CQC report explained · a nursing home
What the CQC found at Linfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, appropriate safeguarding arrangements and improved risk assessments. Medicines were administered safely, and infection prevention measures were in place.
- Effective?
- Good
- This key question was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found clearer management roles, more monitoring and improved quality checks. Staff said they felt supported, and the home showed it had learned from medicines and discharge problems.
What inspectors found, July 2021
Linfield House rated Good; inspectors found safe, kind care, but recent feedback surveys had not been completed.
This was an unannounced, focused inspection on 10 June 2021. Two inspectors observed care, spoke with six people and eight staff, reviewed care, medicines, recruitment and management records, and spoke with a visiting professional.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe medicines practice, suitable safeguarding systems, improved risk assessments and effective infection control measures. People were treated with respect, offered choices and supported to take part in activities.
The last rating was Requires Improvement in October 2019. Inspectors found enough improvement had been made, and the provider was no longer in breach of Regulations 12 and 17. This inspection did not assess Effective, Caring or Responsive. Their previous ratings were carried forward into the overall rating.
Enough staff
Inspectors found staffing levels met people's needs. Staff responded promptly to requests and adjusted staffing when people needed one-to-one support.
“People were cared for by enough staff who responded to their requests appropriately.” from the report
Respectful care
People were treated kindly and offered choices about food and support. Inspectors saw people relaxed, engaged and involved in activities.
“Staff were observed to treat people with respect and kindness.” from the report
Safer medicines systems
Medicines were given safely by trained staff. The home introduced an electronic medicines record after previous errors and trained staff to use it.
“The service has started to operate an electronic medication administration record (eMAR) system, staff had been trained to use the system.” from the report
Improved oversight
The home had improved its care planning and quality monitoring since the previous inspection. The provider was no longer in breach of the earlier governance regulation.
“We found enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17.” from the report
Feedback surveys
minorThe home normally sought formal feedback annually, but inspectors said surveys had not taken place for some time. Ask how relatives and people can now give feedback and how the home acts on it.
“there had not been any surveys for some time.” from the report
- 01What are the current ratings and findings for Effective, Caring and Responsive, which were not inspected during this visit?
- 02How do you now gather feedback from people and relatives, given that surveys had not taken place for some time?
- 03Has the manager's application to register with the CQC been completed?
- 04How are the electronic medicines records and extra checks continuing to prevent the previous medicines errors?
- 05How do you make sure belongings and medicines are returned safely when someone is discharged?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key question ratings were carried forward from previous comprehensive inspections. This explanation was written from the published report of 8 July 2021 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, October 2019
Rated Requires Improvement; inspectors found kind, personalised care but serious weaknesses in risk records, care records and oversight.
This was an unannounced inspection on 20 and 21 August 2019. Inspectors spoke with 12 people, seven relatives and 13 staff. They observed care and reviewed care records, medicines records, staff files and management records.
People were generally treated with kindness and respect. Staff knew people well, responded to their choices and provided enough support. Inspectors rated the home Good for Effective, Caring and Responsive care.
However, some risk assessments and care records were incomplete or contradictory. This created a risk that people could receive unsafe or inconsistent care. The home also failed to notify CQC about some incidents and its quality checks had not found these problems.
The overall rating was Requires Improvement. Safe and Well-led both fell from Good at the previous inspection. CQC identified breaches and said it would request an action plan, monitor progress and return to inspect again.
Kind and respectful care
People were treated with compassion and dignity. Staff responded sensitively when people needed help or became upset.
“Throughout the inspection we observed staff speaking to people in a kind and respectful way.” from the report
Staffing and continuity
Inspectors found enough staff to meet people's assessed needs. People received support on time, and regular staff knew them well.
“There were enough staff on duty to meet peoples assessed needs.” from the report
Personalised support
Staff understood people's backgrounds, interests and preferences. This helped them provide care that was personal to each resident.
“Staff were knowledgeable about people's lives and knew what was important to them.” from the report
Activities and relationships
People had varied activities, community trips and support to keep in touch with family and friends. They could also take part in religious services if they wished.
“People had access to meaning full occupation and activities.” from the report
Training and healthcare
Staff received induction, training and supervision. People had access to routine and specialist healthcare, including weekly visits from a nurse practitioner.
“Care records showed that people had access to routine and specialist health care appointments” from the report
Incomplete risk assessments
seriousSome assessments did not explain the risks clearly or tell staff how to keep people safe. This included risks linked to infections, mobility and choking.
“Some risk assessments lacked detail and did not provide guidance for staff on how risks could be mitigated.” from the report
Conflicting care instructions
seriousDifferent records gave different instructions about mobility and food texture. One person was left alone with food cut into large pieces despite a recorded need for supervision.
“People were at risk of receiving inconsistent or unsafe care; care plans and risk assessments had conflicting information.” from the report
Incorrect thickener
seriousInspectors found that a person at risk of choking was being given the wrong level of thickener, and the tub was not prescribed for that person. Staff corrected this immediately when it was reported.
“The person's care plan identified that they required level three thickener and the tub contained level two.” from the report
Weak record and quality checks
needs fixingThree care-record systems were being used without a clear process to keep information consistent. Management checks had not found incomplete or inaccurate records.
“There were no process in place to ensure the information held within these records was consistent and up to date across all systems.” from the report
Missed CQC notifications
seriousThe home did not notify CQC about nine incidents covered by local authority safeguarding guidance during the previous 12 months.
“The services own records showed that there were nine incidents considered under the local authorities safeguarding guidance in the 12 months prior to our inspection that CQC were not notified about.” from the report
- 01How have you corrected the conflicting mobility, choking and food-texture instructions found in people's records?
- 02How do you now check that every person's risk assessment gives staff clear, up-to-date guidance?
- 03How are the three care-record systems being managed so that information is consistent across all records?
- 04What action has been taken to ensure all incidents that must be reported are notified to CQC on time?
- 05How do you check that staff have read and understood each person's care plan before providing support?
This was an unannounced comprehensive inspection covering all five CQC questions, with the home and the care provided both assessed. This explanation was written from the published report of 5 October 2019 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 Linfield House
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 January 2011.
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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