The Limes Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.
At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of the legal regulation in relation to safeguarding. We identified concerns with regards to people being deprived of their liberty for the purpose of receiving care without lawful authority.
 

This service scored 33 (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 make sure people’s care and treatment was effective. Care plans did not reflect the care people were receiving or provide enough guidance to staff on how to meet people's needs. For example, we found a person's care plan had not been updated following their return from the hospital to reflect they were not able to stand, that they needed bedrails for their safety and lacked an assessment of whether they needed repositioning to promote their skin health. Furthermore, we observed that their skin was showing signs of being sore. This increased health risks to the person.

The provider did not always plan and deliver people’s care in line with their needs. For example, a person was using a catheter, but there were no care plans in place for them around this. Records did not show consistent recording of their fluid output, and monitoring for signs of infection. The provider had also failed to ensure staff had catheter care-related training.
However, overall people’s records showed they received support to be repositioned regularly to promote skin health
 

The provider did not always work well across teams and services to support people. For example, we found evidence that staff were manually lifting people without equipment to support them in moving. Although records and staff told us they had referred a person for occupational therapy, and recommendations were made by a health professional to use a hoist, staff continued supporting a person to move unsafely. During one of our visits, the person's relatives and staff told us the person had nearly been dropped. This increased the risk of harm to that person.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or, where possible, reduce their future needs for care and support. For example, a person's care plans stated that for their wellbeing they needed a structured routine; however, records did not show this was happening, and staff confirmed this.

However, we also observed that people were supported with activities promoting their health and wellbeing, such as walking in the local park and engaging in cognitive function and hand-eye coordination-based activities and taking part in armchair exercises. A relative told us, “They noticed immediately that [relative] was having some swallowing issues and contacted SALT (speech and language therapists). [Relative] is now having a diet appropriate to [their] ability.”
 

The service did not effectively monitor people’s care and treatment to continuously improve it. We identified concerns in monitoring how people were supported when emotionally distressed, medicines safety and managing individual and environmental risks. The provider had not independently identified these concerns before our assessment. This increased the risk of people not experiencing safe, positive and consistent outcomes.

The provider did not always respect people’s rights when delivering care and treatment. Where people experienced physical restraint or restrictive practices such as when they refused support with personal care, the provider had failed to assess peoples’ mental capacity around this and evidence how they would ensure they supported them in their best interests and in the least restrictive manner. This meant the peoples’ rights in this area had not been upheld.

However, a person told us, “What I like is that staff respect my independence and they respect me as a person.” A relative told us, “The care is very effective. [Relative] is allowed to get up or go to bed when they want and their choices are respected.”