We carried out this inspection on 5 May 2017.

Lynncare 2000 Limited provides care for a maximum of eight people. At the time of our inspection there were eight people who lived at the home. These people were younger adults or older people who required care and support with their mental health, learning disabilities or autistic spectrum disorder.

The service had a registered manager. 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. The registered manager was also the provider and had been at the service since 2003, registered since August 2011.

Care plans contained information for staff to help them provide personalised care, were up to date and accurately reflected people’s care needs. People were involved in reviews of the care provided with their keyworkers.

People told us they felt safe living at the home. Staff had a good understanding of what constituted abuse and knew what actions to take if they had any concerns. Staff were effective in identifying risks to people’s safety and in managing these risks.

There were enough staff to care for the people they supported. Checks were carried out prior to staff starting work to reduce the risks of unsuitable staff working at the service. Staff received a comprehensive induction into the organisation, and a programme of training to support them in meeting people’s needs effectively.

People and relatives told us staff were caring and had the right skills and experience to provide the care required. People were supported with dignity and respect and people chose how they spent their time. Staff encouraged people to be independent.

People received medicines from trained staff, and medicines were administered safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported with their nutritional needs and were involved in preparing meals where possible. People were assisted to manage their health needs, with referrals to other health professionals when required.

People had some activities to keep them occupied with day trips out and holidays, and staff supported people with their individual interests.

People knew how to complain and were encouraged to share their views and opinions about the service they received. There were formal opportunities for people and relatives to feedback any concerns through surveys.

People and relatives were positive about the management of the service. Staff told us the management team were approachable and responsive, and they could raise any concerns or issues with them. There were formal opportunities for staff to do this at team meetings and individual meetings.

There were processes to monitor the quality of the service provided. There were other checks which ensured staff worked in line with the organisation’s policies and procedures. Environmental checks were completed and staff knew the correct procedures to take in an emergency.

We carried out this inspection on 8 July 2015. The inspection was unannounced.

Lynncare 2000 is registered for a maximum of eight people offering accommodation for people who require nursing or personal care. People using the service require care and support to manage their mental health, learning disability or autistic spectrum disorder. At the time of our inspection there were eight people living at the service.

A requirement of the service’s registration is that they have a registered manager. 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 a 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 was in post.

People told us they felt safe at the home. Staff knew about safeguarding people and what to do if they suspected abuse. People were protected from harm as medicines were stored securely and systems ensured people received their medicine as prescribed. Checks were carried out prior to staff starting work at the service to make sure they were of good character and ensure their suitability for employment.

There were enough staff to meet people’s needs but there had been a high turnover of staff recently, which put pressure on existing staff to support people, some of whom had high level needs.

Staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLs). When there were concerns about people’s capacity to make decisions, we saw decisions had been made in their best interests.

Staff completed training to do their jobs effectively, in order to meet people’s care and support needs. Staff were encouraged to continue to develop their skills in health and social care. Staff told us they felt supported by the management team so they could carry out their roles effectively.

People’s nutritional needs were met and there was a variety of food available. Snacks and drinks could be accessed when people required these. People enjoyed taking part in organised activities, and many people chose to go out either individually or with care staff, and pursue their own interests.

People told us the management team were approachable and the registered manager knew the staff and people at the service well. We saw systems and checks made sure the environment was safe for people that lived there and that people received the care and support they needed. However, the management team did not always notify us of changes at the service, to enable us to monitor changes or concerns effectively. People knew how to complain if they wished and told us they did not have any concerns about the service they received.

People told us staff were caring. We saw people were treated as individuals and had their preferences and choices met where possible. Staff showed dignity and respect when providing care and all the people we spoke with were positive about the staff. Relatives were encouraged to be involved in supporting their family members where possible.

A single inspector carried out this inspection. Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. During the inspection we met the eight people who were using the service and spoke with two members of staff and the registered manager. We also spoke with two relatives of people who used the service, one volunteer supporting a person using the service and three external support workers from day centres attended by people using the service.

Is the service safe?

People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People who use the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements. CQC monitors the operations of the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act. The provider had appropriately submitted DoLS applications and were awaiting a response to the applications. We saw that staff were provided with training in safeguarding vulnerable adults from abuse. Proper policies and procedures were in place.

People were cared for in an environment that was safe, clean and hygienic. There were enough staff on duty to meet the needs of people living at the home and a management team was available on call in case of emergencies.

Staff personnel files contained information required by the Health and Social Care Act. This meant the staff employed were suitable and had the skills and experience to support people living in the home.

Is the service effective?

Relatives of people using the service told us they were happy with the care and support provided. One relative told us they were: “Really happy with care provided”. The two people using the service we were able to speak with told us they were happy. The external support workers we spoke with told us they found people were well supported by the provider. Staff had received training to meet the needs of the people living at the home.

We saw evidence that assessments were used in planning care and support to people who used the service. This meant that people using the service were protected against risks of inappropriate care.

Is the service caring?

We saw that people were supported by staff who were kind and caring towards them. Relatives of people we spoke with told us that people were well cared for. One person who uses the service told us: “People here kind”.

Is the service responsive?

People’s needs were assessed before they moved into the home. Each person was allocated a key worker. Records confirmed people’s preferences, interests and diverse needs had been recorded and care and support that had been provided that met their needs. People had access to activities that were important to them and were supported to maintain relationships with relatives.

Is the service well led?

We saw that staff, relatives, people using the service and external health and social care professionals were asked for feedback and that any identified needs or wishes were responded to and acted on. The provider ensured that monthly audits of various aspects of the service’s operations were undertaken and we saw records which showed that where any concerns were identified processes were in place to address them.

Staff told us that they were clear about their roles and responsibilities. One staff member told us: “We’re a good team, good atmosphere, all get on well together”. We saw evidence of staff receiving regular supervision, training and support and attending regular staff meetings. We saw that the service had robust contingency, emergency planning in place to ensure that people using the service always had their needs met.

There were seven people living at Lynncare 2000 when we visited. All the people living there were men. Four of the people were out at day placements for most of the day and returned at around 4pm. We saw one person chose to remain in their room during the day until people returned from their day placements.

Most of the people living in the home could not tell us how they felt about living there. We watched how care workers supported people to see if they were happy and comfortable living in the home. We saw people looked happy and comfortable.

We saw people had access to social activities appropriate to their needs. A relative we spoke with was positive about the care being provided. They told us they were in regular communication with the home and were involved in their relative’s care.

People were dressed in appropriate clothing and were able to move around the home with no restrictions placed on them.

We spoke with two care workers. They told us they had access to regular training and supervision to make sure they met the needs of people safely and effectively.

We found some of the care records were not accurate or easy to follow to determine if people’s needs were being met consistently.

There were seven people living in the home when we visited on 10 April 2012. All the people living there were men. Most of the people living in the home could not tell us how they felt about living there. To see if people were happy and comfortable at the home we watched how workers cared for them. We looked at people’s expressions to see if they were smiling to show that they were happy or not. All but one person living in the home came into the lounge or dining room at some time during the day.

We saw that people looked happy and comfortable in the home. We saw that people were smiling for the majority of the time. They were dressed in clothing that fitted them well. They were able to move around the home with no restrictions on them.

We spoke with two care workers, two relatives and two professionals involved with the home. The relatives were very happy with the care being provided. They told us that they had no worries about the people living in the home. They felt that people’s needs were being met in a caring, sensitive and professional way.

Care workers told us that they gave people choices; they had no concerns about the home, received training to help them carry out their roles and felt supported by the manager.

One professional told us that the felt the home worked in a way that treated people as individuals. They found that the service worked very well with families and other professionals to ensure that people’s needs were met. Another professional told us that the home liaised well with medical professionals and sought advice about how to meet people’s individual needs. They felt there were choices in the home but they were quite basic choices.