About the service Lyngate Care Home is a care home which is registered to provide accommodation for up to 41 adults requiring personal care. The home is situated on the main road in the Deane area of Bolton. At the time of the inspection there were 30 people using the service.
People’s experience of using this service and what we found
Some medicines were not stored securely and people did not always receive their medicines safely. Medicines records were incomplete and medicines audits had failed to pick up and address issues.
Daily personal care records were incomplete, and it was unclear whether some people had received the assistance they required.
Individual risks were assessed but there was no information about how these had been addressed and the risk mitigated. It was unclear whether people’s oral health needs were being supported.
The upper floor of the home was quite cold. The water in one of the bathrooms was very hot and could scald people, other taps did not work. The registered manager agreed to address the hot water issue immediately to ensure people’s safety.
Some corridors and rooms were cluttered and could pose a risk to people’s health and well-being. The new dementia unit had poor lighting and was not decorated or furnished in a way that was considered good practice with regard to caring for people living with dementia. Information, such as signage and menus, needed to be produced in a more accessible way to make them more understandable for people living with dementia.
Some people were not presented well and their dignity was not always respected. There were no activities taking place due to the activities coordinator being on annual leave. However, there was evidence that activities and outings did occur quite frequently.
Health and safety certificates were in place as required and equipment was tested regularly. Staff were recruited safely and there were sufficient staff on duty to meet people’s needs.
Staff completed training in safeguarding and were aware of whistle blowing to report poor practice witnessed. Staff wore appropriate personal protective equipment to help prevent the spread of infection.
People’s nutritional needs and choices were recorded within their care files. People told us the food was good and they were given choices. People’s communication methods were documented and staff were aware of how to communicate with each individual.
Care plans included relevant background and support information and the service worked with other professionals and agencies. We saw evidence of people’s involvement in their care and support. People’s spiritual, emotional and psychological needs were documented and choices were recorded.
The service provided a thorough induction and good on-going training opportunities for staff. Staff told us the manager was supportive and approachable. Regular staff meetings and staff supervisions were held.
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.
There was a policy in place around equality and diversity and training was completed by staff. People we spoke with found the home satisfactory and said staff were kind and caring.
The complaints procedure was displayed, there had been no recent complaints but systems were in place to deal with any complaints appropriately. Where people had been willing to share, their wishes for when they were nearing the end of their life were recorded. Some staff at the home were completing training in end of life care.
The provider sent in notifications to CQC of significant incidents, such as deaths, serious injuries and suspected abuse as required. Satisfaction surveys were issued regularly and the feedback from people who used the service and relatives was positive.
The home welcomed visits from various local religious representatives and there were visits from local schools and nurseries to entertain the people living at the home.
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 this service was good (published 23 May 2017).
At this inspection the rating has deteriorated to requires improvement. We have identified three breaches in relation safe care and treatment, dignity and privacy and the leadership and management of the home.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.