The Limes

The Limes is a care home providing accommodation and personal care to a maximum of 6 younger people who have a physical disability. The Limes specialises in supporting people who have sustained acquired brain injuries. Accommodation is provided in one adapted building. At the time of this inspection there were 6 people using the service.

People’s experience of using this service and what we found

People felt safe living at the home and with the staff who supported them. The provider’s staff recruitment procedures helped to protect people from harm and there were enough staff to meet people’s needs. Risks were assessed, monitored and managed with people so they were protected, informed and their wishes respected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People received their medicines when they needed them by staff who were trained and competent in their role.

The views of people, their relatives and staff were encouraged and valued. There were effective systems in place to monitor the quality and safety of the service provided and to drive forward improvements. The registered manager worked with other agencies to achieve good outcomes for people. There was an open and honest culture and learning from when things when wrong.

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

Rating at last inspection

The last rating for this service was good (published 22 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

This was a focused inspection, and the report only covers our findings in relation to the key questions safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Limes on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Limes provides accommodation and personal care for up to six people who have an acquired brain injury. On the day of the inspection three people were living in the home.

The home had a registered manager who was present on the day of the inspection. 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 provider did not recognise that information shared with them were complaints and records were not maintained of what action had been taken to resolve them.

People were supported by sufficient numbers of staff and the provider had contingency plans in place to ensure there were always enough staff on duty to meet people's needs.

People felt safe living in the home and staff knew how to safeguard them from potential abuse. Staff were aware of how to reduce the risk of harm to people and had access to risk assessments that supported their understanding about how to do this. People had consented to their treatment and were supported by skilled staff to take their prescribed medicines.

People could be assured they would receive a service specific to their needs because of their involvement in their care assessment. They were also supported by staff to pursue their social interests.

People were cared for and supported by skilled staff. People’s human rights were protected because staff were aware of the importance of enabling them to make their own decision. People had access to a choice of meals and staff were aware of suitable meals for the individual to reduce the risk of choking. Staff assisted people to access relevant healthcare services when needed to promote their physical and mental health.

Staff were kind, caring and sympathetic to the individual’s needs. People’s involvement in their care planning ensured they received a service the way they liked. People’s right to privacy and dignity was respected by staff.

People, a relative, and staff were aware of who was running the home. Staff felt supported by the management team to carry out their role. The provider had systems in place to monitor the quality of service provided to people.

The name of the recently resigned manager appears in this report as they were still the registered manager for the service at the time of our inspection. Any comments made about the manager in this report refer to the person who is newly employed in this position at The Limes.

When we visited The Limes we met the six people who lived there. We were invited to go to some people's bedrooms. We saw the rooms were well furnished and people had their own things. We were told how everyone was encouraged to keep their rooms clean and tidy. We were shown around the rest of the building which was well kept.

One person we met showed us the pictures of his family which he had put into a frame. He told us where he lived before he came to The Limes. He said he like the home and he liked his breakfast early. He told us that he enjoyed going ten pin bowling and out for dinner. He said he had plenty of choice in what he did and what he had to eat. He said 'at this home I am a person and not a number'. Another person told us he liked to go to the football with his dad. He also liked police shows on the TV and listened to any kind of music. He said 'hoovering is my favourite job'.

We observed the staff give the people their breakfast. We saw that people had choice. We saw that people could change their mind if they wanted something else. We observed that the staff provided personal care and support in a person centred way. The people and the staff team were relaxed and the staff understood the people's needs. We saw the staff working with the people to achieve their goals and undertake their activities.

At lunchtime the staff asked everyone what they wanted for their lunch. We observed lunch being prepared. Everyone sat together talking and enjoying their meal.

We were told by the staff and the registered manager how the staff team work with the people to promote independence. We saw in the peoples activity plans the daily tasks included house work, bedroom cleaning and meal preparation.

We spoke to three members of staff about their work and training. They said the work they did was very challenging but very rewarding. They told us about their previous experience and how they used this knowledge in their work at The Limes. One member of staff said they were teaching some basic sign language. The staff we spoke to demonstrated how well they knew the people they supported. They told us how they recognised changes in people's health and behaviour. They told us how they managed people's challenging behaviours safely. All the staff spoke highly of the training they received. They were all appreciative of the support of management and colleagues.