Archived: Lyndhurst Residential Care Home

Updated 15 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 3 inspectors (1 of which was a pharmacy inspector) and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Lyndhurst Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Lyndhurst Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was not a registered manager in post. A new manager had been in post for approximately six months and had recently submitted an application to register.

Notice of inspection

This inspection was unannounced. Inspection activity started on 14 February 2023 and ended on 23 February 2023 when we delivered remote feedback. We visited the location’s office/service on 14 and 16 February 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who works with the service. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. This is covered in more detail in the well-led domain. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people who used the service and 5 relatives about their experiences of the care provided. We spoke with 8 members of staff including the manager, deputy manager, senior care workers, care workers, domestic staff, general manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records, which included detailed reviews of 3 people's care plans, 6 medicine administration records and we looked at medicines related documentation. We also observed medicines administration and checked storage. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 15 April 2023

About the service

Lyndhurst Residential Care Home is a care home without nursing care, providing accommodation for persons who require personal care for up to 42 people. The service provides support to older people, including people living with dementia. At the time of our inspection there were 26 people using the service. The care home accommodates people across 2 floors in 1 building.

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

The service had made some improvements in medicines management since the last inspection, however, we found medicines were not always managed safely. Risks were not always being appropriately identified and managed and recruitment practices were not safe. Staffing levels in the home had improved, the home was clean and tidy and infection control practices had improved. People were supported to have visitors, lessons learned were taking place and people told us they felt safe.

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.

Complaints were not being acted on in line with the homes policy. Records were being reviewed but they did not always contain the necessary information. We saw evidence that people were starting to be involved in their care planning and person-centred care had improved. People’s communication needs were being met. Activities were taking place and people spoke positively about the improvements in activities. Some people’s end of life wishes had been considered, the home was in the process of adding this information to people’s care plans.

The providers oversight of the service was not robust, the manager had however, implemented a number of audits, these needed to be strengthened to identify all the issues we found during the inspection. Incidents were still not always reported to the Care Quality Commission (CQC) when they should have been and various documents were not in place. The provider had not fully complied with the conditions CQC imposed during the last inspection. Staff meetings were taking place and some surveys had been carried out. People spoke positively about the new management and the service worked in partnership with the local authority and various health teams.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 inadequate (published 5 October 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 the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 4, 8 and 10 August 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. 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 remains inadequate. This is based on the findings at this inspection.

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.

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

Enforcement

We have identified continued breaches in relation to medicines management, risk management, failure to send appropriate notifications to CQC, recruitment, complaints management and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

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.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.