The Care Quality Commission (CQC) has rated Link House in Withern, Lincolnshire, as ‘inadequate’, and placed it in special measures to protect people following an inspection in June and July.

Link House, run by Boulevard Care, is a residential care home that provides personal care and support to young people with learning disabilities.

This inspection was carried out in response to concerns raised with the commission about the service.

Following this inspection, the overall rating for the home, as well as the categories of safe, effective, responsive, caring and well-led, have gone down from ‘good’ to ‘inadequate’.

The service has been placed in special measures which means it will be kept under close review by the CQC to keep people safe and it will be monitored to check sufficient improvements have been made. The CQC is also taking further regulatory action which it will report on when legally able to do so.

Greg Rielly, CQC deputy director of operations in the Midlands, said: “When we inspected Link House, it was disappointing to see such a deterioration in the quality of care being provided since our previous inspection and we identified shortfalls that compromised people’s safety and wellbeing.

“We expect health and social care providers to guarantee people with a learning disability respect, equality, dignity, choices and independence and good access to local communities that most people take for granted.

“Although people and their relatives told us they were happy with the care provided, we identified significant shortfalls around risks. It was concerning that when incidents occurred that placed people at harm, investigations and follow-up actions hadn’t always been done and we found some incidents reoccurred.

“We also found that staff didn’t support people to have maximum choice and control of their lives in the least restrictive way possible and in their best interests.

“Staff didn’t follow appropriate methods to support people when they were distressed or anxious. For example, we observed a staff member carrying out an action which was known to trigger a negative change in one person’s behaviour. In addition, staff sometimes relied on medicines to control people’s agitation rather than use appropriate de-escalation techniques.  

“We found there weren’t always enough staff to support people to go out into the community, especially on evenings and at the weekend which could affect people’s wellbeing. One person had asked multiple times to go to the shop to buy some new slippers, but they were told they would have to wait.

“We have told leaders where we expect to see rapid, widespread improvements and will continue to monitor the home closely to keep people safe during this time. We will return to check on their progress and won’t hesitate to take further action if people aren’t receiving the care they have a right to expect.”

Inspectors found:

• People had their belongings restricted without lawful documentation being in place to justify these restrictions
• Some people may have not been suitably placed at the home as the provider’s head office managed placements and no assessments were made prior to someone new moving in
• The leadership team lacked knowledge on how people could be supported to live an ordinary and fulfilled life
• People’s care plans contained no information about their capacity to make decisions
• Care records weren’t always written respectfully, and we found the registered manager had not done all that was possible to create a culture of dignified and respectful care
• Leaders lacked knowledge on people’s protected characteristics and hadn’t always considered these in planning and assessing their care and support
• People’s care records contained undignified language to describe how people may show signs of distress.

However:

• The service was clean and safe infection prevention and control practices were being followed
• Staff supported people to meal plan and how they encouraged people to make their own meals
• The provider held house meetings with the people who lived at Link House, as well as completing surveys.