This was an unannounced inspection over four days and took place on 11, 12, 13 and 14 November 2014.
Lynde House is a care home registered to provide accommodation and nursing and personal care for up to 76 people who require personal care and may also have dementia. The service is located in the Twickenham area.
During the visit, we spoke with 14 people using the service, nine relatives, 12 care and nursing staff and the 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 and associated Regulations about how the service is run.
In March 2014, our inspection found that the service did not meet the regulations in two areas we inspected, involving people in decision-making and records. At this inspection the home met these regulations.
Some people using the service, relatives and staff told us that they didn’t think there were enough staff at times during the day, they were struggled to meet people’s needs and sometimes it was difficult to find staff. They were concerned that there were not always enough staff to meet people’s needs in a timely way. Other people using the service, relatives and staff thought there were enough staff to meet needs.
We recommend that the home reviews its staffing numbers and the method used to calculate the number of staff required.
People said they were happy living at Lynde House, with the service they received, the staff who delivered it and way it was delivered. They told us staff cared, responded to their needs and the home was well managed. This matched most of our observations during the inspection visit. Some relatives felt the service provided was good, although others thought people spent too much time in bed and in their rooms unnecessarily.
People using the service told us they held the staff in high regard and that they met people’s needs in a caring and understanding way. Most relatives said the staffs was compassionate, caring and carried out their duties well, although some were more so than others.
The staff we saw and spoke with had appropriate skills and training, were familiar with people using the service, generally understood people’s needs and care and support was given in a professional, supportive and compassionate way.
There were a number of group activities that took place during the inspection, although we didn’t see many individual activities in the communal areas. Some people told us there was plenty to do whilst others said there weren’t enough activities.
We saw that the home provided a safe environment for people to live and work in. It was clean, well-maintained and furnished.
We looked at nine care plans from different areas of the home that were clearly recorded, fully completed, regularly reviewed and underpinned by risk assessments. The staff at all levels of seniority were well trained, knowledgeable, professional and generally accessible to people using the service and their relatives.
Fourteen people told us, we saw and records showed that the management team and organisation were approachable, responsive, encouraged feedback from people who use the service and their relatives. They consistently monitored and assessed the quality of the service provided. Staff said they felt well supported by the management team and organisation. Some relatives said the manager was not always approachable.