We carried out a review of the data available to us about The Links on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Links, you can give feedback on this service.
We found the following examples of good practice.
¿ Procedures were in place for safe visits by healthcare professionals, contractors and relatives. These included the wearing of full Personal Protective Equipment (PPE).
¿ Relatives could visit their family member on an appointment only basis. The provider had deemed the conservatory as safe for this purpose as it was spacious and airy.
¿ The premises were spacious, and all bedrooms were single occupancy. This promoted social distancing and reduced any risk of infection transmission within the home.
¿ Infection Prevention and Control (IPC) processes had been followed when new people were admitted to the home.
¿ Staff took a COVID-19 test three times a week and people every 28 days. People or staff who tested positive were required to self- isolate in line with current government guidance.
¿ The premises were clean and appropriate cleaning products were used.
At our last inspection on 29 December 2015 we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ overall. We found the service continued to meet people’s support needs.
The Links is registered to provide accommodation and support for up to five people who lived with a mental health condition, learning disability and/or associated need. CQC regulates both the premises and the care provided, and both were looked at during this inspection. On the day of our inspection there were two people living at the home.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they 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.
People continued to receive a safe service. Staff knew what abuse was and received training so they knew how to take action where people were at risk of harm. There was enough staff to support people and a recruitment process was in place. Risks to how people were supported were assessed and monitored to keep people safe.
People continued to receive an effective service. Assessments showed people’s support needs and their preferences were identified to ensure the service could support them. Staff received the necessary support so they had the skills and knowledge to meet people’s needs. While no one lacked capacity, the provider ensured staff received training in the principles of the Mental Capacity Act 2005. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People decided when and what they had to eat and drink and was able to prepare their meals with little or no support.
People continued to receive support from staff who showed compassion and were caring. People made their own choices with support from staff where needed. People’s privacy, dignity and independence was respected.
People continued to receive a service which was responsive. People were involved in the assessment and care planning process. Staff supported people in the activities they chose to take part in. People knew how to raise a complaint.
People continued to receive a service which was well led. The provider had systems in place to monitor the quality of the service and carry out spot checks. People were able to share their views by completing a provider questionnaire. There was a registered manager in post.
Further information is in the detailed findings below.
The provider is registered to accommodate and deliver personal care to a maximum of five adults who lived with a mental health condition, learning disability and/or associated need. At the time of our inspection three people lived at the home.
At our last inspection of May 2014 the provider was meeting all of the regulations that we assessed.
The manager was registered with us as is required by law. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they 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.
People felt safe. Risks to people had been assessed appropriately and were monitored. Systems were in place to protect people from the risk of abuse.
There were enough staff on duty to meet the care and support needs of people. The provider ensured that staff were recruited safely.
Staff felt that they had received adequate training to equip them with the skills and knowledge they needed to provide safe and appropriate support to the people who lived at the home.
People received their medicines as they had been prescribed. Medicine records were maintained appropriately by staff.
Staff understood the circumstances when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) were to be followed to prevent any unlawful restrictions.
People felt it was a good place and that they were happy there. People were encouraged and supported to be as independent as possible.
People felt that the staff were helpful and kind. They confirmed that were respectful, polite and helpful.
Complaints systems were available for people to use if they felt they had a need to.
People felt that the quality of service was good. The management of the home was stable. The registered manager knew when they needed to send us notifications about incidents that occurred. Audits were undertaken to determine if changes or improvements were needed.
Is the service safe?
People were treated with respect and dignity by the staff. People told us that they felt safe and staff had received training in safeguarding and understood how to safeguard the people they supported. We saw that the service had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty safeguards. On the day of the inspection all the people who lived at The Links had been assessed as having capacity. Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents. This reduced the risk to people and helped the service to continually improve.
People were cared for in a service that was safe, clean and hygienic. The building was well maintained, spacious and had recently undergone some refurbishment. Risk assessments were in place in individual support plans in relation to activities of daily living. Staff personnel records contained all the information required which meant that the provider could demonstrate that the staff employed to work in the home were suitable and had the skills and experience needed to support the people living at The Links.
Is the service effective?
People told us that they were happy with the care they received and felt that their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and they knew them well. Staff had received training to meet the needs of the people living in the home. People's health and care needs were assessed with them and they were involved in writing their plans of care. Staff spoke with pride about the progress that individual people had made whilst they had been living at The Links. People who lived in the service were able to describe specific benefits to their health and wellbeing of living at The Links and the impact that this had had on their daily life. One person told us, " The staff go out of their way, they put us first, it don't matter who it is".
Is the service caring?
People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. People told us they were able to do things at their own pace and were supported to be as independent as possible. People who used the service were invited to complete an annual survey. Where shortfalls or concerns were raised, these were addressed. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with their wishes. One person who lived at The Links told us, "The manager's caring, the staff are caring, she picks her staff well".
Is the service responsive?
People were regularly involved in a range of activities inside and outside the service. The home supported people to take part in local activities within the local community which included volunteering, visiting local places of interest and shopping in the nearby town. People knew how to make a complaint if they were unhappy and people we spoke with told us that they felt that they could talk with any of the staff if they had a concern or were worried about anything.
Is the service well-led?
The service worked well with other agencies and services to ensure that people received their care in a joined up way. The service had a quality assurance system which included planned audits. Records seen by us showed that any identified shortfalls were addressed promptly and as a result the service was constantly improving. When we spoke with a visiting social worker, they told us that they believed that the service was well run and was a positive place for people to live.
On the day of the inspection, there were five people living at the home. We spoke with four people, two staff members and the home manager.
We observed staff obtain people's consent for different aspects of their care. Records showed that people had provided consent before care or treatment was delivered. One person said, 'The staff go through the plan and risks, then we sign it.'
We found that people received care that met their needs. Records were detailed to show what people's needs were. One person said, 'It is brilliant here.' People we spoke with were happy with the care and support they received.
Arrangements were in place for the safe handling of medicines. People were assessed to administer their own medicines where possible. One person said, 'I take my own medicines and staff help me sometimes."
We found that staff were being supported through training opportunities and regular supervision.
We saw that staff positively engaged with people throughout the day and encouraged people to make choices about their care and treatment. We found that people wore clothing that reflected individual choices and preferences.
We found that arrangements were in place to ensure that any allegation of abuse was identified, managed, and reported appropriately. We found that improved arrangements were required to ensure that people's money was safeguarded.
Staff we spoke to told us that they were supported in carrying out their role. We saw that staff received support through training, supervision, appraisals, and meetings. However, arrangements needed to be robust to ensure all staff receive these opportunities on a regular basis.
The provider had effective arrangements to identify and manage systems to improve the quality of services. We found that people were involved in the running of the home and that their views were taken seriously.