Lyndhurst House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People had good outcomes because their needs were assessed. Their care, support and treatment reflected these needs and any protected characteristics. The service worked in harmony with people at the centre of their care. People were enabled and encouraged to make their own choices. People were supported to live independently. People were supported within the service and within the community to achieve their goals and aspirations. However, epilepsy care planning was lacking, and mental capacity assessments were not undertaken according to best practice. Some decisions had been recorded without evidencing that people had been assessed to check if they could understand, retain and weigh up the information to communicate their decision about the matter concerned.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s health and welfare needs were fully assessed to ensure they received the right level of support and were responded to appropriately. A relative told us, “The home always adheres to the hours that have been commissioned. Our son always has 2:1 outdoors and 1:1 indoors and any more would likely heighten his anxiety; it’s a good balance.” Another relative told us, “The staff know exactly what our loved one’s parameters are so they know what areas he can grow regarding his independence.”

Staff were knowledgeable about people’s care and support needs. They were able to describe peoples preferred routines, the best ways to communicate with people and how to support people with their physical and emotional well-being. Changes in people’s care needs were documented in their daily logs and discussed in handover by the shift leader. Changes were also recorded in the communication book, for example, if someone has a cold. Permanent changes to someone’s care needs were updated in people’s care plans and discussed in the team meetings. The manager was putting in place a handover sign sheet for the staff to read, sign and date before their shift started as evidence of their knowledge of such changes. Staff told us that verbal handovers took place at the start and end of each shift. Staff told us they provided people with space alone to explore their sexuality. One staff member told us, “People have private time whenever they need. For example, when [Person] wants to be alone, he will tell us he is going to put deodorant on.”

Before people moved into the service, peoples’ needs were assessed. These assessments were used to develop the person’s care plan and make the decisions about the staffing hours and skills needed to support the person. People were supported by staff through a transition period from their previous placement to their new supported living home. Assessments included important information about how best to communicate with people. This included communication passports and tools to guide staff about how people with limited or no verbal communication presented when they were happy, sad or in pain. People living at the service had access to other health care professionals, such as the learning disability nurse, the GP and a chiropodist.

We received consistently positive feedback about the service from people and their families. Relatives told us, “I have been involved in my daughter’s care plan and reviews, and I am always at the best interest meetings too. I am not left out at all.” Another relative told us, “I have seen our son’s care plan, and the home are always in touch. If staff are unsure about anything, for example, perhaps he is a little off colour, they will check things out with me. He has eaten so many new foods since being at Lyndhurst and has become a healthy weight which wasn’t the case when he was at home.”

Staff had a good understanding of people’s assessed needs and helped people to plan their menus and meal choices and shop for their groceries. The management told us, “Everyone is weighed monthly. When we noticed that [Person] had started to lose weight after coming off Olanzapine, we took them for blood tests and their CT scan was clear. By working with the learning disability nurse, their weight has now stabilised.”

The provider had systems and processes in place to meet people's oral, continence, nutrition and hydration needs. Care plans were detailed and included people’s preferences and wishes regarding the delivery of their care, for example, how they preferred to take their medicine.

People communicated that the service worked with GPs, a behavioural support specialist, the learning disability nurse and other health care professionals to meet their care needs. One relative told us, “Staff listen to anything I have to say.” Another relative told us, “Staff will ring me any time they have any concern or if there have been any developments, they pre-empt everything. The communication and liaison here is exceptional.”

Staff worked with health care professionals such as the behaviouralist and the learning disability nurse to ensure that people got the care and support they needed. The management told us, “We have good links with the local authority as well as the learning disability service, the GP and the behavioural support specialist.”

Feedback from health care professionals was positive. One health care professional told us, “Lyndhurst have been extremely diligent at making referrals to ensure health promoting interventions are implemented.”

The provider had a clear process in place to escalate health concerns in a timely manner.

People communicated that they were supported with meeting their health care needs and trusted the staff to assist them.

Staff had a good understanding of meeting people’s changing needs. A staff member told us about a person who joined the service with very poor oral hygiene, which led to stomach bacterial infection and affected her behaviours and contributed to her weight loss. They contacted the dentist, dietician, and the learning disability nurse and her care plan was updated with a person-centred action plan. When a person started to lose weight after coming off a different medication, the service supported them to access blood tests and undergo a CT scan and followed the advice of the Dietician and learning disability nurse.

People living in the service had access to other health care professionals such as the GP, a behavioural support specialist and the learning disability nurse.

People received support from staff when health clinicians assessed their health needs. One health care professional told us, “The staff at Lyndhurst appear to be doing a great job promoting the quality of life for residents in a respectful manner, and they seek support from professionals when they run into difficulty or require specialist support.”

Staff told us they had the training and support to meet people’s health and care needs. A staff member told us, “Staff who haven’t yet had the training in PROACT-SCIPr, which is about improving communication and looking at things from different perspectives, are having it next week and they can’t wait because it is really great training and will help us to support our people in the best ways for them.”

Care plans were in place which detailed people’s care and support needs, as well as their clinical needs in relation to health conditions. For example, when a person was prescribed emergency as and when required medicine, the care plan provided clear information about when to administer the medicine, why and how. Training had been provided for staff in this area and staff told us they knew what to do.

People’s choice and consent was valued, and staff continually consulted people about their wishes and well-being. Some people were supported to make decisions using alternative communication methods, such as picture cards, verbal or physical signs and technology.

Staff understood people’s capacity to make day to day decisions about their lives. No one at the service had Advocacy support because the parents and families were involved. Staff told us, “If I was concerned about any family member not acting appropriately for any resident, I would raise a safeguarding and talk to advocacy services.” One staff member told us,” Consent is crucial. You deem capacity in first instance, then do the relevant risk assessments and capacity assessments that follow least restrictive actions. It is about understanding that mental capacity depends on what the decision is, e.g., finances or road safety.” Another staff member told us, “We are always asking people for their consent, and we knock on their doors out of respect and in support of their dignity.”

We checked whether the service was working within the principles of the Mental Capacity Act (MCA). Where people were assessed as lacking capacity to make decisions, appropriate procedures were not always followed. For example, where people could not give informed consent, mental capacity assessments had not been consistently undertaken according to best practice. Some decisions had been recorded without evidencing that people had been assessed to check if they could understand, retain, and weigh up the information to communicate their decision. During the assessment, the manager took swift action to address this and sent some additional assessments of people’s capacity.