Link House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Incidents were fully recorded, and staff were debriefed after the incident to review actions and where improvements to their performance could be made. In addition, the person involved in the incident also had the opportunity to discuss what had happened with the manager to highlight if staff could have supported them in a different way.

The manager was knowledgeable about supporting people’s behaviors and identifying early stages of incidents where a positive intervention by staff may support a person to remain calm. The manager also ensured they involved external professionals where needed to support people. All the learning was used to develop a personalised positive behaviour support plan to minimize the risk of a similar incident occurring.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People were supported when they needed to access healthcare. This ensured all relevant information was shared and staff had the relevant information to provide ongoing support to people.

Relatives told us how people had been supported when they moved into the home. This had been done collaboratively and in increments to ensure the care provided was able to meet people’s needs. Social care professionals had been involved when people moved into the home. This professional oversight ensured that people’s needs were being met.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff had received training in how to support and protect people from abuse. They were clear on how to raise concerns both with the home and with external organisations. Systems were in place to protect people’s rights under the Mental capacity Act 2005 and where people could not make a decision to live at the home a Deprivation of Liberty Safeguard assessment was completed. No one living at the home had any physical restraint included in their care plan and the use of medicines to keep people calm wasminimal and fully documented.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people were identified and planned to keep people safe. The provider worked with people and their families to manage risks in the least restrictive way while keeping people safe. They routinely reviewed care plans and incidents to see where improvements could be made to people’s risk assessments. Where needed equipment to support people’s safety was in place.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The manager had systems in place to monitor the environment. These were effective and the environment was well maintained. Regular testing and servicing of equipment was in place and where needed action was taken to support people’s safety. For example, a recent fire drill had highlighted a person was having difficulty navigating the step at the fire exit. Grab handles had been put in place to support them to do this safely.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staffing levels were flexible to meet people’s needs. For example, if people had plans to go out there was always a member of staff to support them. This included weekends and evening.

Records showed that staff training had been completed, and staff had regular meetings with the manager to discuss their performance, training needs and career development. One member of staff told us, “The staff team get on well, we all work together and help each other.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were supported to take part in housework to keep the home clean. We saw all areas of the home were clean and well maintained. Staff were able to tell us how they used personal protective equipment when providing personal care to people. They were working in line with national guidance which minimised the risk of spreading infection.

The provider made sure that people received their medicines as prescribed. However, their oversight of medicines taken out of the home did not fully support the safe management of medicines. Staff involved people in planning, including when changes happened.

The provider had implemented an electronic medicine administration system. This prompted staff if people’s medicines had not been administered in a timely manner. Records showed that people were receiving their medicines as prescribed. Medicines were safely stored and accessible to people when needed. Some people did have medicines prescribed to help them remain calm when they became distressed. However, there was minimal use of these medicines and people’s distress was managed by staff working with people to help them manage their emotions.

However, we found controls on medicines taken out of the home were not always adequate. For example, rescue medicines such as asthma inhalers were not always taken with people when they left the home. Where the medicine was taken out it was not always returned to the office when people returned to the home. In addition, when people went to visit friends and relatives overnight the system to monitor which medicine they took with them and how much was returned was not fully effective in safely managing the risks.

We raised these issues with the manager who took immediate action to resolve the concerns. New systems were put in place to adequately monitor medicines which were taken out of the home.