Lyndale

Lyndale 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. Lyndale accommodates 18 people in one adapted building. On the days of the inspection there were 17 people living at Lyndale, two of whom were on respite. 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.

There was a registered manager in post and they were available during the 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 were safe as staff knew them very well, and there were detailed, individualised risk assessments in place. The staff team was stable with an in-depth knowledge of people living at the home and they were able to describe and show how they supported people in their preferred manner.

Medication administration was safe and followed all required guidance, and infection control practice was also proficient. There were few incidents within the home but where these had occurred, there was evidence of reflection and analysis to minimise the likelihood of reoccurrence.

The registered manager and senior management team demonstrated understanding of key regulation and guidance, and supported people to be as independent as possible. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People needing assistance with nutrition and hydration received this from competent staff and staff also were vigilant in observing for the smallest of changes in people's wellbeing, requesting extra support where necessary. Staff received supervision and training and were competent in supporting people effectively. Staff were also very clear this was people's home and they were there to enable. They worked well as a

team.

There had been a considerable programme of environmental improvements since the last inspection and this had resulted in a usable, accessible outdoor area for people to use independently and also internally building work ensured easier access for those becoming physically frailer.

People were comfortable and affectionate towards staff and we observed some very positive interactions between people. Emotional support was offered to people who were feeling low in mood in a sensitive and discreet manner. Records showed people took an active role in choosing what and how they did things. Privacy was respected at all times and people encouraged to change clothing or seek support with personal care when needed.

Care was delivered as people requested it. People had choice as to how to spend their days and every effort was made to accommodate their wishes. People were keen to share their positive experiences of living at Lyndale.

Concerns were dealt with promptly, and people were supported with issues outside of the immediate control of the home. There was full consideration of each issue and action taken to remedy the situation. The home had received many compliments from people living in the home, their relatives and external professionals.

There was limited evidence of end of life decision making but this had been approached wherever possible with people. The home had utilised all previous contacts to ensure wishes were recorded as much as possible.

Lyndale provided support and care for people in a relaxed and friendly atmosphere. It was evident this was people's home and high quality support was key. There was a strong focus on outcomes, whether in terms of environmental changes or people's health and wellbeing, both mentally and physically.

There had been significant improvements to the quality assurance systems which ensured effective scrutiny over all aspects of life at Lyndale, and because it was shared between the senior management team, a transparency and confidence to challenge was evident. There was evidence of integration in the community through different activities and with different services, promoting partnership working at each opportunity.

The five questions we ask about services and what we found