The inspection took place on 31May 2017 and the visit was unannounced, and carried out by two inspectors. Linden Grange is one of three homes provided by the Linden Care Homes Limited. The service provides accommodation and personal care for up to 35 older people living with physical frailty due to older age and / or living with dementia. The home has two floors; the ground floor provides care to up to 23 people and the first floor for up to 12 people. Both floors have communal lounge and dining areas and share enclosed gardens accessible to people from the ground floor lounge.
The home is required to have 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 and associated Regulations about how the service is run. At the time of this inspection the home had a registered manager in post, who was on leave at the time of our inspection.
At our previous inspection in July 2016, we identified improvements were required in keeping people safe, in delivering effective care and treatment and in the management of the service. We gave the home an overall rating of requires improvement. At this inspection, we checked whether the provider and registered manager had made the improvements needed. We found sufficient improvements had not been made. We identified a breach in the regulations that related to the management of medicines and in the governance of the service.
The provider’s system for the management of medicines was not always effective or safe. People that lived at the home had their prescribed medicines available to them, however, people that had left after a short stay, had not always had their medicines sent home with them. Checks on medicine records were not always completed and staff did not always have all of the knowledge they needed.
The provider had systems and processes in place to monitor the safety and quality of the service, however, these had not always been effective. The provider and registered manager had not always ensured actions, where risks to people’s safety and wellbeing were identified, were managed effectively to reduce risks of reoccurrence. We found there had been a lack of oversight, from the provider, in relation to the governance of the home.
People who lived at the home felt safe. Risks of harm to people were assessed and actions to minimise those risks were taken by staff. There were sufficient numbers of staff on shift who knew how to safely meet people’s needs. Staff were recruited in a safe way and the provider undertook checks to make sure staff were of good character before they supported people who lived at the home.
Staff received an induction when they started to work at the home and on-going training. People felt staff had the skills and knowledge they needed to care for them. Staff worked within the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People had choices about what they ate and drank and were referred to healthcare professionals by staff, where there were concerns about any changes in a person’s weight. People were supported to access their GP when they needed.
People were supported by staff who showed a caring and kind approach. Staff showed respect toward people, and encouraged them to make decisions about their day to day care. People felt their privacy and dignity was maintained by staff when they were supported with personal care.
People had individual plans of care which staff told us they read. There were different group activities offered to people and staff also supported people to pursue their individual hobbies and interests and to socialise with others in the home. People had no complaints and said if they did, they would raise them. Meetings with people and their relatives took place which gave people the opportunity to give their feedback on the service.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The overall rating for this service is ‘Requires Improvement’. You can see what action we told the provider to take at the back of the full version of the report.