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 inspection we rated this key question good. At this inspection, the rating has remained good. This meant people continued to be safe and protected from avoidable harm.

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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People were encouraged and supported to raise safety concerns with the provider. Managers and staff understood the importance of reporting safety concerns and learning lessons when things went wrong.

Systems were in place to support staff to report and record safety concerns and events when they arose. Managers investigated safety concerns and events and used the learning from these to support staff to continually improve their practice, reduce risk and keep people safe.

The service 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.

Information was obtained from people, and others involved in their care, about people’s individual needs and risks they might face. This was used to develop individualised care and risk management plans to ensure people received safe and appropriate care and support from the moment they moved into the care home.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.

Managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “If I witnessed any abuse happening in the home, I would report it to the person in-charge straight away.”

People living in the care home and relatives told us Link House was a safe place to live. One person said, “I feel totally safe here. The staff are particularly good and know how to look after me.” A relative added, “My [family member] is well looked after here and the staff definitely know how to keep them safe.”

The registered manager worked proactively with the relevant external health and social care professionals and bodies when a concern was raised and took appropriate action to safeguard people from further risk, when this was required.

The service was working within the principles of the Mental Capacity Act 2005 (MCA). Staff understood people’s capacity to make decisions about the care and support they received. Managers and staff had received up to date safeguarding, mental capacity, and Deprivation of Liberty Safeguards (DoLS) training.

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

Staff ensured potential risks people might face were mitigated, so that people remained safe when taking part in activities and events of their choice. People told us the staff knew how to keep them safe. Staff were aware of the potential risks people might face and the steps they needed to take to prevent or safely manage them. For example, staff closely monitored people who were at risk of falling, so they would be immediately available if their assistance were required. Staff confirmed they had received up to date falls and pressure wound prevention and management training. A member of staff told us, “We have regular training on how to stop people falling, become malnourished or developing pressure sores, as well as lots of easy-to-understand risk management plans to follow. This ensures we know exactly how to minimise the risk of these things happening to people we look after.” Throughout our inspection we saw staff responded quickly to people’s requests for assistance and to meet their needs.

Individualised and detailed risk assessments and management plans were in place for everyone who lived at the care home. Systems were in place to ensure risks to people were continually assessed, monitored and reviewed.

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

The premises were kept free of obstacles and hazards which enabled people to move safely around the care home. One person us, “The home is always clean. It’s a very pleasant and comfortable place to live.”

There were effective arrangements in place to monitor the safety and upkeep of the premises. Regular checks were completed to help ensure the safety of the care home’s physical environment and fire safety equipment. Managers and staff told us they had clear guidelines available to help them deal with emergencies. In relation to fire safety, we saw personalised evacuation plans were in place to help staff evacuate people in an emergency. Staff confirmed they regularly participated in emergency evacuation drills of the premises. A member of staff told us, “We have monthly fire dills here, so we have plenty of opportunities to practice what we need to do in the event of a fire. Our fire safety training is also refreshed regularly.”

General risk assessments were regularly reviewed and updated including, reference to equipment used to support people, such as mobile hoists. This equipment was regularly serviced and maintained. Maintenance records demonstrated the environment was maintained to a safe standard. For example, regular visual checks were completed to check window restrictors, radiator covers, and fire-resistant doors remained fit for purpose.

The service 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 matched the staff duty rota on the day of our site visit. Staff were visibly present and were quick to respond to people’s questions and requests for support. For example, we saw several instances of staff responding promptly to people who had activated their call bell alarm. People told us the care home was adequately staffed. Typical feedback included, “There’s always lots of staff around. When I call them they come as quickly as they can”, “Whenever I need any support with my personal care I just press my call alarm bell and someone always comes to help me” and “A lot of the staff have worked here for a long time so we do get consistently good care from people who know what we need and like”. In addition, several external health and social care professionals were positive about staffing levels in the care home. One said, “There always appears to be ample staff on shift during my visits.” A second added, “I see staff are always visible in the home and are quick to support my clients whenever they ask for any assistance.” Managers and staff also told us the care home was adequately staffed and that they currently had their full-complement of staff. A member of staff said, “There’s enough carers and nursing staff working here and we don’t need to rely on any agency staff because we have all the permanent staff we need.”

Staff were well-trained to meet people’s individual needs, in line with their choices and preferences and encouraged to continually improve in their role. Staff received a mixture of e-learning and in-person practical and theoretical training, which was routinely refreshed as frequently as staff required it including, competency-based assessments. People told us staff were competent. Several external health and social care professionals told us the staff were well-trained. One said, “Staff training records indicate staff training is of the highest calibre.” Another added, “The staff working here are all competent because they are well-trained, and have the right balance of knowledge, skills and experience.” Staff were also positive about the training they received. A member of staff told us, “All the training we have here is always relevant and useful. It’s constantly being refreshed, so are knowledge and skills remain up to update and on-point.”

Newly employed staff were subject to a probationary review, and records showed staff received an induction to their role and ongoing training and support to ensure they could meet the needs of people living in the care home.

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff had regular individual and group meetings with their fellow peers and line managers. A member of staff said, “We have regular supervision meetings with our line managers and our work is appraised at least once a year.”

The provider continued to operate safe recruitment practices and only fit and suitable staff were employed to work at the care home. Staff files contained evidence of robust recruitment checks including application forms where gaps in employment were explored, professional and personal references, right to work and identity checks. The provider maintained a recruitment tracker to monitor staff recruitment and completed Disclosure and Barring Service (DBS) checks. This helps employers make safer recruitment decisions by processing requests for criminal record checks.

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

The provider had an in-house domestic team who maintained high standards of cleanliness throughout the care home. We observed this team follow structured cleaning schedules to keep people’s rooms and the communal areas visibly clean and tidy. An external care professional told us, “Link House always looks and smells clean.”

Staff had received relevant infection control and food hygiene training and had access to resources and equipment to help them reduce the risk of infections spreading in the care home. We observed staff using personal protective equipment [PPE] correctly when they were about to meet peoples personal care needs. The provider’s infection prevention and control policy were current and reflected national guidance.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Medicines systems were well-organised and safely managed. Medicines stocks, balances and records showed people consistently received their prescribed medicines as and when they should. People confirmed they received their medicines as they were prescribed. An external care professional told us, “I have no concerns in relation to how medicines are managed at Link House.”

Care plans included detailed guidance for staff about how people needed and preferred their medicines to be administered. Staff received relevant training and their competency to continue managing medicines safely was routinely assessed. Staff demonstrated a strong understanding of handling-controlled medications in line with the providers policy. There were regular audits of medicines at the service. This included regular checks of staff’s practice to ensure they remained competent and safe to administer and manage medicines.