Archived: The Limes

Updated 25 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.’

The inspection was prompted in part by information of concern received from the local authority who commission services at The Limes. The information related to concerns around the health and safety of the premises.

This inspection took place on 31 May and 01 June 2018 and was unannounced. The inspection was carried out by one inspector.

We reviewed information we held about the service, this included information received from the provider about deaths, accidents/incidents and safeguarding alerts which they are required to send us by law. Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also contacted the local authority to gather their feedback about the service.

We spoke with six people who lived at the service. We also spoke with one member of care staff, one senior carer, the registered manager, the operations manager and the provider.

We looked at the care records for three people, alongside five medication records. We also looked at two staff recruitment files, staff training information and records held in relation to quality assurance.

Updated 25 July 2018

This inspection took place on 31 May and 01 June 2018. At the last inspection of the service in January 2017, a rating of ‘Requires Improvement’ was given due to ineffective governance and recruitment systems. At this inspection we found that improvements had not been made and the service remains as Requires Improvement.

The Limes is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Limes accommodates eight people in one adapted building. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was 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 provider did not ensure that the building was consistently safe for people. Where essential safety checks were required, these had not been completed. Where potential safeguarding incidents had occurred, these had not been considered in line with safeguarding procedures. Staff were recruited appropriately and there were sufficient numbers of staff available for people. There were safe systems in place for the management of medication.

The design and decoration of the building did not meet people’s needs and left people at risk of injury. People’s capacity had not been assessed in line with the Mental Capacity Act although people were not being restricted or deprived of their liberty by staff. People had sufficient amounts to eat and drink and had access to healthcare services where required. People’s needs had been assessed and people were supported by staff who had received training and supervision.

People were supported by staff who were kind, caring and promoted their independence. People were treated with dignity and given privacy where requested. People had access to advocacy services if needed.

People were involved in the planning and review of their care. There were systems in place to ensure that people were able to partake in meaningful activities that reflected their individual interests. Where complaints had been made, these were investigated and resolved. People’s potential end of life needs had been considered when care planning.

The systems in place to monitor the quality of the service had been ineffective in ensuring the building was safe for people. Where areas for improvement had been identified, these were not acted upon in a timely way. People were given opportunity to feedback on their experience of the service.