We carried out a review of the data available to us about Linden House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Linden House, you can give feedback on this service.
Linden House provides accommodation for people who require nursing or personal care for up to 60 older or younger people some of whom may be living with dementia. There were 52 people living at the home at the time of this inspection. The service has two residential units on the ground floor and two nursing units on the first floor. The home also has several themed living spaces about the home. For example, Linden square café Piazza, curiosity shop, post office and salterns coffee shop. The home is located a short walk from the town of Lymington in Hampshire.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
People felt safe living at Linden House and they were very much at the heart of the service. People’s families felt the service went above and beyond and were extremely experienced at looking after people living with dementia. People received excellent care that was based around their individual needs and that ensured care was personalised and responsive.
Staff working at Linden House understood the needs of people using the service and supported people in an exceptionally personalised way. Staff knew people well and we saw that care was provided respectfully and sensitively, taking into account people’s different needs. This meant people were able to maintain their independence and achieve a good sense of self-worth and wellbeing.
The provider employed an Admiral Nurse to support staff, people and their families living with dementia. The service recognised and responded to people’s needs for social interaction and mental stimulation. One person took part in an initiative by the Bournemouth university buddy orchestra and Alzheimer’s society to promote and respect care for people with dementia.
The home and gardens was designed to create a suitable environment for people living with dementia. People’s wellbeing and independence had been enhanced by the environment. This ensured people had a meaningful life and created a relaxing and calm atmosphere around the home. NICE guidelines were used in creating an environment for people living with dementia. To help people manage their surroundings and reduce feelings of confusion and anxiety.
The home developed and promoted community involvement within the home. The home hosted a mini classic car show which brought back special memories for people. People, their families and staff took part in the local carnival procession. The home had built strong links with the local community dementia matters group and as a result hosted a fortnightly art therapy group at the home.
The home was responsive to people’s needs and wishes. People were able to choose what activities they took part in and suggest other activities they would like to complete.
Relevant recruitment checks were conducted before staff started working at Linden House to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.
Staff had the specialist knowledge and skills required to meet people’s needs living with dementia. Specialist dementia care training was provided so staff could interact with people and fully understand and respond to their needs.
The risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies and fire safety checks were carried out.
People received varied meals including a choice of fresh food and drinks. Mealtimes were positive and sociable experiences. Staff were aware of people’s likes and dislikes and offered alternatives if people did not want the menu choice of the day.
Staff received regular support and received regular one to one sessions of supervision to discuss areas of development. Staff informed us they completed a wide range of training and felt it supported them in their job role. New staff completed an induction programme before being permitted to work unsupervised.
People felt they were treated with kindness and said their privacy and dignity was respected. Staff had an understanding of the Mental Capacity Act (MCA) and were clear that people had the right to make their own choices. Staff sought consent from people before providing care and support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
The home maintained a good level of communication with people through a range of newsletters and meetings. ‘Residents meetings’ and surveys allowed people and their families to provide feedback, which was used to improve the service. People felt listened to and a complaints procedure was in place.
Regular audits of the service were carried out to assess and monitor the quality of the service. There were appropriate management arrangements in place.
At the last inspection on 08 and 09 June 2015 the service was rated Good. At this inspection we found the service was outstanding.
Linden House is registered to provide accommodation for people who require nursing or personal care for 60 older or younger people who may be living with dementia. Living accommodation was arranged with two residential house groups on the ground floor and two nursing house groups on the first floor. At the time of our visit three of the four house groups were operational. The home was purpose built and opened in 2014. All rooms are single occupancy with on-suite facilities. There are lounge and quiet areas in each of the four house groups. The home also has several themed living spaces about the home. For example, Linden Square Café Piazza, Curiosity Shop, Post Office and Salterns Coffee Shop. The home has a dementia friendly garden with a putting green, boules area and a themed ‘town square’ area to stimulate memory. The home is located a short walk from the town of Lymington in Hampshire.
On the day of our inspection visit 41 people were living at the home. There was not a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The manager had recently transferred from another of the provider’s homes and their application to become the registered manager at this location had been received by the Care Quality Commission in May 2015.
This inspection took place on 8 and 9 June 2015 and was unannounced.
People had a variety of complex needs including dementia, physical health needs and mobility difficulties.
The provider had systems in place to respond and manage safeguarding matters and make sure that safeguarding alerts were raised with other agencies.
People who were able to talk with us said that they felt safe in the home; and if they had any concerns they were confident these would be quickly addressed by the staff or manager
People had risk assessments in place to identify risks that may be involved when meeting people’s needs. Staff were aware of people’s individual risks and had
Arrangements in place to manage these safely. Staff knew each person well and had a good knowledge of the needs of people, especially those people who were living with dementia.
There were sufficient numbers of qualified, skilled and experienced staff deployed to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider operated safe and effective recruitment procedures.
Medicines were stored and administered safely. Clear and accurate medicines records were maintained. Training records showed that staff had completed training in a range of areas that reflected their job role.
Staff received supervision and appraisals were on-going, providing them with appropriate support to carry out their roles.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection applications had been submitted by the managing authority (care home) to the supervisory body (local authority) and had yet to be authorised. The manager understood when an application should be made and how to submit one. They were aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty.
Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.
The food menus offered variety and choice. They provided people with nutritious and a well-balanced diet. The chef prepared meals to meet people’s specialist dietary needs.
People were involved in their care planning, and staff supported people with health care appointments and visits from health care professionals. Care plans were amended to show any changes, and care plans were routinely reviewed every month to check they were up to date.
People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed. Staff encouraged people to make their own choices and promoted their independence.
People knew who to talk to if they had a complaint. Complaints were passed on to the manager and recorded to make sure prompt action was taken and lessons were learned which led to improvement in the service.
People’s needs were fully assessed with them before they moved to the home to make sure that the home could meet their needs. Assessments were reviewed with the person their relatives and where appropriate other health and social care professionals.
People were encouraged to take part in activities and leisure pursuits of their choice, and to go out into the community as they wished.
People spoke positively about the way the home was run. The management team and staff understood their respective roles and responsibilities. The manager was approachable and understanding to both the people in the home and staff who supported them.
There were effective systems in place to monitor and improve the quality of the service provided. We saw that various audits had been undertaken.