CQC report explained · a residential care home
What the CQC found at Linden Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks were assessed individually, staffing levels met people's needs, recruitment checks were completed and medicines records had no gaps.
- Effective?
- Good
- People's needs and choices were assessed before admission. Staff received induction, training and supervision, and people were supported with food, healthcare, communication and lawful decision-making.
- Caring?
- Good
- Inspectors observed kind, caring and respectful support. People were involved in decisions about their daily lives and care, and staff promoted privacy, dignity, equality and independence.
- Responsive?
- Outstanding
- Support was highly personalised and helped people pursue education, employment, hobbies, relationships and independence. Communication methods were adapted to individual needs, including pictorial aids and easy-read information.
- Well-led?
- Good
- The home had a positive, open and person-centred culture. Quality checks, reviews of incidents and complaints, feedback from people and relatives, and action plans were used to monitor and improve care.
What inspectors found, January 2020
Rated Good, with Outstanding responsive care; inspectors found safe, kind and highly personalised support.
Inspectors made an unannounced visit on 20 December 2019. They spoke with five people, five relatives, staff and a visiting health professional. They reviewed care, medicine, recruitment, training and management records.
The home was rated Good overall. Safe, Effective, Caring and Well-led were all rated Good. Inspectors found people felt safe, received their medicines as prescribed, had enough trained staff and were treated with kindness, dignity and respect.
Responsive care was rated Outstanding. Inspectors found exceptional support for people's independence, relationships, education, work, hobbies and personal goals. Care plans were highly personalised and people were involved in decisions about their care.
This was an improvement in Responsive since the previous inspection, when it was rated Good. The other four question ratings remained Good, as did the overall rating.
Independence and goals
The home supported people to pursue education, work, hobbies and personal goals. Inspectors saw examples of people gaining skills and becoming more independent.
“People were actively supported by staff to engage in activities, education and employment, all of which had been designed to incorporate people's hobbies and interests and encourage social inclusion and independence.” from the report
Personalised support
Care plans described each person's mental health, needs, goals and preferred support. Staff showed detailed knowledge of the people they supported.
“Care plans were highly personalised to the individual and comprehensively listed their support needs, how their mental health affected them, their goals and aspirations.” from the report
Respect and involvement
People were involved in decisions about their care, routines, food and future plans. Staff respected people's privacy, dignity, culture, religion and sexuality.
“During the inspection we observed people were always involved in making decisions about every aspect of their life.” from the report
Safe medicines support
Inspectors found medicines were stored safely, given as prescribed and recorded completely. Staff were trained and their competence was checked.
“Medicine administration records were complete and no omissions or gaps in recording were identified.” from the report
Positive management
The home had systems to monitor care, medicines, health and safety, complaints and incidents. Inspectors saw that identified issues were acted on promptly.
“The provider had implemented comprehensive systems to assess and monitor the quality of care and support people received.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you support my relative to set and pursue their own goals, hobbies, education or work?
- 02How would you assess and manage my relative's specific mental health risks and update their care plan?
- 03How do you adjust staffing when residents need support with appointments, activities, outings or travel?
- 04How would you adapt communication if my relative found it difficult to speak, read or make choices?
- 05How would you involve my relative and our family in care reviews, decisions and future wishes?
This was an unannounced planned inspection of all five CQC questions; the previous rating was Good, and Responsive improved from Good to Outstanding. This explanation was written from the published report of 24 January 2020 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, June 2017
Linden Lodge was rated Good; inspectors found safe, kind and well-organised care, with minor improvements needed in recording activities.
This was an unannounced comprehensive inspection on 7 June 2017. One inspector and an expert by experience visited the home, spoke with people, relatives and staff, observed care, and checked care records, medicines, staff files and quality checks.
The home was providing care for 10 people with mental health conditions and was full on the inspection day. Inspectors found detailed risk assessments, safe medicines management, enough staff and robust recruitment checks. Staff were trained and supported, and people were helped to make choices and stay as independent as possible.
People had positive relationships with staff. Care plans were detailed and personal, and people were involved in their care, meals, activities and reviews. The home had received no complaints since the last inspection, and the manager and provider used audits and feedback to monitor care.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as at the previous inspection on 5 January 2015.
Detailed risk planning
Each person's risks were identified and there was guidance for staff on how to reduce or manage them.
“Risk assessments provided guidance as to how risks were to be managed or mitigated against in order to keep people safe.” from the report
Personal care plans
Care plans included people's needs, preferences, identity, history and guidance about how staff should support them.
“Care plans were detailed, person centred and provided information about people and how they wished for their care and support to be delivered.” from the report
Kind and respectful care
Inspectors saw trusting relationships between people and staff. Staff respected privacy, dignity and people's choices.
“We observed people had developed positive and caring relationships with staff that were based on respect and trust and which also ensured that their privacy and dignity was maintained.” from the report
Safe medicines practice
Medicines records were complete, storage was secure and staff administering medicines had their competence checked.
“Records confirming administration and management of medicines were complete and no gaps were identified.” from the report
Activity records
minorPeople had a choice of activities, but staff did not always record and review how people experienced them. The manager said improvements were being made.
“The registered manager told us that staff had not always been pro-active in recording and evaluating people's experience after an activity had taken place” from the report
- 01How do you now record and evaluate each person's experience after activities?
- 02How would you update my relative's care plan when their mental health or support needs change?
- 03How do you make sure staffing levels increase when people's needs change or they need an escort to an appointment?
- 04How would you support my relative with their particular dietary, cultural or religious needs?
- 05How are medicines, including any medicines given covertly, reviewed and monitored?
This was an unannounced comprehensive inspection covering all five key questions and checking the overall quality and legal requirements of the service. This explanation was written from the published report of 28 June 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 Lodge
3 rated inspections over 5 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- May 2012
Registered with the Care Quality Commission on 22 May 2012.
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 Enfield
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Most charge £980 to £1,260 a week. 79 can care for a couple. 11 years' experience on average.
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