Linda Grove

Updated 16 March 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Linda Grove is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection, the registered manager had not spent time in the service recently because there was another manager in post who was planning to register with CQC, and they would then cancel their registration. The manager was in the service on both days of our site visit and the registered manager was present on the second day.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed notifications the provider had sent us. Notifications are sent when a significant event has happened in the service. We used all of this information to plan our inspection.

During the inspection

We carried out observations of people's experiences throughout the inspection. We spoke with one relative about their experience of the care provided. We spoke with seven members of staff including the manager, the registered manager, the regional manager and four support workers. We received emailed feedback from two professionals who were involved with the service.

We reviewed a range of records. This included two people’s care records and two medicine records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 16 March 2022

About the service

Linda Grove is a residential care home providing accommodation and personal care to people with a learning disability. The service can support four people and at the time of the inspection three people were living in the service although one person was temporarily away.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right support:

• The model of care and setting did not fully maximise people’s choice, control and independence. For example, people lived in an environment where safety issued had been identified and was not homely. The environment did not meet people’s sensory needs. People were supported to personalise their bedrooms and had privacy for themselves and their visitors. The service was located so people could participate in the local community.

Right care:

• Care was not fully person-centred. For example, while staff knew people well and were caring in their approach, people were not always supported in line with preferences which were outlined in their care plans. People were supported by staff who treated them with kindness and respect.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff did not fully ensure people using services lead confident, inclusive and empowered lives. It was not clear how people had been empowered to have as much choice and control over their care as possible. A lack of management presence meant leaders were not always available to monitor the day to day culture. Despite this, staff remained positive and felt well supported. They were motivated to do the best they could for people.

The service was not always safe. Risks associated with people's support needs and health conditions had not been effectively managed. The premises and equipment were not always secure, properly maintained or suitable. The provider had not ensured measures were in place to prevent and control the spread of infection. This increased the risk of harm to people. The manager told us of their plans to make improvements to ensure safety.

There were enough staff to support people safely and staff were recruited safely. Staff had a good understanding of safeguarding people from abuse and were confident the manager would act appropriately if necessary.

The home was not always well-led. Leadership arrangements did not ensure the safety and quality of the service. Governance systems to monitor the quality of care being delivered to people were not effective and did not always drive the necessary improvement. People did not always receive person-centred care.

Staff felt valued and enjoyed working at Linda Grove. They were kind and cared about the people they supported.

The manager demonstrated a willingness to make improvements and during the inspection began reviewing their systems and process to ensure the service consistently provided good, safe, quality care and support. The senior leadership team additionally demonstrated they took our concerns seriously and acted promptly to support the manager to make the necessary improvement. Further progress was still needed to fully embed and sustain these improvements.

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 13 November 2018).

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Linda Grove on our website at www.cqc.org.uk.

Why we inspected

The inspection was prompted in part due to concerns received about the environment, infection control practices and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Linda Grove on our website at www.cqc.org.uk.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, premises, person-centred care and governance.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.