CQC report explained · a residential care home
What the CQC found at Linda Grove
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk assessments and care guidance were missing for some health conditions and risks such as choking, malnutrition, skin breakdown and falls. The premises, equipment and infection control were also not always safe, although there were enough staff at the time of the inspection and some problems were corrected during the visit.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its rating was carried over from a previous comprehensive inspection.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its rating was carried over from a previous comprehensive inspection.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its rating was carried over from a previous comprehensive inspection.
- Well-led?
- Inadequate
- Leadership and quality monitoring did not provide enough oversight or drive the improvements needed. The manager was usually at the home only one or two days a week, and the home was without sufficient or consistent leadership for much of the time.
What inspectors found, March 2022
Rated Requires Improvement; inspectors found safety problems and inadequate leadership, although staff were kind and some improvements began during the visit.
Inspectors visited the home without notice on 2 and 8 February 2022. They looked only at Safe and Well-led because the inspection followed concerns about the environment, infection control and staffing. They observed care, spoke with staff, a relative and professionals, and checked care, medicine, recruitment and management records.
The home was not always safe. Risk assessments and guidance for health conditions were missing or incomplete. The building and some equipment were not secure or properly maintained. Infection control was not reliable, including problems with protective equipment, testing, cleanliness and audits. Inspectors found no evidence that people had been harmed, but said people were at increased risk.
The home was rated Inadequate for Well-led. Leaders did not have enough oversight, and quality checks had not led to necessary improvements. There were breaches relating to person-centred care, safe care and treatment, premises and equipment, and good governance. Staff were described as kind and supportive, and managers started to address some concerns during the inspection, but more progress was needed.
Kind staff
Staff treated people with kindness and respect. People appeared relaxed with them, and staff supported relationships and personalising bedrooms.
“Staff interacted with people in a kind, caring and respectful manner and people appeared relaxed in their company.” from the report
Enough staff at the visit
Inspectors found enough staff to support people safely, including one-to-one support for activities and visits.
“At the time of our inspection, the service had enough staff, including for one-to-one support for people to take part in activities and visits how and when they wanted.” from the report
Staff safeguarding awareness
Most staff had safeguarding training and understood how to raise concerns. They were confident the manager would act appropriately if needed.
“Most staff had undertaken training in safeguarding procedures.” from the report
Some immediate action
Managers acted on some concerns during the two visits. This included securing items, windows and doors, restoring monitoring equipment and improving some infection control measures.
“The manager acted on some of the concerns we raised, and improvement was noted on our second site visit.” from the report
Missing risk guidance
seriousSome people had risks linked to choking, malnutrition, skin breakdown and falls, but the necessary assessments and instructions for staff were not in place.
“Some people were at increased risk of choking, malnutrition, skin breakdown and falls but there was a lack of risk assessments in place to guide staff” from the report
Unsafe and poorly maintained premises
seriousThe heating, patio, kitchen drawers and some equipment needed attention. Some cupboards, windows and doors were not secure on the first day.
“The home was not well maintained which presented health and safety concerns.” from the report
Infection control shortfalls
seriousInspectors were not assured that protective equipment, COVID-19 testing, cleaning and infection control policies were being used effectively.
“We were not assured that hygiene practices promoted safety.” from the report
Weak leadership and monitoring
seriousThe provider's audits did not consistently identify problems or ensure they were corrected. Leadership was not present consistently enough to oversee the home.
“Quality assurance systems and processes did not identify, or address issues found at inspection.” from the report
Care was not always personalised
seriousPeople were not involved in developing their care plans, and staff did not always follow guidance about activities and preferences. Care plans also lacked goals and longer-term aspirations.
“The failure to provide people with person-centred care was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014” from the report
- 01What risk assessments and care guidance are now in place for choking, falls, malnutrition, skin breakdown and each person's health conditions?
- 02What work has been completed to repair and secure the building, and how are equipment servicing and safety checks now monitored?
- 03How do you check that staff follow current infection control, PPE, COVID-19 testing and cleaning procedures?
- 04Who is responsible for the home's day-to-day management when the manager is not present?
- 05How are people now involved in their care plans, activities, goals and longer-term aspirations?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 16 March 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2018
Rated Good; inspectors found safe, kind and personalised care, with some mixed staff views about management support.
The inspection was unannounced and took place on 16 October 2018. One inspector spoke with four staff members and the regional manager, observed care, and checked care records, medicines, staff files, complaints and quality checks. The four people living at the home were unable to speak with the inspector.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable training, detailed care plans and kind support. People were helped to make choices, stay healthy, take part in activities and maintain their independence.
The home had improved since the March 2016 inspection. Care plans, which had not then been reviewed regularly, were now detailed, up to date and monitored. Staff views about support from the registered manager were mixed, and the regional manager planned to explore this.
Safe staffing and risk support
Inspectors found enough staff to meet people's needs and keep them safe. Staff understood individual risks and responded appropriately when someone became distressed.
“There were sufficient staff to meet people's needs and keep them safe.” from the report
Kind and respectful care
Staff knew people well and treated them with kindness, respect and compassion. They supported privacy, dignity, communication and independence.
“We observed caring, encouraging interactions from staff throughout the inspection.” from the report
Personalised support
Care plans contained detailed information about people's needs, preferences and interests. Support was reviewed and changed when people learned new skills or enjoyed new activities.
“People received a personalised service that met their needs.” from the report
Improved care records
The home had acted on the previous inspection's recommendation about care plan reviews. Records were now current and detailed.
“We found care plans were detailed, up to date and reflective of people's current needs.” from the report
Quality monitoring
Regular checks covered areas such as medicines, nutrition, infection control and safety. Identified issues were added to an improvement plan.
“There were procedures in place to monitor the overall quality of the service provided.” from the report
Medicine record timing
needs fixingOne staff member signed a medicines administration record before the person had received the medicine. Managers said this would be addressed, but families may want to ask how this is now prevented.
“the staff member signed the MAR before the person had received their medicine.” from the report
Mixed views about management support
needs fixingSome staff did not feel supported or able to approach the registered manager, particularly during changes in the people living at the home. Other staff gave positive feedback.
“Three members of staff told us that they did not always find them approachable or supportive” from the report
Bathroom decoration
minorThe bathroom needed decorating. Staff said the work was planned once funding had been secured.
“The bathroom was in need of decoration and a senior staff member told us this work was planned once funds had been secured.” from the report
Earlier induction problems
minorOne longer-serving staff member said their induction had not been good. The home had introduced a more thorough induction, including a buddy system, and newer staff reported better support.
“My induction wasn't great, there were a lot of issues at the time” from the report
- 01How do you make sure medicines administration records are signed only after the person has taken their medicine?
- 02What support and training do staff receive when a new person moves into the home or their behaviour changes?
- 03How do you check that staff feel supported by the registered manager?
- 04Has the planned bathroom decoration been completed, and if not, when will it be done?
- 05How will you involve my relative and our family in reviewing their care plan?
This was an unannounced comprehensive inspection covering all five CQC questions, and the people living at the home were unable to speak directly with the inspector. This explanation was written from the published report of 13 November 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Linda Grove
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- March 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Inadequate
- November 2018Goodstayed GoodSafe: GoodWell-led: Good
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 20 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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