Limetrees

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• 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.

This is the first assessment for this newly registered service that registered with us in 2023. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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.

Care was not always delivered in a fully person-centred way, with some aspects of support appearing routine-driven rather than shaped around individual preferences and needs. We found care plans did not always clearly reflect people’s current wishes, routines, or interests, which impacted how consistently personalised care was experienced.

There were occasions where opportunities to engage meaningfully with people were missed, particularly during busier periods, which reduced the overall person-centred experience.

We saw positive examples where staff demonstrated a good understanding of individuals and their preferences. One relative told us how they felt involved in planning care, telling us, “We discussed [Person’s] diagnosis, medications, and diet in detail.”

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

Care provision and continuity were not always coordinated, with some gaps identified in how care was delivered and followed through. Records did not always clearly demonstrate care was reviewed, updated, and consistently applied, and there were occasions where information was not effectively carried across shifts or between staff teams.

We found variability in how different parts of the service worked together, for example between care staff and other teams, which impacted the consistency of support provided, including around dietary needs and daily routines.

We found some positive examples of integrated working. Staff worked with external professionals when needed. Relatives we spoke with told us about positive experiences with communication. One relative told us, “We are kept well informed.”

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

Information was shared effectively across the service, supporting people, relatives, and staff to understand care and support needs. Relatives consistently told us they felt informed and involved. Relatives and people told us they could easily approach staff or management with any questions or concerns.

There was evidence key information, such as care planning and communication with families, was shared in a way that kept all involved. Information such as the complaint’s procedure was also clearly displayed, helping people and relatives understand how to raise concerns if needed.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People were listened to and involved in their care, with positive feedback from both people and relatives about communication and engagement. Relatives told us they felt included in decisions. People described being able to raise concerns and told us management were approachable and responsive.

Staff were observed taking time to speak with people and involve them in day-to-day interactions, supporting a culture where people’s views were heard and respected.

Some people were less aware of their involvement in care planning. One person told us, “I’ve never had a conversation about anything like that.”

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

People were supported to access care, support, and services in an equitable way, no concerns were raised by people or relatives about barriers to care. Relatives we spoke with told us their family members were able to access the support they needed, when they needed it, and felt reassured staff were available to help.

People living at the home had access to communal areas, activities, and external support where required, and the service demonstrated an inclusive approach by encouraging community involvement, such as visits from volunteers. One relative described the home as “a happy and relaxed place,” reflecting a welcoming and accessible environment.

Relatives also spoke positively about the service meeting individual needs. One relative told us, “[Person] is very comfortable in her room at all times.”

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People and relatives, we spoke with described positive and consistent outcomes, with many highlighting improvements in wellbeing, safety, and overall quality of life. Feedback indicated people felt comfortable in the environment and supported to maintain their routines and independence.

Relatives we spoke to, told us positively about the care provided, describing the home as “a lovely place” and noting their family members had settled well and were receiving the support they needed. Others highlighted improvements compared to previous living situations, particularly in relation to safety and wellbeing.

People also experienced positive social outcomes, with opportunities to engage in activities and interact with others.

People were not always 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.

Planning for the future was not consistently evident or fully embedded within care plans, it was not always clear how people were supported to consider and express their wishes for future care. Care plans did not consistently demonstrate forward planning, including how people’s needs may change over time or how their preferences would be respected as circumstances evolved.

There was also limited evidence discussions around future care planning were routinely documented or reviewed, which reduced assurance people’s long-term wishes were clearly understood and planned for.

Some relatives we spoke with, felt involved in ongoing care discussions and were confident in raising concerns or future needs if required. One relative said, “My daughter would speak up if had to so that’s a reassurance,” indicating families felt able to advocate for future care needs. Others expressed confidence in the support their relatives were receiving and felt reassured about their ongoing care.