The inspection took place on 8 February, 2018 and was unannounced.

Lyndale is nursing home which provides accommodation and nursing care for up to 25 people. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were 20 people living at the home.

Accommodation is located over three floors; there is a shared lounge located on the ground floor, a passenger and stair lift to the upper floors as well as a large garden to the rear of the building and a car park at the front.

At the last inspection, which took place on 20 and 21 October, 2015 the home was rated ‘Good’.

At this inspection we found the service remained ‘Good’ and continued to meet all of the essential standards.

There was a registered manager at the time of the inspection. A registered manager is 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.

During this inspection we reviewed care plans and risk assessments. We found that they contained relevant, consistent and up to date information in relation to the support needs of people who were living at the home. Care plans were person centred and reflected people’s individual wishes, choices and preferences.

Medication management systems were in place. Medication was only administered by staff who had received the appropriate training. Regular medication audits were taking place and people received all medication which was prescribed to them.

The home operated within the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We reviewed information in relation to capacity assessments and processes which needed to be in place to make decisions in a person’s best interest. Staff had received the necessary MCA/DoLS training. Peoples care plans and risk assessments contained current information in relation to their capacity and the restrictions which were in place.

Recruitment processes were safely and effectively managed. The necessary recruitment checks had been completed, suitable references had been sought and Disclosure and Barring System checks (DBS) were in place for all staff. DBS checks ensure that staff who are employed to care and support people are suitable to work within a health and social care setting.

We reviewed staff training, learning and development opportunities the registered provider had in place. We found that staff were supported in their roles, completed the necessary training and were also provided with specialist training in order to effectively carry out their duties.

We reviewed how people’s nutrition and hydration was supported. Peoples’ preferences, likes and dislikes were well known amongst the staff team, kitchen staff were familiar with specialist dietary needs and people were supported with a choice and variety of food and drink provided. People were nutritionally assessed and risk assessment tools were in place to safely and effectively monitor people’s health and well-being.

There was a formal complaints policy in place. People informed us that they knew how to make a complaint if they ever needed to. At the time of the inspection there were no complaints being investigated.

Safeguarding and whistleblowing procedures were in place. Staff were able to explain their understanding of what ‘safeguarding’ and ‘whistleblowing’ meant and the actions they would take in order to protect people who were receiving care.

The home operated an ‘open door’ policy. The culture was supportive, kind, caring, compassionate and respectful. People livi

This was an unannounced inspection of Lyndale Nursing home. The inspection set out to answer our five questions:

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who lived at the home, their relatives, staff providing support and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found there was sufficient staff on duty to meet the needs of the people who were living at the home. Systems were in place to check the environment was safe. Arrangements were in place to monitor accidents and incidents on a monthly basis.

The home protected the rights and welfare of the people in accordance with the Mental Capacity Act (2005). At the time of the inspection nobody who lived at the home was on a Deprivation of Liberty Safeguards (DoLS) plan. Some of the staff team had attended DoLS training.

Is the service effective?

People were satisfied with the care and said their needs were being met. Everybody we spoke with was pleased with the care and support they received. They said staff arranged for them to see a health professional, such as a doctor or dentist if they needed it. Care plans were in place for each person. Care plans were reviewed each month to ensure they were current.

People told us they were satisfied with the food and menus. Any suggestions about changes to the menu were listened to and acted upon.

Is the service caring?

People told us the staff were approachable and responsive if they needed support with a task or activity. One of the people living there said, “The nurses and carers are all friendly and kind to me.”

Throughout the day of the inspection we observed care and nursing staff engaging with people in a positive, respectful and individualised way. Staff had a good knowledge of each person’s needs.

Is the service responsive?

People were involved in decisions about their care and they or a family member had signed a care plan agreement. They told us they had access to recreational and social activities, including activities within the home and trips out to the local community.

Is the service well-led?

The home had systems in place to regularly monitor the quality and safety of the service provided. People who lived at the home and their relatives had the opportunity to provide feedback about the home by completing an annual questionnaire. Meetings were held annually at the home so people could mention any concerns they had and suggest how the service could be improved.

Staff we spoke with said they felt well supported by management. They told us they received good quality training and had an appraisal/supervision every six months.

During our inspection of the home we spoke with four people and invited them to share with us their experience of living at Lyndale Nursing Home. We also spoke with relatives who were visiting the home at the time of our inspection.

People who were living there told us there were plenty of staff on duty each day and they received very good care. One person said, “I can only praise the staff. They are so caring and know what they are doing.” Relatives told us they were very happy with the care and were confident in the ability of the staff team to provide a high standard of care.

Assessments and care plans were in place for each person and were regularly reviewed to take account of people’s changing needs. People were aware of their care needs and care plans were signed by either the person or their relative/representative. We heard from people who were living at the home that a programme of recreational and social activities was in place, including trips outside of the home.

Arrangements were established to monitor the safety of the environment. A complaints procedure was displayed in the foyer and any complaints received were responded to in an effective and timely way. Appropriate measures were in place for the recruitment of new staff.

As part of our inspection visit we invited people who lived at the home to share with us their views and experience of living at Lyndale Nursing Home. They all said that the food was good. They told us that the staff were kind and treated them with dignity and respect. One person said this is “a good place to be if you need to be somewhere because of your care needs.”

We heard that regular activities and entertainment take place in the home. These included beauty treatments, film afternoons, exercise classes and music sessions.

We also spoke with relatives who were visiting the home. They told us they were pleased with the care provided at the home. One relative said “the standard of nursing care is excellent.” Another relative said “they [the staff] genuinely care.” Relatives said they were kept informed of any changes, and that staff act on any worries they may have.

This unannounced inspection of Lyndale Nursing Home care home took place on 21 October 2015.

Situated in a residential area of Southport, Lyndale Nursing Home provides nursing and personal care for up to 25 people. Accommodation is mainly single bedrooms, some with en-suite facilities. A shared lounge is located on the ground floor. A passenger lift and stair lift provide access to the upper floors. There is a large back garden and parking to the front of the building.

A registered manager was in post. 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.

‘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.’

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. People living at the home, families and staff told us there was sufficient numbers of staff on duty at all times.

People living at the home that we spoke with during the inspection said they were safe living at the home. They said security of the building was good. The building was clean, well-lit and clutter free. Measures were in place to monitor the safety of the environment and equipment.

The staff we spoke with could clearly describe how they would recognise abuse and the action they would take to ensure actual or potential abuse was reported. Staff confirmed they had received adult safeguarding training. An adult safeguarding policy was in place for the home and the local area safeguarding procedure was also available for staff to access.

Staff told us they were well supported through the induction process, regular supervision and appraisal. They said they were up-to-date with the training they were required by the organisation to undertake for the job. They told us management provided good quality training.

A range of risk assessments had been completed depending on people’s individual needs. Care plans were well completed and they reflected people’s current needs, in particular people’s physical health care needs. Risk assessments and care plans were reviewed on a monthly basis or more frequently if needed.

Processes were in place to ensure medicines were managed in a safe way.

People’s individual needs and preferences were respected by staff. They were supported to maintain optimum health and could access a range of external health care professionals when they needed to.

Staff sought people’s consent before providing support or care. The home adhered to the principles of the Mental Capacity Act (2005).

Staff had a good understanding of people’s needs and their preferred routines. We observed positive and warm engagement between people living at the home and staff throughout the inspection. A varied programme of recreational activities was available for people to participate in.

The culture within the service was and open and transparent. People living at the home and their families described the staff as caring, respectful and approachable. They said the service was well led and well managed. Staff and families said the management was both approachable and supportive. They felt listened to and involved in the running of the home.

Staff were aware of the whistle blowing policy and said they would not hesitate to use it.

A procedure was established for managing complaints and people living at the home and their families were aware of what to do should they have a concern or complaint.

Audits or checks to monitor the quality of care provided were in place and these were used to identify developments for the service.