CQC report explained · a nursing home
What the CQC found at Lynhales Hall Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2023
Rated Good; inspectors found safe, kind and personalised care, with some work still needed on care records, consent and the home environment.
Inspectors made an unannounced visit on 6 June 2023. They spoke with people living in the home, relatives, staff and outside health and social care professionals. They also observed care and checked care records, recruitment files, training records, staff rotas and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People told inspectors they felt safe and supported. Inspectors found enough staff, safe medicines practice, suitable training, good food and kind, respectful care. People were supported with activities, relationships, healthcare and end of life wishes.
The overall rating improved from Requires Improvement at the previous inspection, published in October 2019. The report says the home had improved its care planning, management structure and quality monitoring. However, some care plans were still being updated, signage was limited, and inspectors identified a concern about some people potentially being deprived of their liberty without the required authorisation.
People felt safe
People and relatives told inspectors they felt safe and supported. Staff understood safeguarding procedures and acted when concerns were raised.
“People told us they felt safe and supported by the staff who worked in the home.” from the report
Kind and respectful care
Staff knew people well, respected their choices and maintained their dignity. People told inspectors they felt listened to and involved.
“We saw staff were friendly and supportive; they knew people well and what was important to them.” from the report
Good food and healthcare support
People had a varied choice of food, with help for those needing assistance or special food textures. Staff also supported people to attend health appointments and responded to changes in health.
“People told us they enjoyed the food which was prepared for them, with a good variety and choice of different meal options to suit people's individual needs.” from the report
Personal activities and relationships
People were supported to follow their interests, maintain relationships and take part in activities inside and outside the home. Gardening and music activities were tailored to individuals.
“People were supported to maintain relationships and take part in social activities which were important to them.” from the report
Stronger management oversight
The home had clearer leadership roles, regular checks and more structured action when shortfalls were found. Working relationships with outside professionals had also improved.
“At this inspection we saw improvements to the management structure, monitoring and taking actions against identified shortfalls had been addressed.” from the report
Liberty safeguards
seriousInspectors found that some people who could not consent to their care may have been deprived of their liberty before the necessary local authority authorisation was in place. Referrals had been made for these cases to be considered.
“This meant some people who were unable to consent to their care may be being deprived of their liberty without authorisation from the local authority.” from the report
Care plans still being updated
needs fixingNew care plans were clearer, but further work was needed to ensure everyone had one. Ask how the home will keep all records accurate when people's needs change.
“Further work was being done to ensure everyone had the new care plans in place.” from the report
Limited signs around the home
needs fixingThere was not enough signage to help people navigate the home or recognise their own rooms. Further environmental improvements were also needed for people with dementia or sensory impairment.
“There was a lack of signage in place to support people to navigate around the home.” from the report
Consent was not always clear
needs fixingMost staff sought consent before giving support, but inspectors saw one occasion where a person was not engaged before support was provided. This was raised with the manager.
“Where we had seen staff had not engaged with a person before providing support we raised this with the registered manager.” from the report
- 01Have all residents now received the new care plan format, and how do you check that plans are updated when needs change?
- 02How do you check that people who may lack capacity have the correct Deprivation of Liberty Safeguards authorisation before restrictions are used?
- 03What has been done to improve signs showing people where to go and helping them recognise their own rooms?
- 04How do you make sure staff seek consent and explain support before assisting someone?
- 05How do you assess and maintain safe staffing levels at night?
This was an unannounced inspection covering all five key questions and infection prevention and control, prompted in part by concerns about people's care and treatment. This explanation was written from the published report of 27 June 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, December 2019
Rated Requires Improvement; inspectors found safe, kind care, but care records and service management were not consistently strong enough.
This was an unannounced inspection on 19 and 20 November 2019. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care records, medicines records and management checks.
The home was rated Good for Safe, Effective and Caring. People were protected from abuse, medicines were managed safely, staff were trained, and people were treated with kindness, dignity and respect.
Responsive and Well-led were rated Requires Improvement. Care records did not always give clear, current and personal guidance. The home also had not completed planned improvements quickly enough, although the management team had started work and staff used handovers to reduce the risks.
The overall rating remained Requires Improvement. This was the home's fifth consecutive overall rating at this level. The provider was no longer in breach of regulations, but inspectors said improvements still needed to become fully established.
Safe medicines practice
Staff followed guidance when giving medicines. Storage, disposal and checks were also in place.
“Staff administered medicines in a safe way, following appropriate guidance, and using an effective system to ensure people had their medicines as prescribed.” from the report
Kind and respectful care
People were treated with kindness and staff protected their privacy and dignity. Relatives also said they felt involved and kept informed.
“People were cared for by staff who were caring. The atmosphere within the home was friendly and welcoming and staff were considerate towards people they cared for.” from the report
Activities and community links
People had regular activities, outings and events. Activity staff adapted support to individuals and the manager was developing links with the community.
“People also went out on day excursions and events were planned at the home for special occasions where everyone could attend if they wanted to.” from the report
Improved management culture
The new manager was described as approachable and open to feedback. Staff said the manager listened and supported them.
“All the staff we spoke with said the registered manager had created an open and positive culture at the home.” from the report
Incomplete care records
needs fixingSome records did not clearly carry information from assessments into care plans. Guidance was not always current, personal or easy to follow, which mattered because the home used agency staff.
“People's care records were not consistently clear and up to date.” from the report
Improvements were too slow
needs fixingThe home had identified some problems and started an action plan, but the provider had not made sure the resources were available to finish the work promptly.
“The provider had not ensured the resources were in place to complete this improvement in a timely way.” from the report
High use of agency staff
needs fixingSome relatives said agency staff did not always know their family member well. Handovers helped, but accurate care records were still needed to support consistent care.
“With the high level of agency use this needed to be a priority to ensure people received consistent care.” from the report
Dementia-friendly design
minorThe John Sperry Unit had adaptations, but the main house lacked some signage and design features for people living with dementia. Improvements had been identified but were not yet complete.
“In the main house there was a lack of signage and design adapted for people living with dementia.” from the report
- 01Which care plans were incomplete or confusing at the inspection, and have they now been fully reviewed and updated?
- 02How do you make sure agency staff receive accurate, person-centred information about each resident's needs?
- 03What resources and deadlines are now in place to complete the improvements identified by inspectors?
- 04What changes have been made in the main house to improve signage and the environment for people living with dementia?
- 05Have oral-care assessments now been added to residents' care plans and included in regular reviews?
This was an unannounced, planned inspection covering all five CQC questions; the previous overall rating was Requires Improvement and this inspection found that the home was no longer in breach of regulations. This explanation was written from the published report of 28 December 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 Lynhales Hall Nursing Home
6 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2019Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015
Registered with the Care Quality Commission on 6 November 2015.
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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11 live-in carers within about an hour of Herefordshire, County of
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £960 to £1,410 a week. 10 can care for a couple. 8 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.