Lindau Residential Home

Updated 17 March 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. The third inspector carried out calls with staff offsite after the inspection.

Service and service type

Lindau Residential 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. Lindau Residential Home is registered as a care home with nursing care. However, during the COVID-19 pandemic and due to staffing difficulties Lindau Residential Home stopped providing nursing care. Nursing care is now provided by visiting community nurses. 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 a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We gained feedback from the local authorities who work with the service. We also sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Healthwatch told us they had not visited the service or received any comments or concerns since the last inspection.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 1 relative about their experience of the care provided. We observed staff interactions with people and their care and support in communal areas. We spoke with 10 members of staff including the registered manager, the deputy manager, team leaders, senior care workers and care workers.

We reviewed a range of records. This included 7 people's care records and multiple medication records. We looked at 2 files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 17 March 2023

About the service

Lindau Residential Home is a residential care home providing accommodation for persons who require nursing or personal care to up to 37 people. The service was not providing nursing care, people’s nursing needs were met by community nurses. The service provides support to older people, some of who lived with dementia and one person had a learning disability. At the time of our inspection there were 24 people using the service.

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

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.

Right Support

Staff did not provide people with a learning disability effective support to identify aspirations and goals and assist people to plan how these would be met. There was not a consistent approach to supporting people to learn new skills or maintain their skills for as long as possible, where this was appropriate. Staff encouraged people to be independent as much as possible. People’s communication needs were not always met, directional signs were not in place to help people orientate in the service. Easy read signage providing information and reminders was not always available.

Some areas of the service were not clean. The service was undergoing a programme of redecoration and repair. However, some safety aspects had not been identified and mitigated prior to the inspection. The risk to people from access to hot pipes, items that could cause harm and risks arising from people's diagnosed health needs had not been addressed. The service provided people with care and support in well-equipped environment.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We made a recommendation about this.

People prescribed 'as and when required' medicines did not always have the appropriate protocols in place to support staff to know how or when to administer these medicines. We made a recommendation about this. The service had systems and processes in place to safely administer and record medicines use. Medicines were administered in line with the prescription.

Right Care

People's care was not always person centred, some people did not have care plans and information about how staff could meet their needs. However, people told us they were treated with dignity and respect and their privacy was respected. People told us that staff were kind and caring. Comments included, “People [staff] are every so kind”; “It is brilliant here. The staff are lovely, they listen to what you want and say, they are always there” and “They are very good, kind and caring.”

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough staff to meet people's needs and keep them safe. However, staff had not always had the necessary training to meet people's assessed needs. Training to work with people who lived with epilepsy had not been provided.

Right Culture

The provider's quality monitoring processes had not always identified concerns and improvements in the service. People, their relatives and staff had been encouraged and supported to provide feedback about the service. People and their relatives felt listened to.

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 19 September 2017).

Why we inspected

We received concerns in relation to the management of medicines, management of people’s mental health needs and infection control. As a result, 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. We have found evidence that the provider needs to make improvements.

After the inspection the registered manager provided assurances and some evidence to show that improvements had been made and were in progress.

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 see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to risk management, planning and designing person centred care, good governance and notifications of incidents and events at this inspection. We have made a recommendation about the management of some medicines. We have made a recommendation about the management of MCA and DoLS.

Please see the action we have told the provider to take at the end of this report.

Follow up

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