CQC report explained · a residential care home
What the CQC found at Lyncroft
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risk assessments, medicines systems, recruitment checks, fire safety checks and staffing arrangements were found to be suitable.
- Effective?
- Good
- People's needs were assessed before admission. Staff had relevant training and support, people had food choices, and the home worked with healthcare professionals.
- Caring?
- Good
- People said staff were kind and attentive. Inspectors saw staff respect privacy and dignity, and people were involved in decisions and supported to remain independent.
- Responsive?
- Good
- Care plans recorded people's preferences, interests, goals and family contact. Plans were reviewed and updated, and people knew how to complain.
- Well-led?
- Good
- People and staff spoke positively about the management. The home held meetings, collected feedback and carried out regular quality checks.
What inspectors found, May 2019
Rated Good; inspectors found safe, kind and personalised care, with clear improvements since the previous inspection.
The inspection took place on 1 April 2019. One inspector and an expert by experience spoke with four people, the manager and staff. They also checked care records, risk assessments, medicines, staff files and quality records.
The home was supporting nine people with mental health needs and was registered for 12 people. Inspectors rated all five areas Good: Safe, Effective, Caring, Responsive and Well-led.
The report says the home had improved since the previous inspection, which was rated Requires improvement. Earlier concerns about risks, medicines, staffing hours, building safety, nutrition, staff support, respect, personalised care, notifications and acting on feedback had been addressed.
Risk management
People had individual risk assessments with guidance for staff on reducing risks, including fire setting, medicines, substance misuse and risks to others.
“People had risk assessments which gave clear guidance to staff about how to reduce the risks of harm people may face.” from the report
Personalised care
Care plans included people's history, preferences, activities, family contact and personal goals. Each person also had a Life Story Book.
“Each person had a 'Life Story Book' which included information about the person's childhood, places important for the person, communication method, favourite things and religious beliefs.” from the report
Respect and independence
Staff knew people well and supported their privacy, dignity, choices and independence. Inspectors saw staff knock before entering bedrooms.
“People's privacy and dignity were promoted. We observed staff knocked on people's doors before entering their rooms and spoke to people in a respectful and dignified manner.” from the report
Healthcare support
The home monitored people's health and supported access to a range of healthcare services, including GP, physiotherapy, dentistry and psychiatry.
“Care records documented people's medical appointments with the outcome and showed people had access to physiotherapy, cardiology, chiropody, optician, dentist and psychiatry as required.” from the report
Learning from feedback
The provider used surveys and meetings to make changes. For example, people were consulted earlier about what they wanted to eat.
“This was now happening.” from the report
Complaints and suggestions
minorThere had been no complaints since the previous inspection. A suggestion box was about to be introduced, so it had not yet been tested as a way for people to raise concerns.
“The registered manager told us this was about to be introduced and they were hopeful this would encourage people to pass on their views about the service and suggest ways to improve their experience.” from the report
- 01How have you maintained the improvements made after the previous inspection, particularly around risk assessments, medicines and staffing hours?
- 02How do you make sure each person's care plan still reflects their preferences, activities, family contact and personal goals?
- 03How do people and relatives currently raise suggestions or complaints, and what happened after the suggestion box was introduced?
- 04How are medicines, including as-needed medicines, checked and reviewed now?
- 05How do you involve relatives in care reviews, appointments and decisions about support?
This was a scheduled inspection of the whole service and covered all five CQC questions, including the premises and care provided. This explanation was written from the published report of 18 May 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2019
Requires Improvement overall, with an Inadequate safe rating and serious concerns about medicines, risks, cleanliness and staffing.
Inspectors visited on 15 August 2018 with 48 hours' notice. They spoke with three people and five staff, and reviewed care files, staff records, policies, incident records and audits.
The home was not consistently safe. Medicines guidance was unclear, risk assessments did not give enough information, bathrooms were dirty and damaged, and staff were working shifts of up to 24 hours. The inspectors also found that incidents were not properly analysed.
Care plans did not give staff enough detail about people's needs, goals, health conditions or preferences. Staff knew people well and supported them with healthcare and worship, but this knowledge was not recorded properly. The home was rated Requires Improvement overall. Safe was rated Inadequate, while Effective, Caring, Responsive and Well-led were all rated Requires Improvement.
Recruitment checks
The home completed identity, right to work, reference and criminal record checks before staff started work.
“Recruitment records showed the provider completed checks on staff to ensure they were suitable to work in a care setting.” from the report
Healthcare support
People were supported to attend medical appointments and access healthcare services when needed.
“Records showed people were supported to access healthcare services and attended regular medical appointments with staff support.” from the report
Privacy
Staff generally knocked and waited before entering bedrooms, helping to protect people's privacy.
“During the inspection we saw staff knocked on people's doors and waited for a response before going into people's bedrooms.” from the report
Safeguarding awareness
Staff knew how to recognise abuse and understood how to escalate concerns if needed.
“Staff were knowledgeable about the different types of abuse people might be vulnerable to and knew what action to take if people made allegations they had been abused.” from the report
Medicines guidance
seriousInstructions for medicines given when needed were unclear or missing. Records did not always match, and one allergy was recorded inconsistently.
“Medicines were not managed in a safe way as staff did not have clear guidance in place to ensure they knew how to support people with their medicines.” from the report
Risk management
seriousRisk assessments did not explain clearly how staff should reduce risks, including risks of assault, financial exploitation and absconding.
“Risks were not appropriately mitigated as guidance was limited.” from the report
Premises and infection control
seriousBathrooms were dirty and damaged, with a strong urine smell. Other problems included a missing shower plug cover, broken fittings and an unsafe garden bench.
“The home was dirty and this meant risks of infection were not controlled.” from the report
Excessive staff hours
seriousA staff member was scheduled to work a day shift immediately followed by a night shift, creating a risk that they might sleep when people needed waking-night support.
“The rota showed staff were scheduled to work excessive hours.” from the report
Care records
needs fixingCare plans and risk assessments were out of date and did not explain the support needed to achieve people's goals or respect their preferences.
“Care plans and risk assessments contained out of date and historic information.” from the report
Weak oversight
seriousAudits did not identify serious problems, and incidents were not properly recorded, reviewed or used to improve care.
“The audit and quality assurance systems were not operating effectively to identify and address issues with the quality and safety of the service.” from the report
- 01What has changed since the inspection to make medicines guidance, including instructions for medicines given when needed, safe and complete?
- 02How are current risk assessments checked so staff have clear instructions about risks such as assault, absconding, financial exploitation and fire?
- 03How do you prevent staff from working 24-hour shifts and ensure someone is awake and able to respond throughout the night?
- 04Have the bathrooms, garden and other damaged areas been repaired and kept clean? Can we see the maintenance and cleaning records?
- 05How are care plans now updated with people's goals, health needs, cultural and religious preferences, and end of life wishes?
This was an announced inspection covering all five key questions and both the care provided and the premises; the previous ratings were from June 2016. This explanation was written from the published report of 15 March 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Lyncroft
3 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Registered with the Care Quality Commission on 1 April 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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