We carried out a review of the data available to us about Lynwood House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lynwood House, you can give feedback on this service.
Lynwood House is a residential care home providing personal care to ten people at the time of the inspection. The service can support up to ten people.
Lynwood House is laid out over two floors, both floors can be accessed by a lift, stairs and stairlift. People have access to communal lounging areas, dining room, kitchen and level access to a well-maintained garden, where there is also a sensory room. The registered manager’s office is located adjacent to the entrance of the service.
People’s experience of using this service and what we found
Right Support: People were supported to retain and improve their independence. Staff supported people to live their lives how they wished and care was person-centred. Professionals we spoke with confirmed this.
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.
Right Care: The registered and deputy managers promoted an inclusive and person-centred environment. Staff knew people well and provided people with dignified support that was person-centred. Assessments were detailed and provided guidance for staff about people’s needs.
Right Culture: Stakeholders told us staff went above and beyond for people they supported. The service was inclusive and people experienced good outcomes. Relatives and professionals spoke positively about the management team and staff. People confirmed they had control of their lives.
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 29 June 2019)
Why we inspected
We received concerns in relation to the culture of the service, poor moving and handling practices and the safety of motor vehicles. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
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 Lynwood House on our website at www.cqc.org.uk.
Recommendations
We made one recommendation in relation to monitoring the temperature of medicines storage to ensure temperatures remain within a safe range.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Lynwood House accommodates up to ten people in one adapted building. The people who live in the home have learning disabilities. At the time of the inspection eight people were living there.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
People’s experience of using this service:
We were introduced to people throughout our visit and they welcomed us. They were relaxed, comfortable and confident in their home. Staff we met and spoke with were happy, proud and cared about the people they supported.
People received a service that was safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. People were supported to take risks, promote their independence and follow their interests. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out before staff undertook employment to assess their suitability to support vulnerable people. Medicines were well managed and people received their medicines as prescribed. The home was clean and staff followed the providers infection control policy and procedures.
The service was effective in meeting people’s needs. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see a GP and other healthcare professionals when required. The registered manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected. People were supported by staff to enjoy a healthy, nutritious, balanced diet whilst promoting and respecting their choice.
Staff provided a caring service to people which respected and promoted their dignity. People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care amended to meet their changing needs. The service was flexible and responded positively to people’s requests. People who used the service felt able to make requests and express their opinions and views.
People benefitted from a service that was well led. The values and culture of the service were clearly communicated to and understood by staff. The registered manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service.
Rating at last inspection: Requires Improvement (published June 2018).
Why we inspected: This was a planned inspection based on previous rating. At this inspection we found improvements had been made and the overall rating had changed to Good.
Follow up: We will continue to monitor the service through the information we receive. We will visit the service in line with our inspection schedule, or sooner if required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Lynwood House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Lynwood House accommodates up to ten people in one adapted building. The people who live in the home have learning disabilities. Some people also have profound physical needs. At the time of the inspection, seven people were living there.
There is a registered manager in post. 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 2008 and associated Regulations about how the service is run.
Although there were sufficient numbers of staff to keep people safe, staff were not always providing the one to one hours as detailed in people’s care plans to ensure their needs were met.
Suitable measures were not always taken to reduce the risk of harm to people, although a range of risk assessments had been put in place. Staff assessed people for the use of bed rails, although they had not been trained. One person’s bed rails were set incorrectly. There was no guidance for staff about pressure relieving mattress settings where people were at risk of pressure ulcers. Not all staff could consistently describe how they would know a person was in pain.
Medicines were not always managed safely and some staff did not have their competency to administer medicines assessed in line with the provider’s policy. The suitability of giving medicines in food had not been checked with a pharmacist and storage temperatures were incorrect.
Staff did not have guidance or training about how to support some people’s specific complex needs and not all necessary training had been completed by staff.
People’s records lacked detailed information to support personalised care in some specific areas. These included dietary needs, communication and specific complex needs. Not all health checks could be confirmed as completed. Where one person required staff support with exercises, these were not always done as directed by the physiotherapist.
The provider did not have effective systems in place to monitor the quality of care and support that people received. Audits had not identified the shortfalls we found during this inspection.
Staff knew how to safeguard people from potential abuse and understood how to raise concerns and report accidents.
People were supported in line with the requirements of the Mental Capacity Act 2005 and people were only deprived of their liberty lawfully.
People responded well to staff who understood their communication needs. However we did not see the specific methods of communication being used with people as described by staff. People told us they were happy and looked relaxed with the staff.
Staff felt well supported by the manager, attended regular meetings to discuss their work and monthly staff meetings to discuss wider issues about the service.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back this report.
Lynwood House is registered to provide accommodation and personal care for up to ten people. At the time of our inspection there were ten people living at the service. The people who live at the service have learning disabilities. Some people also have profound physical needs.
A registered manager was in post at the time of inspection. 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 2008 and associated Regulations about how the service is run.
People’s rights were being upheld in line with the Mental Capacity Act 2005. This is a legal framework to protect people who are unable to make certain decisions themselves. We saw information in people’s support plans about mental capacity and the Deprivation of Liberty Safeguards (DoLS). DoLS applications had been applied for appropriately. These safeguards aim to protect people living in homes from being inappropriately deprived of their liberty.
People had their physical and mental health needs monitored. All care records that we viewed showed people had access to healthcare professionals according to their specific needs.
People were encouraged to maintain contact with their family and were therefore not isolated from those people closest to them.
Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. Staff we spoke with felt the staffing level was appropriate. People were supported with their medicines by staff and people had their medicines when they needed them.
People received effective care from the staff that supported them. Staff were caring towards people and there was a good relationship between people and staff. People and their representatives were involved in the planning of their care and support. Staff demonstrated and in-depth understanding of the needs and preferences of the people they cared for.
Support provided to people met their needs. Supporting records highlighted personalised information about what was important to people and how to support them. People were involved in activities of their choice.
There were systems in place to assess, monitor and improve the quality and safety of the service.