Lyndhurst

Lyndhurst provides accommodation and care to up to 21 people with mental health needs. The home is made up of three, two-storey terraced houses. At the time of this inspection there were 9 people living in the service.

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

At this inspection we identified shortfalls related to the lack of adequate assessment of risks and relapse indicators to some people's health and wellbeing .However these were addressed immediately after our inspection visit and therefore people were not at risk of harm.

People had access to healthcare services and were involved in decisions about their care. Partnerships with other agencies and health professionals enabled effective outcomes for people.

Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice. Staff supported people to take medicines safely.

The staff team was committed to providing a high-quality service. They had undertaken training so that they were skilled and knowledgeable to effectively meet people’s needs. Staff understood their responsibilities to report any concerns.

Staff encouraged people to be as independent as possible and respected people’s privacy and dignity.

People lived in a homely, clean environment. Bedrooms were personalised and people had access to multiple communal rooms. People were able to choose to take part in activities, stay in their room or go into a communal room for company.

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well.

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.

Recruitment practices were safe and relevant checks had been completed before staff worked at the service.

The manager of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised.

There was a positive culture throughout the service. Staff told us they enjoyed working at the service and felt valued.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection we rated this service Good. The report was published on 9 November 2021,

Why we inspected.

This inspection was prompted by information received from the local authority about this service

We undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 has changed from good to requires improvement based on the findings of 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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lyndhurst provides accommodation and care to up to 21 people with mental health needs. The home is made up of three, two-storey terraced houses. At the time of this inspection there were 13 people living in the service.

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

People told us that they were safe and received good care and support.

Recruitment processes and procedures were safe.

Risks identified with people’s health, medical and care needs had been assessed and documented with clear guidance on how to minimise the identified risk to keep people safe.

People received their medicines safely and as prescribed.

Systems and processes were in place to keep people safe There were enough staff to meet people's needs.

The home was clean and odour free. There were increased infection control measures in response to the coronavirus outbreak Staff received the training and support to carry out their role effectively. Support staff told us that although there had been issues with the previous manager, they felt that the current management team were very supportive especially during the recent months of the pandemic.

There was a positive culture throughout the service which focused on providing care that was personalised.

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.

The provider had systems and an improvement plan in place to monitor and improve the quality and safety of the service provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection we rated this service good. The report was published on 31 May 2017.

Why we inspected

We carried out a focused inspection of this service on 12 March 2021. This report only covers our findings in relation to the key questions safe, effective and well led as we were mindful of the impact and added pressures of Covid-19 pandemic on the service.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information, we may inspect sooner.

Lyndhurst provides accommodation and care for to up to 21 people with mental health needs. The home is made up of three, two-storey terraced houses. Two of the properties were adjacent, while the third was very close by and accessible from the others through the back garden which contained a large, open-plan office built between two of the properties.

On the day of our visit there were 13 people living in the home.

The service had a new manager in post who was in the process of being registered with the Care Quality Commission. 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.

People told us they were very happy with the care and support they received. Staff working at the home demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences.

Staff told us they enjoyed working in the home and spoke positively about the culture and management of the service. Staff told us that they were encouraged to openly discuss any issues and had been supported with promotion opportunities within the service. Staff described management as supportive. Staff confirmed they were able to raise issues and make suggestions about the way the service was provided.

The manager and deputy managers provided good leadership and people using the service and staff told us they promoted high standards of care.

The service was safe and there were appropriate safeguards in place to help protect the people who lived there. People were able to make choices about the way in which they were supported and staff listened to them and knew their needs well. Staff had the training and support they needed. There was evidence that staff and managers at the home had been involved in reviewing and monitoring the quality of the service to drive improvement.

There were some issues with recording of risk assessments, but we saw that the manager was taking action to address this. Recruitment practices were safe and relevant checks had been completed before staff worked at the home. People’s medicines were managed appropriately so they received them safely

There were sufficient numbers of suitably qualified, skilled and experienced staff to care for the number of people with complex needs in the home

The service was meeting the requirements of the Deprivation of Liberty Safeguards(DoLS). Appropriate mental capacity assessments and best interest’s decisions had been undertaken by relevant professionals. This ensured that any decisions were made in accordance with the Mental Capacity Act, DoLS and associated Codes of Practice.

Staff were caring and always ensured they treated people with dignity and respect.

Some people participated in a range of different social activities and were supported to attend health appointments. They also participated in shopping for the home and their own needs and were supported to maintain a healthy balanced diet.

The providers head office regularly completed robust quality assurance checks, to make sure the high standards of care were maintained. There was an open culture and staff said they felt well motivated and valued by all of the managers.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

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If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People are treated with respect and dignity by the staff. People told us they felt safe.Safeguarding procedures were in place and staff understood how to safeguard the people they supported. We saw that care was delivered in safe, accessible surroundings that promoted people's wellbeing. The home's three lounges and kitchens were all clean, and extremely well maintained. We saw two bedrooms which were clean, bright, and tidy. Toilets and bathrooms were spotlessly clean and the garden was maintained to a very high standard

Is the service effective?

People's health and care needs were assessed. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People were encouraged and supported to eat healthy, nutritious food. People said that they had been involved in the care planning process and that they were happy with the care that was provided.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. One person told us, "staff are very experienced.'' People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Is the service responsive?

People's needs had been assessed before they moved into the home. Records confirmed that people's preferences, interests and aspirations had been recorded and that care and support had been provided in accordance with their wishes

Is the service well-led?

The Registered Manager had been in post for many years and had a good understanding of the needs of the client group. Staff told us that the manager was "excellent'' and 'she is very supportive.' A relative told us 'she is amazing and keeps me up to date with what is happening'

Staff were clear about their roles and responsibilities, and had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We found that the provider took steps to obtain consent prior to support being provided, however this did not always occur. We saw that the support that people received met their needs safely, and the provider facilitated access to other services that people needed.

People were encouraged and supported to eat healthy, nutritious food, and we found that the premises were safe and suitable and offered a range of personal and communal spaces people could enjoy.

We found that staff had the experience they needed for their roles and were checked appropriately before starting work. We saw that people's personal records were fit for purpose and accurate, however some staff records weren't up-to-date at the time of our visit.

People felt their privacy, dignity and independence were respected. Their comments included, 'staff hardly enter your room, and if they did this is always with prior consent'; 'staff never let themselves in my room' and 'staff are polite and respectful'.

People were equally content with the treatment and support they experienced, which they attributed to staff's awareness of their needs and competency. One person told us 'I write my care plan, so staff have an idea of where l am and my needs' and on staff's competency another had commented 'staff have been brilliant with me, they do an amazing job'.

The same reaction was expressed when we explored views about their safety and protection from abuse. People felt they could raise any concerns with staff or the manager, with one person stating 'staff do not abuse their power'.

We observed a variety of systems that ensured the service was able to respond and deliver quality care, which included surveys, 'residents' satisfaction audits and regular annual audits.