This inspection took place on 26 November 2014 and was an announced inspection. This meant the staff and provider knew 24 hours before the inspection we would be visiting. This was because as a small home for people with learning disabilities, people are often out during the day.
Links Lodge is a detached building situated in a residential area of North Shore, Blackpool. The home is registered to accommodate up to ten adults, with a learning disability who require assistance with personal care. The home specialises in supporting people with learning disabilities who are living with dementia. At the time of our visit ten people lived at the home. Eight people had both learning disabilities and dementia.
Most rooms were of single occupancy, with one double room available for those wishing to share facilities. Some rooms had en - suite bathrooms, but communal bathing facilities and toilets were available throughout the home. There were garden areas to the front and rear of the building.
The service was last inspected in August 2013. They met the requirements of the regulations during that inspection.
The registered provider was an individual who also managed the home on a day to day basis. Registered providers 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.
Risks to people were minimised because the registered provider had procedures in place to protect them from abuse and unsafe care. People who were able to communicate verbally, told us they felt safe in Links Lodge. One person said, “I like it here. All the staff are good to me. They look after me.” Relatives told us that their family members were well looked after and were safe. They said that they had no concerns about their safety at Links Lodge. A relative said.” We are so happy with the care [our family member] gets. We can trust the home and staff and can go on holiday without worrying.” Another relative said, “[Our family member] is even safer there than with me.”
The management team had policies in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). We spoke with them to check their understanding of MCA and DoLS. Where people lacked capacity, best interests meetings involving the person, relevant professions and relatives were taken over any important decisions and the discussions, the options considered and the agreements made recorded.
We looked at how the home was staffed. There were enough staff to meet people’s needs in the home and local community. People had personalised care at a time that suited their needs. We saw that the staffing was structured to the needs of the people who lived at Links Lodge and not the organisation. One person told us “I love it here. The staff are great - the best”. A relative said, [The provider] only has the best staff. They are all excellent.” Another relative commented, “It is a happy family run home with fantastic staff.
Recruitment was safe and robust. People were protected from unsuitable people working in the home because the home’s recruitment procedure was followed and appropriate.
Relatives told us the needs of their family members were very well monitored. They said staff quickly responded to any changing needs. They added they were informed about any needs identified, asked their views and involved in any decisions. One relative told us. “I have the utmost confidence in the staff. They are really on the ball.” Medicines were managed appropriately. They were given as prescribed and stored and disposed of correctly.
The staff team were very aware of the importance of eating and drinking well particularly as the people they supported had complex needs, learning disabilities and were living with dementia. Staff used innovative methods to enable people to have a varied, interesting and nutritious diet. They used a variety of ‘food smells’ and picture menu’s to enhance people’s appetites and choose food. Staff realised that one person used to thoroughly enjoy bacon sandwiches but now had a soft diet. They sought out a specialist food provider who made ‘pureed bacon sandwiches’. The person ate this ‘sandwich,’ smiling as they did so.
Staff had an in-depth appreciation of people’s individual needs around privacy and dignity. All staff routinely treated people with kindness and respect. A relative told us, “The staff are remarkable, they are always cheerful and caring. They are wonderful, they ‘go the extra mile’.”
Staff told us they had excellent access to training and were strongly encouraged to develop their skills and knowledge. One member of staff said, “You only have to ask for particular training and if it will benefit residents we get it, no problem.” The management team worked in partnership with dementia and learning disability organisations. They also used specific systems developed by these organisations to make sure they were training staff to follow best practice. This helped people to experience an exceptional level of care and support that promoted their wellbeing and encouraged them to enjoy a stimulating and meaningful life. A member of staff told us, “It is a privilege to work here. We make a real difference to people so they can still have a good life, going out and enjoying themselves as long as possible.”
The vision and values were imaginative and person-centred and made sure people were at the heart of the service. The staff team looked at innovative ways of including people in planning their care, gaining their views and in choosing activities. They used iPads and other technology to assist people in retaining skills and in activities. The service user guide, care plans and complaints procedures and newsletters were provided in easy read and DVD format. This meant more people could access them and to encourage people to be involved in making choices and understanding information about the home.
Staff were exceptionally focussed on people’s needs especially their individual communication needs. As several people did not have verbal or formal recognised communication staff observed and recorded their reactions to different events, situations and activities. We saw that people were showing evidence of great enjoyment and interest in the conversations with staff and despite their limited verbal communication these conversations were clearly not one sided. This showed the excellent communication skills members of staff had and their inspirational ability to encourage a high level of interaction with people.
Staff inspired people to try different and varied social and leisure activities so that despite their increasing dementia they were able to live life to the full. These included according to individual’s likes and dislikes, circus, shows, sports and music events and theatre. Staff used specialist equipment including light sensory equipment and music to assist relaxation. Staff had been on training to use iPad’s to their best effect and were enthusiastic about assisting people to use these. One member of staff told us, “It is amazing how these get people interested.”
The home had a clear management structure in place. The registered provider and management team were experienced, knowledgeable and familiar with the needs of the people who lived at Links Lodge. They frequently audited the quality of the service. Any issues highlighted in the audits were quickly acted upon and any lessons learnt.
Staff told us they were highly motivated and inspired by the registered provider and management team who researched new ideas on dementia care and learning disabilities and attended care shows in order to develop the service and improve care. People and their relatives told us the registered provider, management and staff team were approachable and available and willing to listen to people. One relative said, “This home is far superior to anywhere [our family member] has been before.”