Linden House

Updated 16 November 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 19 and 20 September 2017 and was unannounced. The inspection team consisted of one inspector, a specialist advisor in the care of older people living with dementia and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this kind of service.

Before this inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also checked other information we held about the home including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law.

We spoke with nine people who used the service and ten relatives, and three visiting health professionals. We also spoke with the manager, provider’s quality manager, provider’s clinical manager, provider’s operation manager, activities co-coordinator, chef, gardener, maintenance manager, trainer, admiral nurse, two nurses and six care staff. We looked at a range of records which included the care records for six people, medicines records and recruitment records for five care workers. We looked at a range of records in relation to the management of the service.

We last inspected the home in June 2015 where no concerns were found. And the home was rating as good in all domains.

Updated 16 November 2017

Linden House provides accommodation for people who require nursing or personal care for up to 60 older or younger people some of whom may be living with dementia. There were 52 people living at the home at the time of this inspection. The service has two residential units on the ground floor and two nursing units on the first floor. The home also has several themed living spaces about the home. For example, Linden square café Piazza, curiosity shop, post office and salterns coffee shop. The home is located a short walk from the town of Lymington in Hampshire.

There was a registered manager in place. 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 and associated Regulations about how the service is run.

People felt safe living at Linden House and they were very much at the heart of the service. People’s families felt the service went above and beyond and were extremely experienced at looking after people living with dementia. People received excellent care that was based around their individual needs and that ensured care was personalised and responsive.

Staff working at Linden House understood the needs of people using the service and supported people in an exceptionally personalised way. Staff knew people well and we saw that care was provided respectfully and sensitively, taking into account people’s different needs. This meant people were able to maintain their independence and achieve a good sense of self-worth and wellbeing.

The provider employed an Admiral Nurse to support staff, people and their families living with dementia. The service recognised and responded to people’s needs for social interaction and mental stimulation. One person took part in an initiative by the Bournemouth university buddy orchestra and Alzheimer’s society to promote and respect care for people with dementia.

The home and gardens was designed to create a suitable environment for people living with dementia. People’s wellbeing and independence had been enhanced by the environment. This ensured people had a meaningful life and created a relaxing and calm atmosphere around the home. NICE guidelines were used in creating an environment for people living with dementia. To help people manage their surroundings and reduce feelings of confusion and anxiety.

The home developed and promoted community involvement within the home. The home hosted a mini classic car show which brought back special memories for people. People, their families and staff took part in the local carnival procession. The home had built strong links with the local community dementia matters group and as a result hosted a fortnightly art therapy group at the home.

The home was responsive to people’s needs and wishes. People were able to choose what activities they took part in and suggest other activities they would like to complete.

Relevant recruitment checks were conducted before staff started working at Linden House to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.

Staff had the specialist knowledge and skills required to meet people’s needs living with dementia. Specialist dementia care training was provided so staff could interact with people and fully understand and respond to their needs.

The risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies and fire safety checks were carried out.

People received varied meals including a choice of fresh food and drinks. Mealtimes were positive and sociable experiences. Staff were aware of people’s likes and dislikes and offered alternatives if people did not want the menu choice of the day.

Staff received regular support and received regular one to one sessions of supervision to discuss areas of development. Staff informed us they completed a wide range of training and felt it supported them in their job role. New staff completed an induction programme before being permitted to work unsupervised.

People felt they were treated with kindness and said their privacy and dignity was respected. Staff had an understanding of the Mental Capacity Act (MCA) and were clear that people had the right to make their own choices. Staff sought consent from people before providing care and support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The home maintained a good level of communication with people through a range of newsletters and meetings. ‘Residents meetings’ and surveys allowed people and their families to provide feedback, which was used to improve the service. People felt listened to and a complaints procedure was in place.

Regular audits of the service were carried out to assess and monitor the quality of the service. There were appropriate management arrangements in place.

At the last inspection on 08 and 09 June 2015 the service was rated Good. At this inspection we found the service was outstanding.