Lynwood is a care home providing accommodation and support with personal care for adults with learning disabilities. The service is registered to provide support to a maximum of eight people. Eight people were using the service at the time of our inspection.

The service had a registered manager at the time of our inspection. 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.

At the last inspection on 14 and18 July 2016 we found six breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. We issued two warning notices following the inspection.

This was because people were not safe at the service. There were poor arrangements for managing medicines and infection control. People were at risk of harm when moving around the service. Systems in place were not always effective to maintain the safety of the premises and equipment. People did not always have access to activities of their choice. Staff did not always receive up to date training, supervision and induction. Robust procedures were not in place to monitor the safety and quality of the service provided.

We inspected Lynwood on 7 June 2017. This was an unannounced inspection. At this inspection we found the service had made the required improvements.

People told us they felt safe using the service. Staff knew how to report safeguarding concerns. Risk assessments were completed and management plans put in place to enable people to receive safe care and support. There were effective and up to date systems in place to maintain the safety of the premises and equipment. We found there were enough staff working at the service and recruitment checks were in place to ensure new staff were suitable to work at the service. Medicines were administered and managed safely.

Staff received supervision and appraisals and training in line with the provider's policies and procedures. Staff had a clear understanding of application of the Mental Capacity Act 2005. Appropriate applications for Deprivation of Liberty Safeguards authorisations had been made. People using the service had access to healthcare professionals as required to meet their needs.

Personalised support plans were in place for people using the service. Staff knew people they were supporting including their preferences to ensure personalised support was delivered. People using the service told us the service was caring and we observed staff supporting people in a caring and respectful manner. Staff respected people's privacy and dignity and encouraged independence. People were offered a choice of nutritious food and drink. People using the service knew how to make a complaint.

Regular meetings took place for staff and people using the service. The provider sought the views of people and their relatives. The provider had quality assurance systems in place to identify areas of improvement. People and staff told us the registered manager and provider were supportive and approachable.

Lynwood is a care home providing support and personal care for adults with learning disabilities. The service is a large residential property arranged over two floors. All eight bedrooms are single occupancy. There were eight people living at the service at the time of our inspection.

The service had a registered manager at the time of our inspection. 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.

At the last inspection on 7 May 2015 we found four breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. The service was not always safe. Medicines were not always managed safely. Robust procedures were not in place to monitor and ensure fit and proper persons were employed at the service. Staff did not always receive regular supervision or appraisals. People did not always have access to activities during the weekend.

We inspected Lynwood on 14 and18 July 2016. This was an unannounced inspection. At this inspection we found six breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

People were not safe at the service. There were poor arrangements for managing medicines and infection control. People were at risk of harm when moving around the service. Systems in place were not always effective to maintain the safety of the premises and equipment.

People did not always have access to activities of their choice. This meant peoples personal preferences were not always met. Staff did not always receive up to date training, supervision and induction.

The systems in place to monitor the safety and quality of the service provided were not always robust. Staff had mixed views about the leadership of the service.

People told us they felt safe using the service and staff knew how to report safeguarding concerns. People knew how to make a complaint.

People told us the service was caring. Staff knew the people they were supporting, respected people’s privacy and encouraged independence. People using the service had access to healthcare professionals as required to meet their needs. The service enabled people to maintain links with their cultural and religious practices.

People’s needs were assessed and care and support was planned and delivered in line with their individual care and support needs. People were provided with a choice of food and drinks ensuring their nutritional needs were met.

We inspected Lynwood on 7 May March 2015. This was an unannounced inspection.

Lynwood provides supported living and personal care for people with learning disabilities. The service is registered for seven people. The service is a large property arranged over two floors. All bedrooms are single occupancy. At the time of the inspection they were providing personal care and support to seven people.

There was a registered manager at the service at the time of our inspection. 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.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People were not always kept safe at the service. Medicines were not always managed safely at the service. Records relating to criminal records checks showed that some staff who had been working at the service for a number of years had not had recent checks.

The staff were knowledgeable in recognising signs of abuse and knew how to report concerns. Incidents were reported and managed in an appropriate way. We found people were cared for by sufficient numbers of suitably qualified, skilled and experienced staff.

The service was not always responsive. People did not always have access to activities during the weekend. This meant peoples personal preferences were not always met.

The service was not always effective because staff did not always receive regular supervision or appraisals.

People were provided with a choice of food and drinks ensuring their nutritional needs were met.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The support plans contained information setting out how each person should be supported to ensure their needs were met. Care and support was tailored to meet people’s individual needs and staff knew people well. Risk assessments addressed the risks to people using the service.

Staff had good relationships with people living at the service. We observed interactions between staff and people living in the service and staff were caring and respectful to people when supporting them.

Staff knew how to respect people’s privacy and dignity. People were supported to attend meetings where they could express their views about the service.

The systems in place to monitor the safety and quality of the service provided were not always robust.

People who lived at the service, relatives and staff felt comfortable about sharing their views and talking to the manager if they had any concerns. The registered manager demonstrated a good understanding of their role and responsibilities, and staff told us the manager was always supportive.

Staff demonstrated they had an awareness of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. During our last inspection we found that planning and delivery of care was not conducted in such a way that ensured people's safety and welfare. During this inspection we found that the issues identified had been addressed.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. The support staff encouraged people to be independent and involved in making decisions about the care and support they received.

People told us that the service was meeting their care needs. One person said "they're nice" when asked about the support staff. Care plans were not reviewed on a regular basis and people were not enabled to contribute to the development of their care plans on a regular basis. This meant that the planning and delivery of care was not conducted in such a way that ensured people's safety and welfare and that their individual changing needs were met.

At the last inspection it was noted that the recruitment process was not sufficiently robust to ensure the safety of people using the service. During this inspection we noted that appropriate improvements had been made and there were effective recruitment and selection processes in place.

A client satisfaction survey was sent out to relatives of people who use the service annually. Their views were acted upon. Risks were identified, assessed and managed. Staff meetings took place every two to three months and were an opportunity for staff to raise any concerns or comments about the quality of the service.

People who used the service spoke positively about Lynwood and informed us that they were happy with the care they received. Relatives told us that they were made to feel welcome at the home when visiting their loved ones. They also told us that they were satisfied with the way their relatives were cared for. One relative said, “I have no complaints about the service, my loved one is happy there. Whenever my daughter comes to visit me she is more than happy to go back to Lynwood. I have no complaints about them at the moment.”

Positive feed back was received from people using the service and they all highlighted that they were very satisfied with the service. An individual living at the home said ‘I’m happy here. The staff are nice and I can talk on the phone to my family. I have my own phone now.’ Another person living at the home said ‘I love my room and I’ve also got my own phone so I can call my boyfriend and he can call me. The food is nice here.’ A relative spoken to said ‘My loved one is fine at the home, and they are well looked after. They are happy there and they like all the staff. I haven’t had to make any complaints.’

A relative said ‘They do keep me updated. My loved one had an accident recently, and they called me straight away, as they had to go to hospital.’

The service was fully staffed and people using the service made very positive comments about the staff and the care they provided. ‘The staff are very polite and my loved one likes all the staff’ said a relative. Another relative told us that ‘The staff take Y out regularly and Y seems happy at the home.’