Linden Grange

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last inspection we rated this key question good. At this inspection the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 71 (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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

There was a culture of collaboration within the service, relatives described the staff as family, they explained people were well cared for and they felt welcomed into the service. For example, we saw relatives of people who had previously lived at the home came to chat to staff. One relative said it was welcoming because, “The staff always have smiles on their faces.”

There was a positive culture in the service and a focus on meeting people's individual needs and supporting and empowering staff to do that.

Staff shared examples of how they supported one another to provide good care. One staff member said, “I enjoy my job, and the girls are really good and we support each other, we are supported by [Registered Manager] and [Owner].” Another staff member told us, “They [Staff] are good here and the owner. It’s a family run company, so it has a family feel.” Staff shared the provider considered the needs of people and was committed to ensuring there was enough resources made available to meet people’s needs. For example, the provider had ensured there were enough staff so that people had the opportunity to go out for Christmas lunch.

The registered manager said they worked with people and their families to build a culture that focused on enabling people to enjoy their lives. The registered manager told us, “I want people to be well cared for, be happy and feel like it’s their home and they are supported to live the best life they possible can.” They told us, “We ensure families are involved as much as they want to be and the resident is included.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

All the staff we spoke to gave positive feedback about the management of the service and told us they felt well supported. Comments included: “I like this job in general. It’s a nice atmosphere and it feels nice and clean and the residents are cared for”, “I am happy here. I left but wanted to come back” and “[Registered manager] is golden. She is a fantastic manager. She will let you know if she wants you to do something differently.”

The registered manager said they felt “Very much supported by the owner.” The registered manager said they were offered flexible working to support their own work life balance. The registered manager said, “The support and care they [Provider] gave me made me realise I want to be in this organisation.” The registered manager said they had an open door policy and staff confirmed this.

External professionals described the registered manager as “Supportive” and 1 professional said, “I feel it’s a well led home by [Registered manager] who has a clear passion for her role as a manager. Staff seem happy at work which I feel is reflected in the atmosphere.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The registered manager told us the service actively supported people to speak up. The registered manager said, “We have explained to staff if you have a concern there is always someone you can talk to because we would protect you. We go through whistleblowing in our safeguarding training and talk about everything. What to look out for such as protected characteristics, we give them scenarios and check they know the correct structure both internally and externally such as CQC and the police.” Staff confirmed this and knew how to report concerns about poor standards of care and felt confident to raise any concerns.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff shared examples how their own disability needs were met by senior and management team. Staff were provided extra support to continue to provide good care for people. One staff member said, “I am treated fairly and respectfully.”

The registered manager had considered the needs of staff during religious festivals such as Christmas. They offered flexible working patterns, so staff had an opportunity to either work a split shift and get part of the day off, or the whole day. The registered manager shared an example how they had considered the needs of staffs work life balance by ensuring one staff had their shift matched to a family member’s availability so during Christmas they could be together. The registered manager said, “I do mine [Rotas] with thought for the people that work here and it’s as simple as that.”

The registered manager told us they created an inclusive environment including for those who identified themselves as lesbian, gay and transgender. People were supported to be safe in an open and inclusive environment.

The provider did not always have systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes.

The provider had not identified the issues we found. The provider’s environmental audit/daily checks had failed to identify 10 out of 11 wardrobes had not been secured to the wall. Following day 1 of the inspection the provider had ensured wardrobes were secured.

The provider’s representatives had completed an internal audit in March 2025, which had identified issues we had also found at this inspection. For example, those relating to medicine administration. The provider had recorded the actions needed as met in May and July 2025. This was not accurate as they continued to be a concern.

The registered manager told us if a person had a fall, “I would expect [Staff] to document it and review the risk assessment and add anything extra, such as the person had a fall on this date.” However, we found the provider’s governance systems had not identified one person’s care records had not been updated after they had fallen. Whilst we found no harm had occurred to the person this does increase the risk staff will not have a full understanding of the person’s history of risk and may contribute to increased risk of falls in the future. We shared our findings with the registered manager who said they would address this. They told us, “My plan is to spend some quality time with the care supervisors” so they could ensure records were updated in a timely manner.

Other completed audits were comprehensive and had identified themes and trends to prevent the reoccurrence from happening such as most accidents and incidents.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

People’s families were integrated as much as they wanted to be in peoples’ care. A relative told us they were treated as a partner in their family member’s care. The relative said they were going away for an extended period of time. The relative told us, “I have absolute confidence in their care. They will face time me with [family member]. The standard (of care) is really high here.”

Staff shared there was an area of the home made available if relatives wanted to host private functions such as birthday celebrations. One staff member gave an example of a suggestion they had made for purchasing walky-talkies so staff could communicate with each other in the event of a fire. Their suggestion had been adopted.

Staff worked with the local community to deliver the best possible care and were receptive to new ideas. For example, the home had worked with a research study group initiative run by the National Institute for Health and Care Research. One professional shared, “[Registered manager] and her team have provided useful information that has helped to shape a new research study looking at care home staff interactions with ambulance staff when residents become unwell.”

Strategic links had also been made with other local community groups, to benefit people living at the home. There was a school choir which came to the home and another local school visited to provide theatre and performance experiences for people’s enjoyment.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The registered manager told us how they had reviewed external audits as part of their learning. We saw an external audit was discussed in a staff meeting to help support ongoing improvements at the home.

The registered manager shared how they worked with the managers of the provider’s sister homes. The provider’s managers came together to discuss any learning and were all participating in research studies, to improve people’s health and wellbeing in care home settings.

Staff were encouraged to develop their skills to further support them in their role in providing effective care. The provider offered additional training such as NVQ2 3 in Health and Social Care. The registered manager said, “We offer it to all staff.” Staff confirmed this, one staff member said, “I am doing my NVQ level 3, I love this. [Registered manager] agreed for me to do this.”

One external professional told us, “[Registered manager] is an active member of the group who both provides advice to researchers but also appears receptive to making changes to their service based on the latest evidence.”

The providers had their own Quality Assurance (QA) team who completed regular visits to the home to check on the quality of the care provided to people. The QA team had used CQC guidance to implement their own single assessment framework to enable them to work in line with this.