The Limes

Updated 5 August 2021

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector on site. Another inspector made phone calls to staff.

Service and service type

The Limes is a ‘care home’. 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 had a manager who had applied to be registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. They will be referred to in this report as ‘the manager’.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all of this information to plan our inspection.

During the inspection

We spoke with one person’s relative about their experience of the care provided. We spoke with six members of staff including the nominated individual, manager and care staff. We spoke with two people using the service. We observed how staff interacted with people, including use of different forms of communication.

We reviewed a range of records. This included two people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 5 August 2021

About the service

The Limes is a residential care home providing personal care to up to five people with a learning disability and/or autism. At the time of the inspection there were three people living in the home.

The Limes is an adapted residential building located close to local amenities. Accommodation is spread across two floors. There are five ensuite bedrooms, a shared living space, kitchen and secure garden.

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

There were policies and procedures in place which were followed to protect people from abuse and the risks of avoidable harm. There were some inconsistencies and gaps in risk assessments and in health and safety checks. These had been identified as an area for improvement by the service.

People’s medicines were managed safely and there were appropriate infection control policies and procedures in place. Staff reflected there had been an improvement in the learning culture within the service.

Staff, relatives and stakeholders reflected that the management of the service was positive and had improved the atmosphere and culture in the home. There were clear improvement plans in place and positive feedback about the changes so far.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The service was small and gave people access to the local community. People’s independence was promoted in how they were supported for personal care and activities. Staff understood how to maintain people’s dignity and treated them with respect. There were clear values established for staff and role modelled by senior staff to ensure the culture was inclusive.

Right support:

• Model of care and setting maximises people’s choice, control and independence.

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

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 (4 January 2019).

Why we inspected

We undertook an inspection to review concerns related to how the provider was managing the service due to issues at another nearby location. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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 until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.