Archived: The Limes

Updated 14 September 2016

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 Focused Responsive inspection took place on 25 July 2016. The inspection was carried out by one adult social care inspector and a CQC pharmacist.

We inspected the service against one of the five questions we ask about services during an inspection, which were not meeting legal requirements, in this case, ‘Is the service safe.’

Before the inspection, we reviewed information we held about the home. We reviewed statutory notifications and safeguarding referrals. We also liaised with external professionals including Salford Health and Social Care Team, who were part of Salford Royal Foundation Trust.

Updated 14 September 2016

This was an unannounced inspection carried out on 25 July 2016, in response to concerns we had received regarding the safe management of medication. This report only covers our findings in relation to that issue. We last inspected the service on the 09 March 2016. 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.

The Limes care home provides accommodation for a maximum of 30 people. It provides intermediate care (rehabilitation) for 28 people, which is shared with Salford Primary Care Trust and staffed by a Multi-Disciplinary Team. The home also provides two respite beds for people who require short term placements.

The provider, which is called Aspire for Intelligent Care and Support C.I.C Ltd, is a new employee owned social enterprise and is a ‘community interest company,’ which registered with CQC in June 2015.The service had up until that point been operated by Salford City Council. The ‘community interest company’ structure is intended to ensure that assets are kept within the company and activities are carried out to benefit the local community. Though Aspire is a new provider, the service is run by the same management and staff team, who were previously employees of the local authority. All staff had the opportunity to purchase a one pound share that had no monetary value, but entitled them to vote at the annual general meeting and to have an input into how their company was run.

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 2008 and associated Regulations about how the service is run.

We found the management and administration of medication was not safe.

We reviewed 13 medication administration records (MAR) and found six did not have people’s allergies recorded. Not having allergies recorded increases the risk of medicines being given to someone with an allergy.

Minimum and maximum fridge temperatures were not recorded everyday as per national guidance.

We checked the Controlled Drugs (CD) cabinet and register and found concerns with how CDs were being recorded, checked and how they were being returned to the pharmacy for disposal.

Medicines were not always administered as prescribed. One person was not given a medicine to thin their blood on one day and a tablet to help their bones for two days as the medicines were not available in the home to give and staff could not explain the reason for this. Another person who was taking a medicine for Parkinson’s disease that needed to be administered at specific times did not receive it at the required time on six occasions.

The medicines policy had not been updated since 2005, and medicine audits had not been completed since September 2015. An up-to-date medicine policy ensures that staff have the most recent guidance and medicine audits highlight areas for improvement.

This is a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of safe care and treatment. The service had not protected people against the risks associated with the safe management of medication.