CQC report explained · a nursing home
What the CQC found at Linksway
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always recorded, applied or disposed of safely. Risk records and some moving and repositioning practice also needed improvement, although staff safeguarding, recruitment and accident reporting systems were generally in place.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Requires improvement
- Care plans did not always contain enough detail about people's needs, preferences or communication. Activities were developing, and complaints were managed appropriately.
- Well-led?
- Requires improvement
- The home had governance and audit processes, but they had not found all the problems inspectors identified. The registered manager was open to feedback and took action during and after the inspection.
What inspectors found, August 2023
Linksway rated Requires Improvement; inspectors found caring staff and good health support, but unsafe medicines management, incomplete care records and weak oversight.
The inspection took place without notice on 6 and 12 June 2023. Inspectors spoke with people, relatives, staff and health professionals. They reviewed care records, medicine records, staff files and management records.
The home was not always safe or responsive. Medicine records and the handling of some medicines were not always safe. Risk records did not always show the care given, and staff did not always support people to change position safely. Care plans lacked important information about people's communication, preferences and distress.
The systems used to check quality had not found all these problems. The registered manager was open about the concerns and took some immediate action. The overall rating changed from Good in 2019 to Requires Improvement. This means improvements are needed and there is limited assurance that care is consistently safe and well managed.
Kind and reassuring care
People and relatives spoke positively about the care and safety of the home. Inspectors saw staff spending time with people and responding to their needs.
“Staff take marvellous care of me. I am very happy here” from the report
Health outcomes
Inspectors found that risks were generally well managed and saw improvements in some people's health conditions. There were no people with pressure ulcers at the time of the inspection.
“People's outcomes demonstrated risks were well managed overall. For example, there were no people with pressure ulcers at the service.” from the report
Links with health professionals
Staff made prompt referrals when people's health changed and worked with health and social care professionals. Visiting professionals spoke positively about the home's response.
“Staff made prompt referrals to relevant healthcare services when changes to health or well-being had been identified.” from the report
Open response to concerns
The registered manager accepted the inspectors' concerns and took immediate action, including reviewing policies, speaking with staff and improving monitoring.
“The registered manager was open and transparent during the inspection, and in relation to concerns raised.” from the report
Medicines were not always managed safely
seriousMedicine administration records were incomplete or not completed in line with the home's policy. Guidance and records for topical medicines were inconsistent, and some medicines were not disposed of correctly.
“Medicines administration records (MAR) were not consistently completed in line with the medicines policy and best practice guidance.” from the report
Risk records and moving support
seriousRecords did not always show whether people had received the repositioning support they needed. Staff also needed more skills to support people safely when changing position.
“Improvements were needed to documentation and recording, to ensure this accurately reflected the care being provided, for example when people were being supported with repositioning.” from the report
Care plans lacked important detail
seriousCare plans contained minimal information about some people's support needs, preferences and communication. One person's distress and confusion were not covered by a specific care plan.
“There was no specific information in care plans about people's communication needs and care plans were not available in different formats, for example large print.” from the report
- 01What has been done to make sure medicine records, topical medicine applications and medicine disposal are now completed safely every time?
- 02How do you check that people are repositioned according to their individual needs, and that staff have the right moving and handling skills?
- 03Have all care plans been rewritten with clear information about communication needs, personal preferences and how to support distress or confusion?
- 04What changes have been made to the audit and governance systems so they identify problems before they put people at risk?
- 05What progress has been made on the action plan, and what evidence can you show that the improvements are lasting?
This inspection rated Safe, Responsive and Well-led and included infection prevention and control; the report does not give ratings for Effective or Caring. This explanation was written from the published report of 8 August 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, August 2020
Linksway was inspected but not rated; inspectors found strong infection prevention and control measures.
Inspectors visited the home on 13 August 2020. This was an announced, targeted inspection as part of a national review of infection prevention and control in care homes during the coronavirus pandemic.
They found that the home was following current infection control guidance. This included social distancing, shielding, personal protective equipment, testing, safe admissions, cleaning, visitor arrangements and plans for managing outbreaks.
Staff received relevant training and regular updates. People were supported with activities, contact with family and friends, and safe visits. Staff also had access to emotional support and counselling.
The home was inspected but not rated. This means the report gives findings about infection prevention and control only, rather than an overall quality rating.
Infection control leadership
An infection control lead helped housekeeping and care staff work together. The home also had Covid-related risk assessments and cleaning schedules that were monitored.
“There was an infection control lead. This enabled the housekeeping team and care staff to work effectively together” from the report
Staff training and support
Staff received training about keeping people safe during the pandemic. They also had access to counselling and support for their emotional response.
“The provider had also ensured staff had access to training about their emotional response to the pandemic and counselling support.” from the report
Support for people's wellbeing
Staff provided individual activities, regular visits to people in their rooms and support in communal areas while maintaining physical distancing.
“There were many examples of engaging person centred time and monitoring people's wellbeing.” from the report
Contact with families
People were helped to stay in touch with family and friends by phone and video calls. Safe visits could also be booked.
“Staff helped people to stay in touch with family and friends through phone and video calls.” from the report
Inspectors raised no specific concerns in this report.
- 01How are visitors currently booked and managed safely?
- 02How often are staff and residents tested, and what happens if someone tests positive?
- 03How are PPE supplies, use and staff training checked now?
- 04How are people supported to keep in touch with family and take part in activities if infection controls are needed?
- 05When was the infection prevention and control policy last reviewed?
This was a targeted inspection of infection prevention and control measures only; the service was inspected but not rated and the other areas of care were not assessed. This explanation was written from the published report of 26 August 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.
Every inspection of Linksway
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2020Inspected but not ratedSafe: Inspected but not rated
- March 2019Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Good
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2010
Registered with the Care Quality Commission on 26 October 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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17 live-in carers within about an hour of Devon
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 £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
“She is such a warm and gentle person while being professional and competent at the same time.”
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
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.