19 September 2023
During an inspection looking at part of the service
Linden Manor is a Victorian property converted into a residential home, with accommodation over three floors which can be accessed via a lift. There is a communal lounge and dining area.
People’s experience of using this service and what we found
Improvements were required around assessing and monitoring risks to people, safe medicines and infection control. The registered manager made some improvements during the inspection to reduce risks to people.
The provider’s systems and processes to monitor the quality and safety of the service required some improvement to ensure they were effective in identifying and actioning concerns. However, the provider and management team were open and transparent throughout the inspection and made immediate improvements to safety during and after the inspection.
People were protected from the risk of abuse and told us they felt safe. Staff knew how to raise concerns and were confident to speak up.
The home was clean and free from odour. Personal Protective Equipment [PPE] and infection control guidance was available throughout the home for staff, people and visitors.
There were enough regular staff members available to meet people’s needs. Staff knew people well and worked as a team to cover holidays and sickness to ensure continuity of care for people. Care staff received regular training and supervision to ensure they had the skills they needed.
Accidents and incidents were monitored and lessons learned when things went wrong.
People’s needs were assessed prior to them moving into the home to ensure their needs could be met. People had access to healthcare monitoring and healthcare services as and when required.
People had enough to eat and drink and specialist dietary requirements and preferred choices were met.
The home had been adapted to support people with varying care and mobility needs. There was a lack of dementia friendly signage but this had not impacted on people currently in the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were treated with respect and told us that staff were kind and caring, Staff spoke fondly of people in their care and we observed positive relationships. People’s religion and culture were included in care planning and people were supported to take part in religious activities and celebrations for their choosing. People’s individual communication needs were assessed and planned into care.
People were supported to be independent and make their own choices. Care plans were written in a person centred manor and included people’s likes, dislikes, personal and work history and hobbies. People enjoyed group and 1:1 activity of their choice and were supported to maintain relationships with their relatives’, friends and the local community who were all welcomed into the home.
There was a positive culture in the home with staff and management working together and with other healthcare professionals to get the best outcomes for people. Feedback was sought via regular meetings and questionnaires with people, their relatives, staff and healthcare professionals we saw that this was positive.
People’s end of life wishes were assessed and planned into care; staff could access information quickly to guide them in an emergency.
The provider had a complaints process and relatives told us when they raised concerns these were resolved. People, relatives and staff spoke well of the management team and felt well supported to voice concerns and share ideas.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 1 April 2023). The service remains requires improvement. The service has been rated requires improvement for the last 3 consecutive inspections.
The provider was issued with a warning notice at the last inspection. At this inspection we found the provider remained in breach of regulation.
Why we inspected
The inspection was prompted in part due to concerns received about care and support in an emergency. A decision was made for us to inspect and examine those risks. We also followed up on action we told the provider to take at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Linden Manor on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to the managerial oversight of the safety and quality of the service.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.