Linden House Nursing Home

We undertook this inspection following a COVID 19 outbreak at the service.

We found the following examples of good practice.

Staff had received infection control training. Staff were seen using personal protective equipment (PPE) correctly and in accordance with current guidance to minimise risks to people.

Staff and people were regularly tested in line with the government’s current testing programme. We were assured that the provider understood and was meeting shielding and social distancing rules.

Staff had received update training on how to keep people safe during the COVID-19 pandemic and had plentiful supplies of PPE.

The home was clean with no unpleasant odours. There was a robust cleaning schedule in place and touch points were cleaned using chemicals which are effective against Covid 19.

Further information is in the detailed findings below.

Linden House is a residential care home providing personal and nursing care to up to 34 people. The home specialises in the care of older people. At the time of the inspection there were 25 people living at the home.

The home is a large older style property with a modern extension. Accommodation for people is arranged over two floors with passenger lifts to enable people to access all areas.

People’s experience of using this service and what we found

People lived in a home where they felt safe and well cared for. There were adequate numbers of staff to keep people safe and to meet their needs. People told us they received support promptly when they requested it.

The provider had systems which minimised risks to people. These included ensuring staff were well trained and competent, maintaining a safe and hygienic environment and making sure people had the equipment they required to minimise individual risks.

People were happy with the food provided and received the support they required to eat their meals. Specialist diets and individual food preferences were catered for.

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. Staff respected people’s choices and decisions.

People were cared for by a stable staff team who were kind and caring. Staff supported people in a way that promoted their dignity and respected their privacy. People and visitors had formed trusting relationships with staff and felt included in decisions about their care and the running of the home.

People’s friends and family were always made welcome and the home to enable them to stay in touch with people who were important to them. People and their friends and family were able to take part in activities which helped to reduce the risks of social isolation.

People could be confident that at the end of their life they would be cared for with compassion and kindness. People being cared for at the end of their life were well cared for and their comfort was closely monitored by trained nurses.

The home was well managed by a manager and provider who were committed to continually monitoring the standard of care people received. The provider learnt from mistakes and sought people’s feedback to make sure improvements were made in accordance with people’s wishes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (Published 6 July 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good:

People remained safe at the service. People told us they felt safe. There were sufficient staff on duty to support people and recruitment was safe. People received their medicines as required and staff understood how to identify and keep people safe from abuse or avoidable harm. People’s risks were assessed and incidents and accidents were monitored. The environment and equipment within it were maintained.

People continued to receive effective care, however, we have made a recommendation in relation to ensuring legislation is followed relating to applications for the Deprivation of Liberty Safeguards. DoLS is a framework to assess the requirement to lawfully deprive a person of their liberty when they lack the mental capacity to consent to treatment or care and need protecting from avoidable harm. Staff received training to ensure they had the skills and knowledge required to effectively support people. People’s healthcare needs were monitored by staff and they had access to healthcare professionals when needed. People received support to eat and drink sufficient amounts.

The service continued to provide a caring service to people. People told us, and we made supporting observations that staff were kind and patient. People and their relatives had sent compliments to the service to express their gratitude and thanks. Staff understood the people they supported and people’s visitors were welcomed. People were supported to have a dignified death in line with their wishes.

The service remained very responsive to people’s individual needs. Following an assessment before admission, care and support was personalised to each person which ensured they were able to make choices about their day to day lives. There was a system to ensure complaints would be appropriately dealt with. People were supported with their hobbies and the service continued to use innovative methods to enhance the quality of people’s lives.

The service continued to be well led. Staff spoke positively about their employment and told us there was support available. The provider had systems to offer staff confidential support. There were systems to seek the views of people, their relatives and staff through surveys. There were links with the local community and the service supported national charities. There were effective governance systems in place.

Further information is in the detailed findings below.

People who lived at the home told us 'It's like one big family' 'I really like it here' 'I am very happy here' 'Everyone is so friendly' ' I feel very safe'

People were confident in the skills and ability of the staff caring for them.

We found that people were consulted and involved in decisions concerning their welfare and in all aspects of their everyday life. We found that the care they were provided with met their individual needs and preferences. Care needs were assessed planned and reviewed and the home was proactive in listening and acting upon peoples preferences and acting on their requests.

Records were accurate and demonstrated care and support being delivered in line with the assessed needs

As well as care needs the home was very proactive with providing social events and activities and encouraging people to remain engaged and involved in their surroundings. They appeared committed to assisting people to live as fulfilled lives as possible.

Staff understood the safeguarding process this helped to keep people safe and protected. There were also appropriate policies and procedures in place to ensure this.

People told us they liked living in the home. One person told us, 'I enjoy it, I'm quite happy here.' Another said the staff treated them well. People told us they had enough activities to do if they wanted to join in. We saw people enjoying the company of others, reading books, watching television, talking with staff and joining in planned activities at the home. People received the support they needed to meet their physical health needs. People were complimentary about the staff working in the home. They were confident that the staff working in the home had the skills to care for them.

We looked at how people's medicines were managed. We found systems in place which ensured people received their medicines safely. We also looked at records of staff recruited to work in the home and saw these were robust ensuring that staff employed had the right skills and attributes to work with vulnerable older people.