Linden Grange

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

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 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.

Care plans reflected peoples’ choices, likes and dislikes and preferred routines. For example, their favourite television programmes and where people liked to have their personal items placed which offered them comfort, such as their preferred chair when eating.

Staff ensured people’s wellbeing was maintained and they were given opportunities to connect with their past. One staff member gave an example of where 1 person was taken onto a narrowboat as this was of particular interest to this person. The staff member said “They talked about it before we went, we had picnic and icecream. They spent the whole day on the boat; it took them back to their childhood.” Staff took people blackberry picking. One staff member told us “It’s about the joy they feel because it triggers memories of picking fruit with their own families.”

Staff said gifts were purchased for those people without family this meant people felt valued.

The registered manager explained person centred care to them was “Being fair, I like to hear laughter on the floor with staff and residents. I just want everyone to be happy. There is a standard I expect and I will check and maintain it. I want residents well looked after.”

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.

There was a consistent staff team, this meant people received continuity of care. Relatives told us it was positive to see the same staff team when they visited. Where people were admitted to hospital staff told us they visited them to ensure people did not feel isolated.

The registered manager said a lot of their staff had been with them a long time. The registered manager told us “We are good company to work for and people realise that. We actually care that’s why we retain staff, sometimes my time is taken up with staff but I like to make time.”

Health and social care professionals said they worked with staff at the home to ensure people’s care needs were met. One professional told us they had delivered insulin training to staff, and said, “This has proved to be successful as insulin is now being given correctly around patient meal times. Which is beneficial to both patients and staff to stabilise blood glucose.” Some people with diabetes need insulin medicine to help control their blood sugar.This is important for people to maintain their health.

The provider knew people’s health needs and developed the care they provided to link in with what was available locally to support people. Systems were in place to ensure people were supported to obtain help from other health and social care professionals and referred to specialist health teams where appropriate.

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

The service appropriately identified people’s individual communication needs to make sure information was always provided in an accessible way. The provider had developed communication plans based on accessible information standards to address people’s needs. This included when people experienced communication difficulties with sight or hearing. One staff member explained how they adapted their communication to suit people’s individual needs.The staff member said if a person was unable to communicate their needs verbally, they would check the person’s body language. This helped them to determine if a person was in pain and needed support.

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.

We saw feedback such as compliments and thank you cards and letters had been sent to the service. These highlighted how positively relatives felt about the care provided to their family members.

People and relative meetings took place to obtain their views of the service. The provider had a complaints policy in place. People and relatives told us they felt comfortable raising concerns or suggestions and were confident their feedback would be acted on. However, some care records were not updated following a complaint/concern to show these had been addressed, to help prevent these from reoccurring. The registered manager assured us records would be updated.

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

Relatives told us staff advocated on people’s behalf when they needed equipment. One relative said, “[Registered Manager] advocated for [person] with the tissue viability nurse and she now has a shower chair in place.”

Staff considered if they could meet people’s needs before they came to the home. This included if they needed any additional equipment in place before they came so the provider could ensure this was in place.

The home had a good relationship with the local doctor surgery who supported the home with a weekly round but also visited outside of these times if needed. This also included district nurses. This meant peoples health needs were promptly met.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Relatives shared people were treated equally and fairly. One relative explained how their family member used to be anxious when hoisted but this was no longer the case because of the approach taken by staff at the home. They said, “She isn’t now.” The relative told us about their family member’s health had improved and said, “[Relative] recovered because of the love and care from staff. They understand the physical side of things. I sent in a letter of thanks because the care here is first class.”

Staff completed training in equality and diversity to understand and reduce inequalities or prejudices that could affect people’s needs being met.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s decisions and what mattered to them were detailed in their personalised care plans. This included decisions on end of life care. This information helped to ensure people spent their final days as they wished to. One relative described the end of life care their family member received and said they were fully supported. They said, “I never felt so looked after. Staff washed and dressed [person] when they passed. They [staff] said they were part of the family, and it meant so much.” The relative said during this time, “I felt like I wasn’t alone. Seeing [person] like that at the end gave me comfort.” They commented “Everytime we turned up we always had a conversation. [Person] didn’t have strength and was mainly in bed. They [staff] respected that they didn’t stop caring.”

Staff provided boxes containing care items such as mouth care and pampering kits which staff or relatives could use with people when at the end of their life. There was also information signposting relatives to other organisations for guidance and support and information on what happens before and after death. One staff member explained using the contents of the boxes gave opportunities for relatives to stay actively involved and connected to their family member during challenging times and provided comfort to both the person and the relative.

Staff shared they attended people’s funerals and felt they were supported when a person had died. Comments included: “We [staff] all support each other”, “Staff go to funerals to represent the home.” Staff shared when a person had passed away and they were leaving the home for the final time; they were present outside to say goodbye as a sign of respect.

Some staff had been trained by a local hospice to support people with end of life care. Staff who had attended this training said this gave them a greater understanding of providing safe, effective and holistic care. They gave us examples of best practice they had taken from these training sessions.

The registered manager also shared examples of how they had considered what was most important to the person during their end of life care. They did this by providing comfort and reassurance and considered respite opportunities for relatives during these difficult times. They told us “People had a good death, it’s really important, we get that right.”