Linden Lodge Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.This meant people’s needs were met through good organisation and delivery.

This service scored 82 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People said staff used their understanding of what mattered to them when planning and delivering care. Staff recognised what was meaningful to people and responded in ways which upheld people’s individuality. Relatives and friends also described how people’s support was tailored to their specific needs and preferences. For example, a relative told us staff had identified what their family’s goal was and worked with their family member and other health and social care professionals to help them to progress towards achieving this. A person’s friend told us, “Staff always made sure [person’s name] was clean and smart, and this was so important for them.”

Staff recognised how important it was for people’s wellbeing to continue with their preferred routines and supported them in ways which reflected what mattered to each individual. One staff member told us, “It helps them feel like they are more at home, that they have a say and it will help their state of mind because they are doing things the way they like to do them." Another staff member explained how people's desired routines were supported. They said, “If someone wants to get up at 8.00am every morning, we will try and make sure they are up at 8.00am every day. It ensures residents are being listened to and their choices are being met." These examples showed staff were committed to delivering person‑centred care and responding to people’s wishes in a consistent and meaningful way.

Staff were mindful of the impact of different environments on people’s wellbeing and understood different environments suited people. Staff adapted the support they provided accordingly. Some people enjoyed taking part in activities and spending time in busier areas of the home, while others preferred quieter spaces where they could relax more comfortably.

Staff said understanding people’s backgrounds and past occupations helped them make sense of how individuals reacted in different situations. One staff member explained this knowledge gave them meaningful topics to talk about and made care more person‑centred. They described someone who often picked things up and tried to take them apart because they had previously worked as a mechanic.

Staff were quick to notice changes in people’s demeanour. We saw a staff member who noticed someone looking withdrawn, sat with them and gently checked how they were feeling. When the person said they were having a low day, the staff member reassured them they were there to help and began chatting about their family, which helped lift their mood. Another staff member told us, “Emotional support is very important for residents. Sometimes we all get muddled up and it is nice if someone comes in and has a chat with you and unwinds that worry for you."

People’s care plans reflected their goals, needs and preferences, and were updated when changes occurred. Staff told us understanding how people’s wellbeing varied over time helped them keep care plans accurate and person‑centred. One staff member explained some people’s emotional needs could shift from month to month, so plans were reviewed to reflect how the person was feeling at the time.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People were supported by staff who ensured they had access to a full range of other health and social care professionals and specialists who were be able to support them. Staff use their knowledge of which other services were available locally to ensure people’s support needs were met. A health and social care professional told us staff triaged any concerns effectively, enabling people to receive timely and suitable referrals to their service.

Staff worked closely with other healthcare professionals to ensure their knowledge of people informed decision‑making. Professionals told us they were appropriately involved in key decisions about people’s care. One staff member explained weekly ward rounds with their GP’s representative and regular communication with the GP helped ensure any concerns were shared promptly and referrals were made in good time.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s sensory and communication needs were assessed, and care plans guided staff on how to communicate information in ways each person could understand. Although most people living at the home required only minimal adjustments in line with the Accessible Information Standards, the registered managers told us they would provide information in alternative formats when this was required.

Staff gave examples of how they adapted the way they communicated to meet people’s individual needs. One staff member explained a person sometimes preferred using a keyboard to express themselves because it was easier for them than speaking. Another described supporting someone to use a talking clock to help them stay independent and maintain a sense of time.

Staff also assisted people through communications which met their sensory needs. One staff member told us, "You look for posture, facial cues and when you touch them, their response. I adapt, I know which ear is better and to talk more slowly to some people." We saw staff took time with people and did not rush people to provide a response to their queries or questions.

Staff also adapted their communication to meet people’s sensory needs. One staff member told us, "You look for posture, facial cues and when you touch them, their response. I adapt, I know which ear is better and to talk more slowly to some people." We saw worked at people’s pace and allowed them time to understand information which was given to them, ensuring communication was comfortable and person‑centred.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People were encouraged to share their views and opinions at ‘resident and relatives’ meetings’ to drive improvement in the home. These gave people and relatives the opportunity to find out about developments at the home, contribute their ideas for events and celebrations and to provide feedback on the care provided. Group discussions were also held to provide people with the opportunity to make suggestions about the meals available at the home. A member of staff explained, “It is their home and they have a right to an opinion about every element of this home, and they have a right to be heard. We close the doors and if I can act on something to make it better or help them understand something, it helps them feel part of this home and the community. If you can make a difference for somebody it is a positive thing for them."

Staff knew how to support people if they raised any concerns. One staff member said, “I would follow protocol. I would go and report it, and it would be investigated and looked into. If it was something that could be sorted there and then, then I could immediately address it."

Systems were in place for managing any concerns and signposting complainants to other sources of assistance and resolution, should this be required.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People experienced care which promoted fairness, inclusion and equal access to support. Staff recognised people with protected characteristics may face barriers when engaging with health and social care services, and they took active steps to ensure everyone received the same opportunities to maintain their health and wellbeing. For example, staff supported people who were at risk of marginalisation due to health diagnosis or anxiety. Staff advocated on people’s behalf to ensure they received the services they wanted from health and social care professionals. This helped to ensure people had access to specialist advice and support related to their diagnosis when needed.

Staff understood each person’s baseline health, communication style and emotional presentation. This helped them identify when someone might be at risk of not having their needs recognised or met. Staff monitored for subtle changes, such as shifts in mood, changes in people’s facial expression and mobility and looked for non‑verbal cues. Staff then acted quickly to ensure people received timely referrals or assessments. This approach helped prevent people from being disadvantaged due to communication difficulties, sensory needs or cognitive impairment.

Staff and leaders were exceptionally person-centred in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

People experienced highly equitable outcomes because staff understood, respected, and actively supported each person’s unique identity. This created an environment where people felt confident to express their whole selves. Staff recognised and valued people’s important relationships and the things which mattered most to them. This meant people were empowered to live in ways which reflected their wishes, reduced isolation, and enhanced their wellbeing.

Relatives shared examples of how their family members with protected characteristics were supported to achieve exceptional outcomes. One relative told us, “[Person’s name] mobility has improved so much since they moved here from hospital. The movement and song sessions here have really helped.”

Staff demonstrated a deep and intentional commitment to equity in outcomes, ensuring no one’s health, needs, or circumstances limited their ability to achieve what mattered most to them. They continually reviewed support, identified subtle changes, and acted early to prevent disadvantage. For example, staff closely monitored 1 person’s progress and recognised when additional involvement from external organisations was needed. They worked promptly with health and social care professionals to remove barriers and ensure the person had the same opportunities and choices as anyone else. This collaborative approach enabled the person to fulfil their wish to return to their own home, reflecting a strong focus on fairness, autonomy, and positive outcomes.

Staff also took proactive steps to ensure people with memory impairments or physical disabilities had equal access to meaningful engagement. Staff adapted activities and provided tailored support, so no one was excluded. One staff member described how they adapted musical bingo, explaining, “If people can’t do that, then we can sit next to them and tap along to the music. We would sit with the person who may just sit tapping and enjoy singing along.” This demonstrated a clear commitment to removing barriers and promoting inclusion.

Staff consistently advocated for people who were at risk of inequality, describing this as central to their role. One staff member told us everyone should, “Feel valued, listened to, acknowledged, and have someone to speak for you if you can’t be heard.” Another explained when people could not fully express their wishes, staff acted in their best interests, adding that advocacy meant “Ensuring people are treated with respect and feel safe and protected.” This approach meant people received fair, person‑centred support which upheld their rights and promoted confidence and safety.

People’s cultural and religious needs were also identified, respected, and met, ensuring these important aspects of identity were fully supported.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

People and relatives were given sensitive, timely opportunities to discuss future wishes, including end‑of‑life care. Staff approached these conversations with compassion and ensured people had the information they needed to make informed choices. People’s representatives told us staff were proactive in upholding these wishes, ensuring they remained central to all planning and care delivery.

Relatives and people’s representatives consistently described the end‑of‑life care as exceptional. One relative told us, “We had already talked with her about not going into hospital at the end, as she was anxious there.” Another said, “[Staff] were magnificent in supporting the church to come in for [person’s name]. The home was fantastic as always.”

Families described highly personalised support which enabled people to remain comfortable in familiar surroundings, with regular visits from the GP and nursing professional’s support. Staff were always available to discuss any concerns, and relatives and people’s representatives felt fully informed and involved.

One person’s representative shared how staff created a calm, dignified environment when their family member was in the last stages of their life. The registered manager came in early to work to support them, offered a private space for friends and the vicar, and ensured they had time to say goodbye. Staff carried out the person’s final offices, [personal care], with great respect, and stood in the corridor to pay their final respects when the undertaker arrived.

Relatives and people’s representatives spoke to us about the meaningful moments staff created in people’s final weeks. One person celebrated their 90th birthday in their room with balloons, cake, and singing. A staff member even dressed as a cake, which the person’s representative was able to photograph and share with the person’s family members. The representative said this had provided the family members with a, “Powerful and positive memory” which brought comfort.

Another relative told us, “Staff always kept us in the loop. They were caring, professional and so understanding. There was no rush, no pressure. They were golden.” They described how staff supported them throughout, ensured pain was well managed, and gave them space and time after their family member had died.

Families highlighted the dignity, respect, and personal touches staff provided, saying the home was, “A lovely place to be at the end of life” and 1 relative said their family member was, “Sent off like a proper queen.” They also praised the excellent communication, emotional support, and partnership with external professionals, which ensured people’s end‑of‑life plans were carried out exactly as they wished. One relative said, “They were great, every single of the staff, but I do want to say [staff member’s name] was exceptional for emotional support and their signposting was amazing. They were a brilliant team. They need 5 stars for end‑of‑life care.”

Managers and staff were deeply committed to providing the highest standards of care to people and their family members, friends and representatives before, during, and after death. The service was accredited under the Gold Standards Framework (GSF) which is a national framework of tools and tasks which aims to deliver a ‘gold standard of care’ for all people nearing the end of their lives. The service had achieved the Platinum Award, demonstrating sustained, long-term excellence in end-of-life care.

Staff spoke with pride about supporting people to live their final days exactly as they wished. One staff member told us, “Death is not a taboo subject; we try to erase any fear of that.” Another said, “We follow the GSF and pride ourselves in that. It is important because it is the last thing we can do for that individual, to make sure it is a pain free and dignified death and their wishes are met. We make sure they are comfortable and we also support the families as well during that hard time.”

Staff were also highly attentive to the emotional needs of families, representatives and friends. Comments included: "I would go and sit with people when their families are not there, give them hand touch comfort, sing to them, play music that was special for them. I would get all the photos of them and put them out for the family as well, it is nice as that might spark a conversation."

This compassionate, personalised approach ensured people experienced a peaceful, dignified end of life, and families felt supported, informed, and cared for throughout.