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Inspection carried out on 20 December 2019

During a routine inspection

About the service

Linden Lodge is a residential care home providing accommodation and personal care to up to 10 people living with mental health conditions. Linden Lodge is two residential houses adapted into one building. At the time of the inspection there were 10 people living at the service.

People’s experience of using this service and what we found

People gave us examples of ways in which the service proactively supported them to live independently and achieve their goals and aspirations. Relatives also spoke with praise about the exceptional care and support that their relative received and gave examples of how the service continued to positively support their relative, enabling them to successfully lead as independent a life as possible.

People told us that they felt safe whilst living at Linden Lodge and were looked after well by all the support staff at the home. Staff knew how to recognise signs of abuse and who to report their concerns to.

People were supported to access work and activities which considered their hobbies and interests. Some people were also supported to acquire skills and training to further develop in their chosen hobbies and interests.

Without exception, care and support was personalised and was delivered with people as the leaders of their care, guiding staff on how they wished to be supported.

People’s diverse needs and qualities including their protected characteristics were recognised and valued. Support staff knew people well and supported them in ways which were individual to them, their character and their needs.

Risks identified with people’s health and care needs had been assessed and appropriate guidance was available for support staff to follow to support people safely.

Processes were in place to ensure people received their medicines safely and as prescribed.

We observed there to be enough support staff available to support people safely. Recruitment processes were followed and ensured that only those staff assessed as safe to work with vulnerable adults were recruited.

Staff received appropriate training and support to carry out their role and meet people’s assessed needs.

People were supported to maintain healthy lives. People’s dietary needs were known by staff and recorded within their care plans. People were supported accordingly based on their identified needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and relatives knew who to speak with if they had any concerns and were confident their concerns would be addressed and resolved.

We observed support staff to be kind, caring and respectful of people’s privacy and dignity.

Quality assurance systems implemented by the registered manager and provider ensured that the quality of care people received was continually monitored. Where issues were identified these were addressed and further learning and improvements were considered.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (published 28 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 7 June 2017

During a routine inspection

This inspection took place on 7 June 2017 and was unannounced.

At the last inspection on 5 January 2015 the service was rated ‘Good’.

At this inspection we found the service remained ‘Good’.

Linden Lodge is a care home for people with mental health conditions. The home is registered for 10 people and the home was fully occupied on the day of our inspection.

People told us that they felt safe living at Linden Lodge and were supported by staff who knew them well and supported them in a way that promoted their independence but provided appropriate support where required.

Staff demonstrated a good understanding of the terms safeguarding and whistleblowing and clearly explained how they would protect people from abuse.

The service had developed and completed detailed risk assessments which identified peoples individual risks associated with their care and support needs. Risk assessments provided guidance as to how risks were to be managed or mitigated against in order to keep people safe.

The provider followed their medicine policy to ensure that medicines were managed and administered safely.

During the inspection sufficient numbers of staff were seen to be available to ensure people’s needs were met.

Staff told us and records confirmed that they were supported to carry out their role through a variety of processes which included induction, regular training and development, supervision and appraisal.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The provider had policies and systems in place to support this practice.

People were enabled to choose and prepare their own meals with support provided by staff where required.

We observed people had developed positive and caring relationships with staff that were based on respect and trust and which also ensured that their privacy and dignity was maintained.

Care plans were detailed, person centred and provided information about people and how they wished for their care and support to be delivered.

People and relatives knew who to speak with if they had any concerns or issues to raise. The service had not received any complaints since the last inspection.

People and relatives knew the registered manager. Throughout the inspection we observed that the registered manager knew people well and people felt comfortable approaching them. Staff also confirmed that the registered manager was always available and ran an ‘open door’ policy.

A variety of management systems and processes were in place which looked at and monitored the quality of care delivered to ensure that high quality care was provided and where improvements were noted to be required this was addressed and that subsequent learning could take place.

Further information is in the detailed findings below.

Inspection carried out on 5 January 2015

During a routine inspection

This unannounced inspection of Linden Lodge took place on 5 January 2015. This care home provides support to ten people with mental health needs. At the time of our inspection eight people were using the service.

At our last inspection on 28 November 2013 the service met the regulations inspected.

There was 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 2008 and associated Regulations about how the service is run.

People who used the service told us they felt safe in the home. The provider had taken steps and arrangements were in place to help ensure people were protected from abuse, or the risk of abuse.

We saw that appropriate arrangements were in place in relation to the recording and administration of medicines. We saw that medicines were managed safely. There were arrangements in place in relation to obtaining and disposing of medicines appropriately and systems in place to ensure that people's medicines were stored and kept safely.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person’s best interests. Appropriate policies and procedures were in place for DoLS. People identified as being at risk when going out in the community had risk assessments in place.

People were able to make their own choices and decisions. When speaking with the registered manager and care staff, they showed a good understanding of the Mental Capacity Act 2005 (MCA) and issues relating to consent.

People were cared for by staff who were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care staff spoke positively about their experiences working at the home and the support they received from the registered manager.

We saw positive caring relationships had developed between people who used the service and staff and people were treated with kindness and compassion. People were being treated with respect and dignity and care staff provided prompt assistance but also encouraged and promoted people to build and retain their independent living skills.

People received personalised care that was responsive to their needs. Care plans were person-centred, detailed and specific to each person and their needs. We saw that people’s care preferences were also reflected. People were consulted and activities reflected people’s individual interests, likes and dislikes. People were supported to follow their interests, take part in activities and maintain links with the wider community.

Systems were in place to monitor and improve the quality of the service. The home had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. There were clear procedures for receiving, handling and responding to comments and complaints.

Inspection carried out on 28 November 2013

During a routine inspection

The provider respected people's individuality and had processes in place to involve people in their care and in the running of the service. We found that people and staff had regular meetings and worked in partnership in care delivery. People using the service were supported to be involved with activities that interested them.

People's care was planned using a personalised whole life approach. Care plans and risk assessments were up to date and most were reviewed regularly. People were positive about their care experience. One person told us "Here I am helped to help myself." Another person commented "They really look after us." We observed that people and staff at the service appeared to get on well together.

Medicines were stored safely and we found that medicine stock and administration records were accurate and up to date. Staff received support and supervision to follow the provider's policy for managing medicines.

The provider used effective recruitment processes to select suitable candidates for vacant posts. We saw that appropriate pre-employment checks were conducted to safeguard people who used the service. This included previous employer references and background checks.

The service had an up to date complaints policy in place. This was accessible in an easy-to-read format if required. We saw that the service investigated all complaints through to an appropriate resolution and communicated outcomes to staff and the complainant.

Inspection carried out on 7 November 2012

During a routine inspection

People told us they were listened to by staff and involved in decisions about their care.

People said they felt safe and they were happy with the staff supporting them.

The staff told us they received regular supervision. Training records showed that staff had received up to date training in topics such as Deprivation of Liberty Safeguards and the Mental Capacity Act 2005. There were systems in place for gaining feedback about the quality of the service.