Archived: The Links

We found the following examples of good practice:

We looked around the ground floor of the home, seeing the two reception areas, the main hallway, some of the bedrooms and the nearly completed visitor’s area. We kept our movements to a minimum and complied with the provider’s visitor’s policy. Those areas of the home we saw were clean and tidy. The care team maintained the cleanliness of the home. ‘COVID-19’ cleaning schedules had been introduced and three times during a 24-hour period, all touch points were cleaned. The registered manager and senior care staff monitored work practice, checked on the cleanliness of all areas of the home, and staff compliance with wearing personal protective equipment (PPE).

Staff entered the home via the front door. They were required to wear a face mask and change from their outdoor clothing into their uniforms. After washing their hands’, they entered the hallway and their temperature was checked. Hand sanitising gels were available in both areas and in various places throughout the home.

Visits from healthcare professionals such as GPs, community-based nurses, and allied healthcare professionals were kept to a minimum. Where people needed health care support, the registered manager used the telephone, emails and video calls to share information and gain advice. Nine of the 11 people had already received their first dose of the COVID-19 vaccine. Most of the care team had also already received their first dose.

The home has been closed to visitors for the last six weeks but before this an empty room at the rear of the house was being used as a visitor’s room. A visitor’s hub was being constructed in readiness for when family were able to visit again. Visits from family had to be pre-booked and the visitor was only allowed into the home after a negative lateral flow test (LFT), hand washing, and completion of a health questionnaire. The LFT was undertaken in an outside area. Visitors were escorted to and away from the visiting area and were not permitted to access other areas of the home. The provider had a visitor’s policy and a copy of this had been issued to all family and friends.

People were being supported to stay in contact with their family and friends. The care team helped them with telephone calls and video calls. The registered manager had set up a social media group with people’s families and sent a generic email each week saying what had and is happening at The Links. At Christmas the staff had held a video party and people’s families were able to watch whilst their family member opened presents.

Staff socially distanced from their colleagues and people as much as they were able. When they were delivering personal care, they wore a face shield and apron as well. Each staff member had their own face shield, and these were cleaned at the end of each shift. Some of the residents remained in their bedroom each day. Those who used the communal areas during the day have been cared for in a ‘social bubble’ with a small number of other people. The lounge room and the dining room were both changed so each room was a lounge/diner. The rooms have now been returned to a separate lounge and dining room.

The home had admitted two people since the start of the pandemic. Their admission policy had been amended to include two recent negative COVID-19 results prior to admission and then isolation in the bedroom for a 14-day period. If a person was hospitalised, upon return to the home, the procedures would be followed. If the home had an outbreak of COVID-19, people would be isolated in their rooms and the staff would work following the provider’s barrier nursing policy.

All staff completed infection prevention and control training as part of the provider’s mandatory training programme. Additional training had been arranged on barrier nursing, pandemic awareness, hand hygiene, the COVID-19 toolkit, donning and doffing PPE, and LFT device training. The staff team were tested each week for COVID-19: once a week with the full laboratory test (known as a PCR test) and twice a week with a lateral flow test. People who live in The Links were tested each month however if they were symptomatic, they would be re-tested and isolated until their test results were known.

The service had updated all their infection prevention and control policies and procedures, and had a business continuity plan in place. The registered manager and provider had regular contact with community health services and the local authority COVID team. They kept abreast of any changes in policy provided by Public Health England, CQC and the Department of Health and Social Care.

People’s experience of using this service: People felt safe and supported by staff who were kind and caring and who knew them well.

People received their medicines safely and when required.

All people felt safe and staff were able to confirm who to go to should they have concerns.

Infection control procedures were in place and the service was clean.

Recruitment procedures were in place to ensure staff had relevant checks prior to starting work.

People spoke positively about the food provided at the service.

People had personal evacuation plans in place in case of an emergency.

Feedback was sought from people and people felt it was a nice friendly service.

Staff had received training and supervision and an annual appraisal.

People felt comfortable in raising any concerns or issues.

Health care professionals who visited the service felt the service was responsive, welcoming, homely and staff and the management were approachable and very welcoming.

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

Rating at last inspection: Good (November 2016)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

The Links is a small residential care home for older people and people living with a dementia. The home is registered to accommodate up to 13 people who require support with their personal care needs. The service does not provide nursing care. At the time of the inspection there were 9 people living at the home. People needed assistance from staff with some of their daily care routines but most of the people had relatively low dependency needs.

The service had 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. The registered manager told us their service philosophy was “For residents to feel this is their home without any restrictions. The staff have come into their home to help rather than feel they live in the place where staff work. And to encourage people to be independent as they are able to be”.

People who lived in the home and the staff all said the registered manager was very supportive, accessible and responsive. One person who lived in the home said “The manager is very nice. I can talk to her if I have any problems. The home is well run”. A member of staff said “The manager is very good. She bends over backwards for the staff and the residents. She’s hands on and not just sat in the office”.

Staff supported people in a caring and considerate way and had a good understanding of each person’s needs and preferences. People who lived in the home told us they got on well together and considered the staff and the other people who lived in the home to be their friends. One person said “The staff are lovely. I think they are the best in Somerset”.

People were also supported to access relevant healthcare practitioners when needed. The service worked closely with the local Residential Home Support Team, local GP practice, occupational therapy, falls team, and the incontinence team.

People and their relatives told us the service was responsive to their needs and people had choice about how they spent their days. People benefitted from individual engagement with the care staff as well as organised social and recreational activities. The registered manager said one of their priority areas was to continue to develop increased opportunities for people to engage in social activities.

People were supported to have sufficient to eat and drink and to maintain a healthy diet. One person said “They are very good cooks. The food is always lovely and always different”. Another person said “We get more than enough to eat but you can ask for more if you want it”.

There were enough suitably trained staff to keep people safe and to meet people’s individual care needs. People were also protected from abuse and avoidable harm through appropriate policies, procedures and staff training. People received their medicines safely and were protected from the risk of acquired infections.

The service provided a homely and comfortable environment but the building was not suitable for wheelchair access. There were bedrooms on both the ground and first floors. Access to the first floor bedrooms was via a flight of stairs, with a stair lift for people with limited mobility. The accommodation was reasonably spacious and it was clean and well maintained throughout. People were able to decorate and furnish their bedrooms to suit their individual tastes.

The service had links with the local community and received regular support from a local church and chaplain.

People who spoke with us said they could choose how to spend their day. We saw there was information for people in the reception area of the home so that people were aware of the activities available. We were also told that visitors were always welcome in the home. People who lived at the Links had a key fob for the front door and could go out as they wished.

People we spoke with told us that they were happy and safe at The Links. One person commenting on the home told us, 'I have a lovely view from my room and I can watch the world go by.'

The staff we spoke with had a very clear understanding of the care needs of people who lived in the home. We saw that people were treated with respect and dignity, for example, staff were observed to make good eye contact and used touch to reassure people. One staff member told us 'I love working here, I always have time to chat to the people who live here and listen to them.'

We observed the atmosphere and general ambiance of the home to be friendly, calm and relaxed.

Staff we spoke to told us that they had received good training and felt well qualified to do their jobs. The manager told us that further learning and development options were being sourced for specialised training from external organisations.

People we spoke to were confident that if they had concerns they would be listened to by the manager or senior staff; however they told us that they had no need to make any complaints as they were happy with the care and support provided.