Care Home: Lynwood House

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Annual service review Name of Service: Lynwood House The quality rating for this care home is: The rating was made on: two star good service 2 8 1 1 2 0 0 8 A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   Yes You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Sarah Webb Date of this annual service review: 1 8 0 2 2 0 1 0 Annual Service Review Page 1 of 8 Information about the service Address of service: Lynwood Close Midsomer Norton Bath & N E Somerset BA3 2UA 01761412026 Telephone number: Fax number: Email address: Provider web address:   Voyagecare.com Voyage Ltd Name of registered provider(s): Name of registered manager (if applicable) Conditions of registration: Category(ies) : learning disability Conditions of registration: May accommodate people who in addition to their learning disability have associated needs including autistic spectrum disorder. May accommodate up to 10 people in Lynwood House. May accommodate up to 4 people in Lynwood House Annexe May accommodate, in designated rooms within Lynwood House, up to 4 people who in addition to their learning disability are wheelchair dependant. May accommodate, in the ground floor bedroom within Lynwood House Annexe, 1 person who, in addition to their learning disability, is a wheelchair user Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service 2 8 1 1 2 0 0 8 Number of places (if applicable): Under 65 Over 65 14 0 Annual Service Review Page 2 of 8 Voyage Limited, who are part of the Paragon Healthcare Group, operate Lynwood House. The home consists of two properties, which are very close to the town centre where there is a wide range of shops and other amenities. There are car parking spaces to the front of both properties and large gardens to the rear, which back onto school playing fields. The main house, known as Lynwood House, is a large and spacious Victorian building that has ten single bedrooms, three on the ground floor and seven on the first floor, all of which have en-suite facilities. Four of these bedrooms are suitable for people who use a wheelchair and there is a passenger lift between floors. There are two communal lounge areas, a large dining area, an activity room with kitchen area and a separate domestic style kitchen. The other property is known as The Annexe and is a more modern building situated next door to the main house. This has four single bedrooms, each with en-suite facilities. One bedroom is on the ground floor and has been adapted to meet the needs of a person who uses a wheelchair. The communal facilities consist of a lounge, kitchen, dining room and well equipped sensory room, which all service users are free to use. The ethos is transitional care in the sense of young adults moving from specialised educational settings or from parental homes to a setting where their needs can be met on as long-term a basis as their healthcare conditions allow. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information we have received, or asked for since the last key inspection of 10 May 2007. At that time we judged that the people who were living in the home, were being provided with a good quality service. We planned to inspect the service again within two years and to complete a service review after one year - this we did on 26 June 2008. However there have been changes to our regional inspection plan. We are now carrying out a further annual review to determine our future inspection plan for Lynwood house. The information we have looked at includes1) The annual quality assurance assessment (AQAA) that was sent to us by the manager. This is a self-assessment that focuses on how well outcomes are being met for the people using the service. It also gave us some numerical information about the service. 2) Surveys returned to us by people using the service. These had been completed with the help of families. 3) Surveys returned to us by staff employed at the home. 4) Information about how the service has managed any complaints. 5) What the service has told us about significant things that have happened, these are called notifications and are a legal requirement. 6) Information we have received about how the service has responded to safeguarding issues. 7) The previous key inspection and the results of any other visits to the service. 8) Relevant information about the service from other organisations. 9) What other people have told us about the service. What has this told us about the service? There has been a new manager in place since June 2009. She has applied to be the Registered Manager and has an interview with us in March 2010. The manager sent us their annual quality assurance assessment in October 2009 when we asked for it. It was clear and gave us all the information we asked for. We were told changes have been made as a result from listening to the people living at the home. These include- employing an activities coordinator to help support people to experience more Annual Service Review Page 4 of 8 activities. -Changes to the staff rota to ensure there are sufficient staff on duty at peak times. -The development of Health Support Plans. We have also been told of future planning to make further changes and improvements for the benefit of the people using the service. We provided surveys for the people living in the home at the end of 2009. Due to the support needs of these individuals, their relatives helped them to fill in the surveys and have included their views. Several comments were made including: Lynwood provides a caring homely environment and staff are always welcoming and friendly. Looks after the residents well at night and generally tidies the place at night. However there were several comments made about how the home could do better. These included: Ensure staff read, understand and follow care plans, encourage staff to empathise with the residents and consider the residents needs first. Communication is a major failure of the home. Activities need to be more structured. The timetable of activities dosent always reflect what actually happens. Positive comments were also received through the surveys including: The new home manager appears very open and honest about past failures and has told me about new structures and recordings to be put in place. One family indicated they wanted to speak to the inspector. The inspector has contacted them and they have expressed their views about the home. We received 13 completed staff surveys. There were no staff that indicated they wanted to speak to the inspector. Staff surveys told us they are given up to date information, and that they were given training that was relevant to their role. The majority of staff agreed the training helps them understand and meet the individual needs of the people living at the home. We were told that their employer carried out checks on them before they started work. A few surveys received indicated their induction did not cover everything they needed to know including knowledge about health care and medication. To the question Are there enough staff to meet the individual needs of all the people who use the service? One staff told us Usually, six said Sometimes while two told us Never. Comments made by staff about what the home does well included-The home has made me feel welcome as a new member of the team. The homes Annual Service Review Page 5 of 8 homemade food is a good thing and cooked in a healthy manner. The home tries hard to meet the needs of all. Since being under new management I think its starting to improve. Tries to promote a happy and loving home for the service users. Tries to promote choice. Plans some lovely thought about activities for the service users. Comments made by staff about what could be done better included-Better staffing levels so the servive users can do the activities each day which they are allocated to. Take better care of service users clothes Organise better food shopping -plan further ahead- not always enough food in the house. Enforce teamwork Better communication ensure all messages are received. More staff on shift would improve safety, choice and care needs Training needs to be given before new staff start work. One survey told us the care service never responds appropriately if concerns are raised. However there were several comments agreeing that the new manager is doing a brilliant job at trying to get us back on track. Since the last inspection a number of concerns have been raised including the management of the home, recruitment of staff and whether the individual health needs of the people living at Lynwood House can be met through specific clinical procedures. An unannounced Random Inspection took place in August 2008 to investigate allegations reported to us through the whistle blowing process. The allegations were of a serious nature and the local authority was informed under agreed Safeguarding protocols.An immediate requirement notice was issued at this visit as well as several other requirements and recommendations. A family also made a complaint at this time to the Chief Executive of Voyage in 2008 relating their unhappiness at falling standards of care. Since these concerns were raised we have met with the new manager, operational manager and other professionals involved in the care of the people living at the home. We have been told peoples clinical needs have been reassessed, revised support plans are now in place and a training programme has been developed and has begun to train Annual Service Review Page 6 of 8 staff in aspects of peoples needs. We have been told about other safeguarding issues including financial abuse by the previous manager in March 2009 who was subsequently charged by the police. This was responded to robustly with changes made to the financial protocols in the home to help ensure no further financial abuse takes place. We have been recently informed of malicious damage that has occured in the home and that this has been reported to the police. There have been two further concerns raised through us recently that have been reported under safeguarding protocols. These are being investigated by the home currently. We have met with the manager on several occasions through safeguarding strategy reviews, and have been told how improvements are being made. The manager is working well with us to implement positive outcomes for the people living at the home. However due to concerns still being reported to us we need to gain assurance that the people living at the home continue to receive a good service. What are we going to do as a result of this annual service review? Following this service review, we will be bringing forward the key inspection. However we can inspect the service sooner if we have concerns about the quality of the service or the safety of the people living there. 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