Linden House provides personal care and support for a maximum of 32 older people, some of whom may be living with dementia. On the day of our inspection 24 people were living in the home.
This was an unannounced inspection that took place on 9 December 2015.
The home 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 and associated Regulations about how the service is run. The registered manager assisted us with our inspection on the day.
People may not always be receiving safe care and treatment from staff because we observed staff struggling to transfer people from chairs to wheelchairs in an appropriate and safe manner. Staff did not always follow correct and appropriate procedures in dispensing medicines.
Although there were a sufficient number of staff on duty we found deployment of staff could have been better organised to ensure an appropriate number of experienced, permanent staff were on duty during a shift.
Although staff understood their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards we found the legal requirements in relation to these were not always followed by staff. For example, decisions were made on behalf of people without evidence to show how this had been done.
Staff were not always aware of people’s dietary requirement and we saw people being given inappropriate foods.
People were not always treated with respect and dignity by staff and staff did not take the time to make sure people knew what they were about to do. However, we did see some good examples of kind care from staff.
Care plans were individualised and contained information to guide staff on how someone wished to be cared for. However, this was not always followed by staff and we found some care records lacked detailed information about the person.
We saw evidence of checks carried out by staff to check the quality of care being provided to people. However shortfalls identified from these weren’t always acted on. The registered manager did not always have a good management oversight of the home.
Accidents and incidents in relation to people were recorded and monitored by the registered manager to identify trends. Risk assessments were in place for people for particular issues, such as risk of falls or particular behaviours.
Should there be an emergency in the home, there was guidance in place for staff to follow in order to ensure people’s care was not interrupted and if people needed to be evacuated this would be done in a safe way.
Staff were aware of their role in relation to safeguarding people from abuse and were able to tell us how they would report any concerns they may have. Robust recruitment practices were followed, which meant the provider endeavoured to employ staff who were suitable to work in the home.
Care was provided to people by staff who were trained and received relevant support from their manager. This included regular supervisions and undertaking training specific to their role. Staff were involved in the running of the home as regular staff meetings were held.
People’s health was maintained as staff involved external health care professionals when appropriate.
Visitors were welcome in the home and felt the registered manager was approachable and supportive. People were given information on how to make a complaint and we were told if people had any concerns they would approach the registered manager.
During our inspection we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.