Link House

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We identified 1 breach of regulation in relation to treating people with dignity and respect. We observed staff to not always talk about people in a dignified manner and we observed one staff member to make an inappropriate contact with a person during our assessment. Care records were not always written in a respectful manner, and we found the registered manager had not done all that was possible to create a culture of dignified and respectful care. People had not always been supported to maximise their independence, choice and control and although people and their relatives told us they were happy with the care and support provided at Link House. We found people had not always had a positive experience as staff had not always responded appropriately and in a timely manner to meet some people’s needs.

This service scored 30 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not always treated with kindness, compassion and dignity in their day-to-day care and support. People were subject to restrictive practice which were often in an undignified, and unlawful manner. Language used within care plans was not always positive or dignified. For example, one person's care plan stated ‘should [the person] present anti-social behaviour, they should be removed from an audience and reminded of what is acceptable behaviour and the possible consequences of what they are doing'.

During our conversations with staff and the registered manager, we found they did not always speak about people with kindness and in a dignified way. We heard staff refer to people’s feelings of distress as, 'Throwing a paddy'. The registered manager told us of an incident which had occurred on the day of our conversation. There was little empathy shown for the person and the registered manager stated, “Well it’s more paperwork to do."

We received positive feedback from partners on how staff engaged with people using the service. Stakeholders told us when they had visited people had appeared 'Happy and smiling'.

We observed one staff member make an inappropriate contact with a person who lived at the service. This was highlighted in the persons care plan as a known trigger of distress.

People were not always treated as individuals. We observed some people to be treated in a disrespectful way by staff, we found records were written about people in a derogatory manner, so we were not assured people’s experience using the service was consistently positive.

Leaders lacked knowledge on people’s protected characteristics and had not always considered these in planning and assessing the care and support people required. Staff had undertaken training in equality, diversity and inclusion but we found this training was not consistently put into practice.

We observed some people to be treated in a disrespectful way by staff, some staff described people using derogatory language and we observed some staff not to always treat people with dignity .

People’s care records contained undignified language to describe how people may show signs of distress. People’s care plans did not always consider people’s needs and wishes and therefore did not always reflect their views and wishes of how they wished for their care and support to be delivered.

People had not always been supported to explore their personal relationships. Following a review of incidents at the service, trends and patterns were identified by the inspectors on-site. A request was made by the inspectors for a referral to external stakeholders for support for this person with seeking consent and relationships.

The provider had not holistically explored people's sexual, and relationship needs. They did not support people to have access to education and information to help them develop and maintain relationships and express their sexuality. Staff did not have enough skills and knowledge to support people they care for to have positive personal relationships, should they wish.

People’s individual preferences in relation to going out into the community had not been considered. For example, 1 person was observed to have asked multiple times to go to the shop to buy some new slippers. The person was told they would have to wait until this activity was planned.

We found systems and processes in place did not consider people’s individual’s choice on how they wished for their care and support to be delivered, we found limited information on how people were supported to develop relationships or take part in activities outside of Link House. We found when people had interests and hobbies, people had not always been supported to pursue these.

People and their relatives told us they were happy with the care and support provided at Link House. We found people had not always had a positive experience as staff had not always responded appropriately and in a timely manner to meet some their needs. For example, we found referrals to external agencies to seek support and guidance had not been made when this was required. We also found that not enough action had been taken when a person had raised concerns to staff about the way they were being treated.

Staff told us how people were referred to external agencies for support when this was required for example with support for eating and drinking. However, we found staff had not always identified other aspects of people's care when referrals to external agencies was needed.

We observed staff to respond to people in a timely manner when people requested assistance throughout our assessment, however we found staff did not always understand people’s needs and wishes as we observed a person requesting to go out and they were told this would need to be planned.

Staff told us they felt supported by the provider and the manager and gave us examples when their well being had been promoted.

Although staff provided us with positive feedback about how the provider supported their well being, we found a culture had been created which did not promote person centred care. For example, we found staff lacked knowledge on mental capacity, protected characteristics, and restrictive practice. We also found that staff used derogatory language to describe people.