Background to this inspection
Updated
22 June 2019
The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: The inspection was carried out by one inspector.
Service and service type: The Links is a care home that provides personal care and support for up to six people with mental health needs. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection
The service is owned by an individual who also manages it. The provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: The inspection was unannounced.
What we did: Prior to the inspection, we looked at the information we held on the service including notifications of significant events and safeguarding. Notifications are for certain changes, events and incidents affecting the service or the people who use it that providers are required to notify us about. We also contacted the local authority’s safeguarding team to gather further information about their views of the service.
During the inspection we spoke with two people using the service, one care worker and the provider. We viewed the care records of two people using the service and four care workers’ files that included recruitment and supervision records. We looked at training records for all care workers. We also looked at medicines management for the four people who used the service and records relating to the management of the service including service checks and audits. After the inspection we contacted a medical professional and social care professional for feedback about their views of the service.
Updated
22 June 2019
About the service: The Links is a care home that provides personal care and support for up to six people with mental health needs. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection there were four people living at the service.
People’s experience of using this service: At this inspection we found the provider had made some improvements, however some aspects of the service required further improvement.
Risk assessments and risk management plans were not always robust enough to provide appropriate guidelines for staff to meet people’s needs and minimise risks.
The provider completed incident and accident forms where required but these did not have outcomes or actions to help prevent reoccurrence.
Safe recruitment practices for new staff to ensure they were suitable to care for people using the service were not always followed.
Medicines were not always managed safely.
The provider did not always follow the principles of the Mental Capacity Act 2005 (MCA) regarding people consenting to their care.
People were involved in planning their care but care records did not include end of life wishes.
The provider had systems in place to monitor and manage service delivery and to improve the care and support provided to people. However, these were not always effective as they had not identified issues raised during the inspection.
We recommended the provider follow safe recruitment practices.
We also recommended that they follow the principles of the MCA.
We recommended that the provider seek and implement national guidance on end of life care in the home.
The provider had systems in place to safeguard people from the risk of abuse and staff knew how to respond to possible safeguarding concerns.
People’s needs were assessed prior to moving to the home to ensure their needs could be met.
Staff had up to date training, supervision and annual appraisals to develop the necessary skills to support people using the service.
People were supported with dietary and health needs and to maintain healthier lives.
We observed, and people told us, staff were caring. People were supported to make day to day decisions and have choice and control of their environment
There was a complaints procedure in place and the provider responded to complaints appropriately.
People using the service and staff told us the registered manager was approachable and listened to any concerns.
Rating at last inspection: At the inspection of the service on 4 September 2018 the service was rated inadequate in the key question of ‘safe’, and requires improvement in the key questions of ‘effective’, ‘caring’ ‘responsive’, ‘well led’ and overall. We served warning notices for the Regulations regarding safe care and treatment, and good governance. We also asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective, caring, responsive and well led to at least good. During this inspection we found the service had made some improvements but had not met all the Regulations.
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk