family where appropriate. The manager showed examples of how seeking input from family had positive outcomes for people. For example, relatives of people living with dementia were contacted and invited to share their family members specific likes and dislikes to ensure care staff had adequate knowledge to meet their needs.

We observed staff to work in line with agreed care plans and risk assessments. Staff demonstrated an understanding of maintaining people's safety whilst supporting them to mobilise. Risks identified in care plans were managed appropriately by staff.

Care plan reviews were undertaken by leaders to ensure they continued to manage risks associated with people's care. Where people were living with health conditions, the risks associated with these conditions had been managed in conjunction with healthcare professionals. The management team had sufficient processes in place to ensure risks were monitored and action taken in response to changes.

People we spoke with told us they found the environment to be clean and well maintained. People's equipment and mobility aids had been serviced and inspected to ensure they were safe to use. Overall, people and their families told us they found the home to be a safe place to live.

Leaders spoke passionately about the improvements made to the service to manage risks. This included increased maintenance, new flooring and supporting people to move to rooms which better met their needs. High risk areas such as the kitchen and laundry were secured to reduce the risk of people being exposed to harm. Staff told us that where environmental issues were identified, these were quickly resolved by the maintenance person.

We found the environment to be clean and well maintained. High risk areas were secured and people's safety was held in high regard by staff and managers. Equipment was clean and staff used this in line with the training they had undertaken.

Environmental risk assessments were in place and had been reviewed regularly. Maintenance checks on the environment had been undertaken in line with recommended frequencies. Health and safety checks were undertaken by members of the management team which offered additional opportunities for concerns to be identified. Where audits found safety concerns, action was taken in a timely way. For example, a night audit had found that a fire door had been propped open. This was immediately rectified and follow up discussions held with all staff.

We asked people their views on the capability of staff, and everyone we spoke with found staff to be knowledgeable and well trained. One person told us 'I do not get worried about anything, nothing here is lacking. All the staff are very good, it is good for me'. Another person told us that when they experienced a fall, staff were quick to respond and demonstrated good knowledge of what they needed to do.

Staff and leaders said they felt able to provide a good level of care because they had been well supported and trained. The manager told us they received guidance and support from the owner, and they had a very good working relationship. Staff practice had been observed with recommendations made for how they would further improve.

We observed a culture of continuous improvement at Lyles House, and found leaders to be eager to support staff to grow and develop. Where people had specific health needs, training had been provided to staff. We saw the management team to work alongside the staff team. This meant staff were mentored by leaders to further build the confidence and competence of more junior staff members.

The service reviewed staffing levels based on people's care needs. Whilst we found there to be enough staff to meet people's care needs, the tool used to calculate staffing levels was unclear and required review. Staff had been safely recruited and had sufficient supervision to monitor their practice. We saw the management team had written personal messages of praise about individual staff's strengths and placed them within their staff files. These were well received by staff.

People we spoke with, including people living at the service and their relatives, told us the environment was clean and well maintained. Staff wore appropriate personal protective equipment when providing personal care to people. One persons relative told us the owner has recently purchased new furnishings which were easier to keep clean.

Staff were trained in Infection Prevention and Control, and knew how to minimise the spread of infection through safe working practices. PPE was worn when appropriate and was disposed of safely. Leaders spoke to us about cleaning regimes within Lyles House, and how they had reviewed cleaning frequencies to ensure they were robust.

We found the cleanliness of Lyles House to be much improved from our previous assessment visit. We noticed some malodours at the start of our visit, however these were quickly rectified once the cleaning staff attended. Staff were seen to promote good hand hygiene at mealtimes.

The management team regularly carried out audits to identify and action any areas of concern. Infection prevention and control was discussed during staff meetings. Contingency plans were in place to guide staff on action to take in case of an infection outbreak within the service.

People were supported to take their medicines in a safe way by trained staff. One person we spoke with told us staff always bring their medicines to them on time.

The manager told us they ensured medicines were safely managed by ensuring staff were well trained and by undertaking regular audits. Where concerns were identified through audits, action was taken quickly to maintain safety. Where incidents involving medicines had happened, staff had reported it to the manager and recorded the incident.

The leadership team had good oversight of the management of peoples medicines within Lyles House. Audits were completed regularly and action take in response to concerns. Where external professionals had offered advice to the service, this was accepted and implemented. The process for reporting and recording incidents involving medicines was robust.