CQC report explained · a residential care home
What the CQC found at Lyndale
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found detailed risk assessments, enough staff, safe recruitment and safe medicine arrangements. Infection prevention measures, building checks and safeguarding processes were also in place.
- Effective?
- Good
- People's rights and choices were respected, and staff supported people in the least restrictive way. People had enough to eat and drink, received staff training and supervision, and could access healthcare.
- Caring?
- Good
- The report does not give a separate rating for Caring. It describes a calm and friendly atmosphere, respectful support and people being involved in their care and daily choices.
- Responsive?
- Good
- Care plans were detailed and personalised. The home supported independence, relationships, communication needs, cultural and spiritual needs, activities and complaints.
- Well-led?
- Good
- Inspectors found robust monitoring and auditing systems. People, relatives, staff and professionals were asked for feedback, and the service used this information to make improvements.
What inspectors found, November 2022
Lyndale rated Good; inspectors found safe, kind and personalised care, with improvements sustained since the previous inspection.
Inspectors visited on 31 October 2022. They spoke with the person living at the home, a relative and staff, observed interactions, and checked care, medicine and management records. They also reviewed information from health and social care organisations.
The home was calm, clean and well maintained. Inspectors found enough staff, safe medicine arrangements, detailed care plans and good support with food, healthcare, activities and personal choices. Staff knew the person's risks and needs well.
All four reported key questions were rated Good: Safe, Effective, Responsive and Well-led. The home had previously been rated Requires Improvement in 2019 and had breached Regulation 12, but inspectors found the improvements had been maintained and there was no longer a breach.
Personalised care
Care plans were detailed and reflected the person's needs, choices and risks. The person was involved in creating their plan and said they were happy with the support.
“Care plans in place for the person living at the home were detailed and showed they were involved in their creation.” from the report
Respect for choice
Staff supported people to make decisions and live their lives with as much independence as possible. People could come and go as they pleased.
“There was an opportunity for the person living at the home to live their life the way they wanted to.” from the report
Safe care
Risk assessments gave staff clear instructions, medicines were managed safely and checks were made on the building and equipment.
“Improvements had been made, sustained and embedded within the service.” from the report
Good leadership
The service had several layers of management oversight and used audits, feedback and incidents to improve care.
“Systems and processes to monitor the safety and quality of the service were robust and operating effectively.” from the report
Supportive staff team
Staff received induction, training and supervision. Staff told inspectors they felt supported and had opportunities for further training.
“Staff felt supported and were well trained.” from the report
Inspectors raised no specific concerns in this report.
- 01How many staff are usually on duty, and how would staffing cover planned and unplanned sickness?
- 02How would you assess and support my relative's mental health needs before they moved in?
- 03How are residents involved in writing and reviewing their care plans?
- 04How do you support residents to come and go, maintain relationships and take part in activities?
- 05How are medicines, risk assessments and staff competency checked and reviewed?
The inspection reviewed the overall quality of the care home, including care, premises, records, medicines, infection control and management systems; the report gives ratings for Safe, Effective, Responsive and Well-led but no separate Caring rating. This explanation was written from the published report of 11 November 2022 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, April 2019
Rated Requires Improvement; the home had improved since its previous Inadequate rating, but risks, medicines, activities and oversight still needed attention.
Inspectors made an unannounced visit on 13 February 2019. They spoke with people, the manager and staff, contacted professionals, and checked care plans, medicines records, training records, monitoring records and the home's quality checks.
People said they felt safe and were comfortable with staff. Inspectors found kind and reassuring care, better training, improved premises and good access to health professionals.
However, some risks were not managed properly. Medicines checks were not fully effective, restrictive practices had not been fully reviewed, some planned activities had not happened, and records and oversight were not consistently complete.
The overall rating and the ratings for Safe, Effective, Responsive and Well-led were Requires Improvement. Caring was rated Good. The home had previously been Inadequate and in Special Measures, but it was no longer in Special Measures after this inspection.
Kind and reassuring staff
People were comfortable with staff and received friendly, attentive support. Staff understood how to reassure people when they were distressed.
“Staff offered support and reassurance to people.” from the report
People felt safe
People told inspectors they felt safe, and staff had safeguarding training and understood how to report concerns.
“I feel safe with the staff. They are nice.” from the report
Improved premises and fire safety
The home was cleaner and more homely than at the previous inspection. Electrical, gas and fire checks had been completed, and the fire procedure had been updated.
“Improvements had been made to ensure that the premises were maintained and regular checks were completed that included electrical, gas, and fire safety.” from the report
Access to health care
Staff contacted health professionals when people were unwell and supported people to attend appointments, including appointments further away.
“People told us they had access to healthcare when they needed it.” from the report
Management improvements
The manager had introduced changes and a consultant was supporting the management team. Professionals' feedback reflected an improving service.
“The manager had implemented and led change since the last inspection and this had resulted in an improvement in people's experience.” from the report
Risk controls were not followed
seriousSome doors that risk assessments said should be locked were left unlocked. Two people's risk plans did not have recorded assessments, and monitoring records were incomplete.
“Doors which risk assessments described as needing to be locked when not in use were not locked.” from the report
Safeguarding monitoring was missed
seriousAn assurance given to professionals about monitoring one person's care had not been put into practice. This was part of a continued breach.
“An assurance related to the oversight of one person's care made to professionals following a safeguarding concern had not been implemented.” from the report
Restrictive practices needed review
seriousSome restrictions remained without clear legal decision-making. Inspectors recommended checking ongoing consent and reducing the impact of any necessary restriction.
“Restrictive practices had not yet been fully addressed and continued to be in place without clear decision making within the framework of the law.” from the report
Medicines stock checks were incomplete
needs fixingSystems had found some medicines errors and omissions and led to staff support and better ordering. However, stock levels were not checked sufficiently.
“The system did not ensure sufficient checks of stock levels.” from the report
Agreed activities did not happen reliably
needs fixingThe home had recorded what activities mattered to people, but one agreed weekly activity had happened only once by the inspection.
“This had not been embedded and had happened once when we visited.” from the report
Oversight and records were still developing
needs fixingSome supervision records were unavailable, and the home's monitoring systems were not fully embedded. Inspectors could not yet assess whether improvements would be sustained.
“At this inspection we had not been able to assess whether the improvements made had been embedded and sustained.” from the report
- 01How are risk assessments completed, updated and checked to make sure agreed safety measures, such as locked doors, are followed?
- 02How do you check medicines stock levels and prevent errors or omissions in medicines administration?
- 03What restrictions are currently used, what legal decision supports each one, and how is ongoing consent reviewed?
- 04How will you make sure activities agreed with each person happen regularly and are recorded?
- 05What checks now confirm that safeguarding monitoring, staff supervision and other improvement actions are completed?
This was an unannounced inspection covering all five key questions and checking improvements since the October 2018 inspection. This explanation was written from the published report of 13 April 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 Lyndale
4 rated inspections over 6 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2018Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 2011.
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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