CQC report explained · a residential care home
What the CQC found at Linden Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2018
Linden Grange is rated Good; inspectors found kind, safe and responsive care, with some small gaps in care planning, cleaning and access to coded doors.
This was an unannounced comprehensive inspection on 6 and 7 September 2018. Inspectors spoke with people living in the home, relatives and staff. They observed care and checked care plans, medicine records, recruitment files and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found medicines were handled safely, staffing levels were sufficient, risks were assessed and people received kind care that reflected their choices and needs.
The home had improved since the May 2017 inspection, when the overall rating was Requires Improvement and there were breaches about safety and leadership. Inspectors said the required improvements had been made.
Safer medicines
The home had improved its medicine systems since the previous inspection. Staff had received further training and inspectors found medicines were handled safely.
“Medicines were stored, managed and given to people safely and in accordance with best practice.” from the report
Kind and respectful care
People said staff were caring and inspectors saw relaxed, friendly interactions. Staff respected privacy, offered choices and encouraged people to remain independent.
“People made positive comments to us about the staff that provided care and support for them.” from the report
Personalised support
Care plans described people's individual needs and preferences. Staff used personal histories and supported activities, hobbies and visits outside the home.
“People had care plans that were personalised to their needs.” from the report
Improved leadership
The provider had strengthened its checks on safety and quality since the previous inspection. Management listened to feedback and took action when problems were found.
“Improvements had been made to the quality assurance system to ensure people received a safe, effective and responsive standard of care.” from the report
Care plan did not include skin-care advice
needs fixingOne person had skin damage and district nurse advice about elevating their leg had not been added to the care plan. Inspectors raised this and immediate action was taken.
“this advice had not been incorporated into the plan of care used by staff” from the report
Some bedrooms missed deep cleaning
minorA few bedrooms had missed their planned deep clean because of staff holidays, and thick dust had built up. The home cleaned the room discussed with inspectors and said usual standards would be maintained.
“a few bedrooms had not received their planned deep-clean due to recent staff holidays and some thick dust had built up on some surfaces.” from the report
Access through coded doors
needs fixingPeople who had capacity were dependent on staff for the code to some doors. The provider said the code would be displayed in an accessible way.
“people with capacity were dependent on asking staff for the code if they wished to open coded doors.” from the report
- 01How do you make sure advice from district nurses and other health professionals is added promptly to care plans?
- 02How do you check that bedrooms receive their planned deep cleans, including when housekeeping staff are away?
- 03Can residents who have capacity access coded doors independently, and how is this managed in practice?
- 04How are medicine changes, returned medicines and disposal records checked?
- 05How do you use residents' and relatives' feedback to decide what needs to improve?
This was an unannounced comprehensive inspection covering all five key questions and checking whether improvements required after the May 2017 inspection had been made. This explanation was written from the published report of 21 September 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.
What inspectors found, July 2017
Requires Improvement; inspectors found kind and responsive care, but medicines safety and management oversight were not reliable.
This was an unannounced inspection on 31 May 2017 by two inspectors. They spoke with people living at the home, relatives and staff. They observed care and checked care plans, food and drink records, medicine records and quality checks.
People generally felt safe and said there were enough staff. Staff were caring, respectful and supported people's choices. The home provided suitable meals, activities, healthcare support and ways for people and relatives to give feedback.
The main problems were with medicines and management checks. Medicines were not always sent home with people after short stays. Medicine records and controlled drug checks were not always completed correctly, and some staff lacked important medicines knowledge. Management audits had not found these problems or other risks.
The overall rating was Requires Improvement. Effective, Caring and Responsive were rated Good. Safe and Well-led were rated Requires Improvement. The report found breaches of two regulations, and the provider was required to say what action it would take.
Kind and respectful staff
People said staff were caring and respectful. Inspectors saw staff offering reassurance, promoting dignity and supporting people to make everyday choices.
“People told us they felt well cared for because the staff were 'very nice', 'wonderful' and 'lovely, really good to me'.” from the report
Enough staff
People and staff said there were enough staff to meet people's needs. Inspectors saw staff responding to call bells and spending time with people.
“Everyone we spoke with told us there was always enough staff to support them according to their needs.” from the report
Food and health support
People had choices about meals and staff supported dietary needs. Healthcare professionals were involved when people's health or weight changed.
“People were supported to eat a balanced diet that met their dietary needs and preferences.” from the report
Activities and involvement
People could take part in group and individual activities, follow their faith and pursue hobbies. Residents and relatives were able to give feedback.
“People and their relatives told us they felt able to give feedback and that ideas would be acted up on.” from the report
Medicines were not consistently safe
seriousSome medicines were not sent home after short stays. There were errors or gaps in controlled drug records, medicine fridge checks and staff knowledge. This was a breach of Regulation 12.
“The provider's system for the management of medicines was not always effective or safe.” from the report
Management checks missed risks
seriousAudits did not identify medicines problems or make sure action was taken after accidents and infections. This was a breach of Regulation 17.
“The provider's systems and processes to monitor the safety and quality of the service were not always effective.” from the report
Some records were out of date or unclear
needs fixingSome care plans did not reflect changed needs. Food monitoring records were not always accurate and staff were unclear about how they should be used.
“Some care plans had not been updated recently.” from the report
- 01What changes have been made to ensure medicines go home with people after short stays?
- 02How are controlled drug records, medicine fridge temperatures and staff medicines competency now checked?
- 03Who is responsible for quality audits, and how are actions tracked until risks are reduced?
- 04How are care plans updated promptly when a person's needs or abilities change?
- 05What action was taken in response to the 20 accidents recorded in April 2017?
This was an unannounced inspection of the overall service, checking all five CQC questions and whether improvements from the July 2016 inspection had been made. This explanation was written from the published report of 7 July 2017 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 Linden Grange
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2014
Registered with the Care Quality Commission on 22 September 2014.
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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At least 100 live-in carers within about an hour of Warwickshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £950 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.