During an assessment under our new approach
Our view of the service
About the service
Linden Cottage is a care home. The service provides accommodation and personal care for up to 6 people living with a learning disability. It is a converted building and accommodated 5 people at the time of this assessment.
Who the service is for
This is a specialist service for people with a learning disability. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence, and good access to local communities that most people take for granted.
Key findingsWe carried out this assessment on 2 and 16 September 2026. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.
People living at Linden Cottage had a number of health and physical needs. Risks associated with these and providing safe care and support had been assessed and responded to. Staff responded to any accident and incidents quickly. Staff described emergency situations that required immediate interventions to maintain people’s safety and health. Reporting systems used supported a thorough review and mechanism to learn and take actions to reduce any ongoing risk. For example, reviews with professionals to support safe swallowing were undertaken following any concerns being identified.
Staff had completed safeguarding training and had a good understanding of how to respond to safeguarding concerns. These were raised quickly to an appropriate manager and referred as safeguarding concerns when appropriate. This supported people against discrimination and abuse.
The environment was well designed and adapted to support people with high physical needs and disabilities. It was well maintained and systems were in place to ensure relevant health and safety checks were maintained.
There were enough staff with appropriate skills deployed in the service to meet people’s support and care needs. Records confirmed appropriate recruitment procedures were followed. Staff completed regular training to ensure they had relevant skills and knowledge. This included training on supporting people with a learning disability and specific care needs. For example, equipment used in the support of nutrition and breathing. Staff told us, “Yes we have enough staff to look after people well.” And “The training is very good.”
Systems and training ensured medicines were handled safely and people received their prescribed medicines at the correct times. Electronic Medicine administration records (eMAR) were used and staff worked in pairs to complete checks and audits. This supported safe practice and stock control.
A full assessment of people’s needs was completed with input from family and the local authority before a placement was agreed. This took account of people’s complex care needs and included a number of visits to the service. People’s needs were reviewed with their keyworkers on an ongoing basis and staff worked closely with the local authority.
People’s health needs were assessed with health care professionals to support evidenced based care. A visiting professional was positive about the staff and their commitment to people and delivery of best care. They said, “Staff follow the correct procedures and record what they have done. Everything is kept correctly with attention to infection control. Staff are all up to date with relevant training to ensure best practice.”
Staff recognised changes in people’s health and responded. For example, they had completed additional training to understand one person’s health needs more deeply. This had allowed for early interventions that had reduced the need for regular admissions to hospital improving their health outcomes.
Staff worked hard to support people to have choice and control over their lives whenever possible. Every opportunity to involve people in decisions was taken. This practice ensured the ‘Right support, right care, right culture’ guidance and principles were followed.
Each person had an allocated key worker to facilitate individual choice. A staff member confirmed, “We always ask people and give them choices. We are working on next week’s menu at the moment. People have different ways of showing what they want with the help of pictures.”
People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions. They had choice, control and freedom over their lives.
Observations and discussions with staff confirmed staff were kind, thoughtful and patient. They promoted individual choices in a way that people understood and could respond to. A staff member told us, “This place has changed my perspective on care homes, everyone is so compassionate here and everyone is so conscientious about doing the right thing for people.” There were good relationships seen between people and staff and both enjoyed each other’s company.
Staff worked hard to promote people’s independence, choice and dignity. Staff described how people were supported to eat as independently as possible making choices on what they wanted to eat. We observed food choices being offered with photographs being used to aid understanding.
People’s individual needs and preferences were accommodated. This included supporting people to have active and enjoyable lives. Recent endeavours by staff and managers had provided additional opportunities to people to be included in further activities and entertainment. A staff member said, “We make sure they can go anywhere anyone else would. They have as much right to live like anyone else.” This supports the ‘Right support, right care, right culture’ guidance and principles.
The registered manager and deputy manager provided stable and effective leadership for the service. They had regular contact with people and staff receiving daily feedback from both. Staff felt listened to, able to share their views, and valued for the work they completed.
The organisation’s vision and values were shared via the management team’s approach and conduct and within the induction and ongoing training provided. Quality systems were in place and used to improve the service. However, complaints and issues raised were not routinely recorded. The opportunity to record themes and trends was therefore missed. This was discussed with the registered manager who confirmed records would be kept in the future to confirm actions taken to resolve issues and to confirm any learning as a result.