The Limes Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question inadequate, and the service was in breach of legal regulations related to safeguarding and safe care and treatment. At this assessment the rating has changed to good and the service is no longer in breach of the legal regulations. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. For example, since our last inspection, the provider had introduced a tracker following review of any incidents. Lessons from these incidents were then shared with the staff team to avoid recurrence.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Health risks were managed, and care plans were reflective of people’s needs. A relative said, “They [staff] are quick to contact me if there are any issues.” Another relative told us, “[Family member] had to go to hospital recently and they [staff] kept us involved with what was happening.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. We found where safeguarding concerns had been identified, this was shared promptly with the local authority and actions were taken to reduce risks. A relative told us, “There have been a few things that concerned me in the past… since the last inspection I feel [family member] is safer.”

The provider did not always work effectively with people to understand and manage risks in a holistic or person‑centred way. Although risk assessments were in place, some were too generic and did not give staff the information they needed to support people safely. For example, one care plan instructed staff to use breathing exercises and grounding techniques but did not describe what these involved or how staff should carry them out. This meant staff did not always have clear guidance to deliver safe and consistent care. People told us they felt safe, one person said, “I feel safe when the staff come in.” Another said, “Oh yes, I definitely feel safe.However, a relative said, “Risk plans don’t always cater the care to meet my [family member’s] needs.”

The provider detected and controlled potential risks in the care environment. Equipment and facilities were maintained to support the delivery of safe care. Since our last inspection, the provider had made several environmental improvements. For example, window restrictors had been fitted where required, and fire doors had been fitted with appropriate hold-open devices. Fire‑related risks had been identified and addressed, contributing to a safer environment for people.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. At our last inspection we identified concerns with staff training and competence. At this inspection, improvements had been made. The provider had introduced an updated competency workbook and was reassessing and supporting the staff team. We received mixed feedback from people, one person told us, “They don’t come quick at all. It takes a while for them to come and answer the bell.” Another said, I think they are a bit short staffed.” We reviewed staffing levels during our visits and observed people were attended to promptly.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. We observed the service was clean, personal protective equipment (PPE) was available to staff and waste was stored and disposed of correctly. A relative commented on the improved cleanliness, they told us, “The home doesn’t have that horrible smell anymore.”

The provider did not always make sure that medicines and treatments met people’s needs, capacities and preferences. Although medicines were generally stored and administered safely, and people received their routine medicines as prescribed, medicines prescribed to be given as required (PRN) protocols were not always sufficiently person‑centred. We observedone personhad to wait for their PRN medicines,staff told us they would administer the PRN medicines at the end of the medicines round,meaning medicines management was not always responsive to people’s immediate needs.