About the service:

The Lindens Care Home is a residential care home in a rural part of Buckinghamshire. At the time of the inspection 56 older people some of whom were living with dementia lived at the home.

People’s experience of using this service:

People and their relatives gave us positive feedback about the care and support they received. Comments included “They [Staff] are so friendly and warm and treat him with respect. There are some excellent examples of connecting with him. For example, one carer speaks Italian (Father is Italian) and makes a point of speaking to him in his language. They also have a sense of humour” and “They’re [Staff] generally quite caring.” Other comments included “I feel safe living here, I am 85 but I am comfortable and I wouldn’t want to be anywhere else” and “Yes, I feel safe living here, it is not a bad home and I get well looked after, it is all clean and I get what I need and I have nothing to moan about at all.”

There was a lack of good governance at the home. Quality assurance processes did not always drive improvement. The provider failed to ensure staff followed policies and procedures. Record management required improvement. Risk assessments were required to be in place, however, staff did not have enough information recorded to help them manage potential risks. We have made a recommendation about this in the report.

People’s care needs were not always detailed in writing. However, when we spoke with staff they were knowledgeable about people’s needs. We have made a recommendation about this in the report.

People were supported to receive their prescribed medicines on time. We have made a recommendation about record management for medicines that required additional protection due to the potential for abuse of them.

People were supported by staff who required training and support. However, the support provided was not in line with the provider's policies. We have made a recommendation about this in the report.

We found the home to be light, clean and consideration had been given to the environment so people living with dementia were not disadvantaged.

People were supported by staff who demonstrated compassion and were kind. People’s dignity and privacy was maintained.

People were supported to maintain important relationship with family and friends.

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

Rating at last inspection:

The previous inspection was carried out on 5 January 2016 we published the report from that visit on 26 February 2016. The service was rated Good at the time.

Why we inspected:

The inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Inspections will be carried out to enable us to have an overview of the service, we will use information we receive to inform future inspections.

We made recommendations in our inspection report. We will check any actions taken by the provider at our next inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 5 January 2016 and was unannounced.

The Lindens Care Home provides accommodation and personal care for up to 58 older people and people with dementia care needs. At the time of our inspection, the service was providing support to 45 people.

The service had a registered manager. 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 felt safe. Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse and people had risk assessments in place to enable them to be as independent as possible.

Effective recruitment processes were in place and followed by the service and there were sufficient numbers of staff available to meet people’s care and support needs

Medicines were stored, handled and administered safely within the service.

Staff members had induction training when joining the service, as well as regular on going training.

Staff were well supported by the registered manager and had regular one to one supervisions.

People’s consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met.

People were able to choose the food and drink they wanted and staff supported people with this.

People were supported to access health appointments when necessary.

Staff supported people in a caring manner. They knew the people they were supporting well and understood their requirements for care.

People were involved in their own care planning and were able to contribute to the way in which they were supported.

People’s privacy and dignity was maintained at all times.

People were encouraged to take part in a range of activities and social interests of their choice.

The service had a complaints procedure in place and people knew how to use it.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed.