Lynwood Home Care provides personal care to older adults, some of whom have dementia, in Sunningdale, Berkshire. BEN is a not-for-profit organisation, dedicated to those who work, or have worked, in the automotive industry and their family dependents. The office is located in BEN’s Lynwood Village; a very large purpose-built modern community, where the provider also operates a 96 bed care home with nursing. In additional, there is a café, restaurant, pub, hairdresser and health centre.The village currently has 66 self-contained apartments and 10 cottages. The provider is currently building another 100 apartments due to open in about spring 2017. The service will increase in size as the village reached full occupancy. People who currently use the service currently live in the existing apartments.
Staff provide care to people within their own homes. Services provided range from assistance in the morning (including helping people get out of bed, to wash, get dressed and have breakfast) shopping, preparation of food, medication prompting and assistance with evening care routines. There is a continuum of care, as people who receive personal care and require residential or nursing care can then opt to move into the care home on site.
At the time of the inspection, there was no 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 service manager had applied to become the registered manager and the application was in progress with our registration team.
The service has not previously been inspected since registration. Therefore, this is the first inspection of the location under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and rating required by the Care Act 2014.
At the time of the inspection, 17 people used the service and there were 5 staff. People received calls in their apartments at set times throughout the day. The service also operated 24 hours a day, seven days a week and people, relatives, staff and healthcare professionals could telephone the office anytime to receive support. After hours, calls were diverted to the on-call manager’s mobile telephone.
People were protected against abuse or neglect. People’s and relatives’ opinions of safe care were overall positive. There were sufficient staff to meet people’s needs and the service appropriately determined correct staff deployment. Feedback from people and relatives indicated that staff were sometimes late to calls but people told us they were not concerned. When we checked, delays in calls were minimal. People’s medicines were administered, stored and disposed of appropriately. The service needed to ensure that medicines administered were always signed for.
We found staff received induction, training, supervision and performance appraisals. The service utilised Skills for Care’s ‘Care Certificate’ for new carers and there was evidence. Recruitment and selection of new staff members was robust and ensured safety for people who used the service. Consent was gained before care was commenced and people’s right to refuse care was respected by care workers. However there was a risk that consent may not always be gained lawfully by the service from the ‘relevant person’.
Staff were kind and caring. People’s comments showed they were satisfied with the care they received. We determined care workers respected people’s privacy and dignity, and ensured people remained as independent as possible. People had regular opportunities to provide feedback to the service and also have a say in their care package.
The service was responsive to people’s needs. People had the ability to share their compliments, concerns and complaints in an open and transparent manner. Where feedback was provided by people or relatives, management would undertake necessary investigations, make changes to their care package and report back to the person. People’s care plans were not person-centred and needed to change from a task-led focus. The service manager showed evidence they had worked on this and transfer of care plans to a better format was underway.
All of the people we spoke with after the inspection expressed confusion about the management of the service. They were unsure who the manager was and wanted better information about the management of the service. We were unable to gauge staff opinion about the leadership of the service. However, the service manager explained to us their recognition of care workers’ good performance. We found that the management conducted a small amount of checks to assess the standard of care.