CQC report explained · a nursing home
What the CQC found at Link House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Link House was rated Good; inspectors found clear improvements in safety, staff support and management since the previous inspection.
This was an unannounced focused inspection on 19 December 2022. One inspector spoke with people living at the home, staff, managers and outside professionals. The inspector reviewed care plans, staff records, medicines records and management documents.
The home had improved since the previous inspection. Risk assessments and care plans were up to date, medicines were stored safely, staffing levels had improved and staff training and support were stronger. The home had a registered manager in post, and managers were using audits and action plans to check and improve care.
The home was rated Good overall, with Good ratings for Safe, Effective and Well-led. This inspection did not cover Caring or Responsive. The report says the overall rating also used ratings from the previous inspection for those areas.
Safer risk management
Care plans contained individual risk assessments and clear instructions for staff. These were reviewed when people's needs changed.
“People's care plans now contained up to date, individualised risk assessments and management plans, which helped staff prevent or manage hazards people were at high risk of facing.” from the report
Medicines were well controlled
Medicines were kept in locked rooms, cupboards, trolleys and fridges. Records checked by inspectors had no errors or omissions.
“Medicines records were kept up to date with no recording errors or omissions found.” from the report
More stable leadership
A registered manager had been in post for about a year, supported by an area manager. Inspectors found managers were approachable and used audits to drive improvement.
“A suitably competent manager had been in day-to-day charge of the care home for the last 12 months and was registered by the CQC in July 2022.” from the report
Improved staffing and training
The home had increased staffing on day shifts and was no longer heavily reliant on temporary staff. Training and supervision had also improved.
“In addition, the service had its full complement of staff and was no longer heavily reliant on temporary nursing or care staff who were not so familiar with the individual needs and preferences of people living in the care home.” from the report
Inspectors raised no specific concerns in this report.
- 01How have you kept management stable since the inspection, and who would be responsible for my relative day to day?
- 02How do you review my relative's risk assessments when their mobility, eating, drinking or behaviour changes?
- 03How do you check that medicines continue to be stored safely and given on time?
- 04What current staffing levels will be available on each shift, and how often will temporary staff be used?
- 05How will you involve my relative and our family in decisions, care reviews and feedback about the service?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and the report says their previous ratings were carried forward. This explanation was written from the published report of 12 January 2023 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, April 2022
Rated Requires Improvement; inspectors found risks from weak care guidance, unsafe medicine storage, incomplete staff training and unstable leadership.
This was an unannounced focused inspection carried out on 10 and 17 March 2022. Inspectors spoke with people living in the home, visitors, relatives, staff and health and social care professionals. They also reviewed care plans, medicine records, staff files and management records.
The home was not always safe. Some care plans and risk assessments were missing, inaccurate or not detailed enough to guide staff. Medicines and clinical equipment were also not always stored securely. Staff numbers had been low during the winter, although inspectors found enough staff on duty during their visit and the provider planned to increase staffing.
The home was not always effective because some staff lacked up-to-date training, supervision and appraisals. Leadership remained inconsistent because there was no registered manager and managers had changed frequently. The new management team had started an action plan, and people, relatives and staff gave positive feedback about the new managers.
The overall rating changed from Good to Requires Improvement. Safe, Effective and Well-led were all rated Requires Improvement. Caring and Responsive were not assessed during this focused inspection, so their previous ratings carried over.
Protection from abuse
The home had safeguarding procedures, and staff knew how to recognise and report abuse. Inspectors found people were protected against abuse and neglect.
“People were protected against the risk of abuse and neglect.” from the report
Infection control
Inspectors were assured about the home’s infection prevention arrangements, including personal protective equipment, testing, visiting and outbreak management.
“We were assured that the provider was using PPE effectively and safely.” from the report
Food and drink
People received meals and drinks suited to their dietary needs and preferences. Staff were seen supporting people to eat and drink respectfully.
“We observed staff assisting people to eat and drink in a dignified and respectful manner.” from the report
New management approach
People, relatives and staff spoke positively about the relatively new management team. Managers were described as approachable and had started an improvement plan.
“People living at the care home, their relatives, and staff all spoke positively about the way the care home was now managed by the new management team.” from the report
Incomplete risk information
seriousSome care plans and risk assessments did not explain clearly how staff should manage risks such as diabetes, falls, behaviours or mental health needs. Inspectors said this had placed people at risk of harm.
“People had been placed at risk of harm because staff did not always have access to sufficiently detailed guidance that made it clear what action they needed to take to keep people safe.” from the report
Unsafe medicine storage
seriousA medicines room had been left open. Needles were not in a lidded container, and medicines were in an unlocked fridge with its keys left in the lock.
“Inside this unoccupied room were needle sticks left in a lidless container on open shelving and stocks of medicines stored in an unlocked fridge with the keys left in the lock.” from the report
Gaps in staff training
needs fixingSome staff had not completed up-to-date training in areas including falls, pressure sores, moving people and handling medicines. Only half the staff team had received a formal appraisal in the previous year.
“Staff had not received all the up to date training and the support they needed to effectively carry out all their roles and responsibilities.” from the report
Unstable leadership
needs fixingThere was no registered manager, and three managers had been in day-to-day charge since the previous inspection. The home had been without a registered manager for 18 months.
“The care home also continues to experience unexpectedly high rates of management turnover.” from the report
- 01Have all care plans and risk assessments been checked and updated, particularly for diabetes, falls, behaviours and mental health needs?
- 02What changes have been made to ensure the medicines room, medicines fridge, needles and clinical equipment are always securely stored?
- 03Has every member of staff completed the outstanding training on falls, pressure sores, moving and transferring, and safe handling of medicines?
- 04Is there now a registered manager, and how long do you expect the current management team to remain in post?
- 05What evidence can you show that the action plan was completed by 1 May 2022 and that the improvements have been sustained?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 14 April 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.
Every inspection of Link House
8 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- January 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2022Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2021GoodSafe: GoodEffective: GoodWell-led: Requires improvement
- November 2020Inspected but not ratedSafe: Inspected but not rated
- March 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Requires improvementstayed Requires improvementCaring: Requires improvementWell-led: Requires improvement
- November 2016Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2015Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2019
Registered with the Care Quality Commission on 4 April 2019.
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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