Linden Lodge Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed before they moved into the home, where possible. People’s assessments covered their health conditions, communication needs, and personal care preferences. Staff worked with people, relatives and other health and social care professionals to gather detailed, person‑centred information. The outcomes of these assessments were used to determine whether the staff could safely and effectively meet each person’s needs.

Some people and relatives were able to visit the home before deciding to move in. Others were discharged directly from hospital and did not have this opportunity. In these cases, staff met with them and reviewed and updated initial assessments as they learned more about each person’s needs, routines and expectations. This ensured people received care which remained effective and continued to reflect what they needed and wanted. One relative told us because of this approach, “They did absolutely fantastically from the day [person’s name] went in, staff were nothing but caring and professional, it made [their care] go really well.”

The assessment of people’s needs was used to create an initial care plan, which staff then updated and refined as they got to know each person better. One staff member explained, “When we assess someone initially, we put that in the initial care plan, and as we get to know the resident more, we keep it up to date.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People were supported to have enough to eat and drink to help them remain well. People described mealtimes as social and enjoyable, and we saw staff actively promoted choice. One person told us, “The food is good; they have choices every day and in the evening of hot or cold buffet.” Another said, “[It’s] smashing food, if we don’t like what is on the menu, they would do something else for you.”

Systems to communicate information regarding people’s allergies and dietary needs were working effectively. Where people required a specific diet or texture of food this was delivered in line with their needs and preferences. Catering staff explained they prepared alternative meals, snacks and treats so everyone could take part in celebrations. For example, by making cakes suitable for people with diabetes.

Staff understood the importance of good hydration and nutrition in maintaining people’s health and regularly offered people drinks. Where staff were concerned someone might not be eating or drinking enough, they used nationally recognised assessment tools to identify risk and escalated this to nurses and other health professionals, so appropriate support plans could be put in place.

Staff were also knowledgeable about other evidence‑based tools, such as those used to assess skin integrity, and malnutrition universal screening tools, ensuring people received care and treatment aligned with best practice.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People told us staff worked well together and collaborated effectively with other health and social care professionals. This supported good continuity of care across staff teams and ensured people had timely access to input from professionals such as GP representatives, speech and language therapists, physiotherapists, wheelchair services and Diabetes or Parkinson’s disease specialists.

Other health and social care professionals confirmed the systems put in place by senior staff helped them to see people promptly and deliver effective care. One health and social care professional told us, “[Staff] know each [person] as an individual and exactly what their needs are in regards to medical history, medications and behaviours.”

Staff described communication within the team as positive and supportive. One staff member described communication between staff as, "Good, we try and keep it on a good level, everyone tries and supports each other where we can. Handovers are pretty good; we do a verbal handover where we tend to address any concerns or any medical concerns. As a pathway for communication, we have the handover on PCS. We all support and help each other where we can." Another staff member said, "We have verbal handovers at the end of every shift, if you have got any queries, you can query it then and there."

Staff also understood what essential information and items needed to accompany a person should they require hospital admission, helping to maintain continuity and safety during transfers.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Relatives described how staff support had helped people improve their physical health and mobility. A health and social care professional told us, “[People] are encouraged to take part in daily activities and to make healthy choices in regards to food and hydration.” This showed how staff promoted healthier lifestyles as part of people’s everyday care.

Staff had a good understanding of people’s overall wellbeing needs. People were encouraged to spend time in communal areas to support their social connections and emotional wellbeing and reduce isolation. One staff member explained, “To feel well is more than physical wellness. If you feel well in yourself, it helps any physical illness you may have. Your mental wellbeing is all part of looking at a person’s entire needs.” This demonstrated staff recognised the importance of holistic wellbeing, supporting people to stay physically, emotionally and socially well.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People were supported to monitor key aspects of their health. A health and social care professional told us staff’s approach to monitoring meant any changes in people’s health were identified quickly and communicated promptly, enabling appropriate plans to be put in place to meet people’s changing needs.

Care staff understood the importance of monitoring people through their observations and reporting any concerns to the clinical staff. One member of care staff explained, "Everything is very important because maybe it is an infection which needs quick attention, so it is always important to let the nurses know." Another staff member told us, "Communication is brilliant, we all keep an eye out for things. Sometimes it could be a rash; we put it on the system and let the nurse know straight away."

Staff used recognised tool to check for any signs of deterioration to ensure people received timely support. A staff member explained how they had appropriately and sensitively escalated a concern across staff teams and to external health and social care professionals, so a person’s needs would be met. People’s weight, percutaneous endoscopic gastrostomy sites, skin integrity, bowels and wellbeing were also monitored regularly to identify any emerging risks.

We found 1 person’s care plan required review to ensure staff had consistent guidance on blood sugar monitoring. The registered managers confirmed this would be addressed without delay.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were supported to make as many choices as possible and to retain control over their daily lives. We saw staff sought people’s consent before providing care, and staff understood why this was essential. One staff member explained, “One [person] says no because they want us to know they are in charge somewhere. I give it 5 or 10 minutes and go back to them. They have full capacity but sometimes you need to give them that time and for them it is to give them the opportunity to still be in charge of something in their life."

Staff had received training in The Mental Capacity Act 2005 (MCA) and worked in the least restrictive way, acting in people’s best interests when required. They applied MCA principles consistently, involving people and their families in decision‑making wherever possible, to ensure people’s rights were upheld. A staff member told us, “[People’s families and the resident themselves as much as possible would be involved. My views as a member of staff are also asked for.” A health and social care professional told us they were consulted as part of best interest decision making processes. This demonstrated a collaborative approach to ensuring decisions reflected each person’s wishes and needs.

Staff also understood when people had representatives with legal authority to make certain decisions on their behalf. One such representative told us, “[Registered manager] and staff were fabulous in supporting ourselves in a challenging situation and went far beyond what we expected.” This helped ensure the person’s wishes and rights remained central to the care they received.