10 January 2023
During a routine inspection
Linwood is a residential care home for up to 67 in one adapted building across three floors. Linwood provides care to older people who may have a physical disability or may be living with dementia. On the day of the inspection there were 44 people living at the service.
People’s experience of using this service and what we found
People’s medicines and risks associated with their care were not always managed in a safe way.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Care was not always provided that met people's individual and most current needs. This included the lack of accurate care plans, the lack of activities for people and the environment not set up to meet the needs of people living with dementia. Staff were not always familiar with people’s needs and supervisions were not taking place with staff to assess their performance. Although there were sufficient numbers of staff, they were not always deployed effectively to ensure good delivery of care. We have made a recommendation around this.
We observed examples of people not always being treated with respect and dignity. Although people and their families did feedback there were staff that were kind and caring. People and relatives fed back they were not happy with the quality of the meals although there were steps being taken to address this. People choices around care delivery and meals choices were not always considered. We have made a recommendation around this.
There was not always a record of the investigation into complaints that had been made. We have made a recommendation around this. There were other complaints that had been addressed to the person and relatives’ satisfaction. There was a lack of communication between staff at the service which was impacting on the delivery of care. The provider had not ensured systems and processes were established and operated effectively. Audits were not always identifying areas that required improvement. People fed back they liked the manager who had recently joined and could see they were making positive changes at the service.
Rating at last inspection and update
The last full rating for this service was requires improvement (published 8 October 2019). We undertook a focused inspection more recently however we only looked at Safe and Well Led. Both of these domains were rated good (published 13 July 2021)
Why we inspected
The inspection was prompted in part due to concerns received about the management of medicines, staffing and incidents of accidents and incidents. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report. After the inspection the provider took action to mitigate risks to people.
Enforcement and Recommendations
We have identified breaches in relation to the safe management of medicines and risks to people’s care, lack of detailed care planning and activities and the requirements of the mental capacity act. We found breaches in relation to people not always being treated with dignity and respect, staff not being supervised in their role and lack of robust governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk