CQC report explained · a residential care home
What the CQC found at Lynfords
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- The inspectors were assured about infection prevention, use of protective equipment, hygiene and managing infection risks. The previous Safe rating was Good but was not fully reviewed.
- Effective?
- Good
- This key question was not inspected in this follow-up report.
- Caring?
- Good
- This key question was not inspected in this follow-up report. Inspectors did observe caring and respectful interactions.
- Responsive?
- Requires improvement
- People's needs were not always met in a person-centred way. Records did not always show choices about food and activities, and planned activities were not always completed.
- Well-led?
- Requires improvement
- Management and leadership had improved, but records were not detailed enough and improvements were not yet fully embedded. The home had a new manager and was still working through several actions.
What inspectors found, February 2023
Lynfords Requires Improvement; inspectors found caring staff and recent improvements, but person-centred care and management records were not yet consistent.
This was an unannounced follow-up inspection on 13 and 22 December 2022. One inspector spoke with people, relatives, staff, the manager and a visiting professional. They also reviewed care plans, records, audits, training information and meeting minutes.
The home supported five people at the time, with learning disabilities and varying personal care, mobility, health and communication needs. Staff were seen to be kind and respectful. People responded warmly to them, and infection prevention arrangements were judged satisfactory.
The inspectors found that records did not always show people had choices about food and activities. Activities were not always delivered as planned, and daily records lacked detail. A new manager had started three weeks before the inspection, and staffing had been increased afterwards.
The overall rating remained Requires Improvement. Responsive and Well-led were both rated Requires Improvement. Safe was inspected but not rated, while the other key question ratings were not reviewed at this inspection.
Kind and respectful staff
Staff were observed to be caring, discreet and respectful when supporting people with personal care. Relatives and professionals also described the staff positively.
“The interactions I have seen have been respectful and kind and take into account residents' relatives.” from the report
Good understanding of communication
Staff knew how people expressed their needs, including through gestures, facial expressions and behaviour. Communication needs were assessed and recorded.
“Staff knew people well and how they liked to receive care and support.” from the report
Infection control
The inspectors were assured that the home had suitable arrangements for preventing and managing infections, including safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
New management action
The new manager had identified areas for improvement, worked with professionals and relatives, and responded to several practical issues. Staffing was increased after the inspection.
“The new manager has been very proactive with making introductions and getting on board with the client I am involved with, so my experience so far has been very positive.” from the report
Choices were not always recorded
needs fixingRecords did not always show that people had chosen their food or activities. This made it difficult for inspectors to confirm that care was consistently person-centred.
“Records did not always demonstrate that people were given choices in relation to the food they ate and the activities they participated in.” from the report
Activities were not always provided
needs fixingWeekly activity planners existed, but daily records did not always show that planned activities happened. Inspectors noted a heavy reliance on television and music.
“Daily records showed a heavy reliance on TV and music for entertainment. This is an area that requires improvement.” from the report
Personal toiletries and oral care
needs fixingInspectors could not be sure that everyone had their own toiletries. One person did not have a toothbrush or toothpaste, and another toothbrush appeared unused.
“One person had no toothbrush or toothpaste. Another person's toothbrush looked dried and unused.” from the report
Records lacked detail
needs fixingDaily records did not clearly show people's choices or whether they had enjoyed activities. The manager had identified this issue, but further work was needed.
“There was no reference to people's daily planners and whilst records showed what people had done, they did not demonstrate that people had made choices” from the report
Staffing was under review
needs fixingAt the inspection there were two staff on duty for four people, including people needing one-to-one or two-to-one support. Staffing was increased to three staff at all times afterwards.
“At the time of inspection there were only 2 staff on duty for 4 people.” from the report
- 01How do you now record each person's choices about food, activities and daily routines?
- 02What activities are currently available beyond television and music, and how do you make sure planned activities happen?
- 03How do you make sure every person has their own labelled toiletries, toothbrush and toothpaste?
- 04What changes have been made to daily records, and how are they checked for quality?
- 05What is the current staffing level on each shift, and how does it meet people's one-to-one and two-to-one support needs?
This was a focused follow-up inspection covering infection prevention under Safe, Responsive and Well-led; the other key question ratings were not reviewed and carried over from the previous inspection. This explanation was written from the published report of 16 February 2023 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, July 2019
Lynfords is rated Requires Improvement; inspectors found safe, kind care but gaps in personalised care and management oversight.
Inspectors visited the home without notice on 28 and 29 May 2019. They observed care, spoke with staff and a visiting professional, and checked care records, medicines, recruitment, training and quality checks. Six people were living there.
The home was rated Good for Safe, Effective and Caring. Inspectors found enough staff overall, safe medicines practice, suitable training, good support with healthcare and food, and kind staff who knew people well.
The home was rated Requires Improvement for Responsive and Well-led. Some care plans were not followed or did not contain enough health guidance. Quality checks had not found these problems, a fire drill had not been followed up, and the staff skill mix was not suitable at one point.
The overall rating changed from Good at the previous inspection, published in November 2016, to Requires Improvement. The provider breached two regulations and was asked to send CQC an action report.
Safe care
Inspectors found good safeguarding arrangements, safe medicines systems and appropriate checks on the building and equipment.
“People were safe and protected from avoidable harm. Legal requirements were met.” from the report
Kind and respectful staff
Staff understood people's communication, preferences and routines. Inspectors saw people being treated with dignity and supported to remain involved in their care.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Choice and independence
People were supported to make everyday choices and use equipment, activities and local facilities to build or maintain independence.
“People were supported to make choices in all areas of daily living from choosing clothes to wear to what they wanted to do.” from the report
Activities
Activities were varied and included trips, college, aromatherapy and musical entertainment. Inspectors saw people enjoying an inclusive music session.
“It was a lively, inclusive and very entertaining session and it was very evident from people's faces, vocal sounds made, and positive reactions that they really enjoyed the session.” from the report
Care plans not always followed
seriousOne person's plan said they should be supported to eat at a table and encouraged to feed themselves. Inspectors saw this guidance was not followed.
“We observed the person was supported away from the table and they were not given the opportunity to feed themselves.” from the report
Incomplete health guidance
seriousA care plan did not contain enough information about one person's health conditions, risks or how staff should provide support.
“The care plan lacked information about each condition, the risks associated with each, the likely impact on the person and how they should be supported.” from the report
Weak quality checks
seriousThe home's monitoring systems did not identify several problems, including incomplete care records, limited activity monitoring and missing mental capacity assessments.
“The quality assurance system was not robust enough to identify all the shortfalls we found.” from the report
Fire drill follow-up
needs fixingRecords showed that a fire drill had been disorganised, but there was no record that the promised follow-up drill had taken place.
“There were no records to demonstrate this had been done.” from the report
Staff skill mix
needs fixingAt one point, a senior worker and a new worker with no previous care experience were supporting people while another worker attended a health appointment. Inspectors also saw one person's personal care discussed in front of others.
“However, the skill mix on any given shift should be set to ensure the best possible care for the people supported.” from the report
- 01How do you now check that every person's care plan contains full health guidance and is followed in practice?
- 02What action was taken after the disorganised fire drill, and when was the follow-up drill completed?
- 03How do you decide the staff skill mix on each shift, especially when staff accompany people to appointments?
- 04How are activities recorded and checked to make sure they take place as planned?
- 05How are mental capacity assessments and best-interest decisions recorded for restrictions such as food limits?
This was an unannounced, comprehensive inspection covering all five CQC questions, with care and the premises both included. This explanation was written from the published report of 19 July 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 Lynfords
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2019Requires improvementdown from GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2014
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.
- December 2010
Registered with the Care Quality Commission on 6 December 2010.
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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