Lime House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

The service was in breach of a legal regulation in relation to person-centred care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

We were not assured person-centred care was always provided to people. Care plans lacked person-centred details and there were inconsistencies in care records. The service predominantly supported people living with a diagnosis of dementia and there was a lack of dementia support, dementia friendly signage and visuals in the service to meet people’s needs. For example, bedroom doors were not clearly marked or individualised so people could easily recognise them as being their room.This contributed to the breach of regulation 9 (Person-centred Care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

There were some shortfalls in how the provider understood the diverse health and care needsof people and their local communities, so care was not always joined-up, flexible or supportive ofchoice and continuity.

Activities for people to engage within the service were limited. An activity co-ordinator was employed 3 times a week and people told us they enjoyed engaging in the activities planned by the activities co-ordinator. However, during the remaining days of the week, there were limited and no meaningful activities for people to engage in. We observed a lack of activities when the activity co-ordinator was not in work, and people were sat in their chairs most of the day. We reviewed people’s activities records which showed a lack of meaningful activities. There was limited evidence of people being supported to build or maintain relationships outside of the service and limited opportunities of accessing activities in the community. This contributed to a breach of regulation 9 (Person-centred Care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communication needs and preferred methods of communicating were recorded in their care plans. This helped staff provide information in a way which was accessible, and each person could understand.

During our inspection we saw staff communicated effectively with people.

The provider understood their responsibilities in ensuring people received information in a way they understood.

The provider did not always make it easy for people to share feedback and ideas about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Although care reviews took place, there was no evidence people and their relatives had been involved in their care reviews. One person told us, “I am not involved in my care reviews.” This contributed to a breach of regulation 9 (Person-centred Care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Complaints were responded to in line with the provider’s policy. There was an up to date complaint policy in place and people told us they knew how to make a complaint. Comments included, “I would go straight to [registered manager] for anything and they have always said their door is always open” and “If I needed to complain, I would go to [registered manager].”

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People received care and support equitably, regardless of a person’s background, language, or culture.

The provider had policies and procedures around equality and diversity. Staff told us they had received training in equality and diversity. This helped to ensure they had awareness of people’s protected characteristics and the requirement for all people to receive fair and equal treatment.

Staff and leaders did not always actively listened to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People’s needs were not always considered, and care was not always tailored in response to their needs. People had limited opportunities to access their community. The activities provided were limited. Reasonable adjustments had not been made to the environment to enhance the independence of people living with dementia. This meant action had not been taken or considered to address and remove barriers ensuring people had all opportunities to live a full and varied life. This contributed to a breach of regulation 9 (Person-centred Care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were supported with their end of life care appropriately. An end of life policy was in place and end of life training was facilitated to staff. Systems were in place to ensure end of life support could be provided working alongside community professionals. Care plans contained details of people's end of life wishes for those people who wished to disclose them.