The Links Care Centre

Updated 27 January 2021

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 and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Links Care Centre 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.

Notice of inspection

This inspection was unannounced. Inspection Activity started on 8 December 2020 and ended on 18 December 2020. We visited the service on 8 December 2020.

What we did before the inspection

We reviewed information we had received. We asked for feedback from local authority commissioning and safeguarding teams. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We observed care and support in communal areas of the home. We spoke with seven people who used the service and six relatives. We spoke with 13 members of staff including the regional manager, registered manager, training and quality lead, nurses, care workers and an activity coordinator. We also spoke with an advocate and health and social care professionals about their experience of the care provided. We talked with relatives, staff and professionals on the telephone after the site visit.

We reviewed a range of records. This included people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 27 January 2021

About the service

The Links Care Centre is a nursing home providing nursing and personal care to people with dementia and other complex mental health issues. The home accommodates up to 85 people over five self-contained units. At the time of the site visit there were 66 people living at the home.

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

Staff did not always follow the provider’s COVID-19 policy or infection and protection government guidelines. This posed a risk that staff could transfer infection. Risks to people’s health and safety were assessed. Plans were clear and up to date and contained person centred information. However, on the day we visited the service we saw they were not always followed. Audits and checks were in place to monitor the quality of the service. They had not identified the risks which were identified during the inspection.

People were supported by a consistent and experienced staff team. Recruitment was managed safely.

Staff understood the importance of safeguarding and the provider worked closely with local authorities.

Medicines were managed safely. There were close links with health professionals and other agencies to ensure people’s health needs were met and changes responded to promptly.

The registered manager had commenced in post in June 2020. They had introduced wide ranging changes. Staff, people and relatives spoke highly of the registered manager and described the changes that were underway as positive. One long standing care worker at The Links said, “ We have the continuity to create and maintain a new culture.”

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

Rating at last inspection and update: The last rating for this service was requires improvement (published 17 April 2019) and there was one breach of regulation.The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 18 March 2019. A breach of legal requirements was found.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has stayed the same. This is based on the findings at this inspection.

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 coronavirus and other infection outbreaks effectively.

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.

The last rating for this service was requires improvement (published 17 April 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two inspections.

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

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.