10 September 2018
During a routine inspection
At the last inspection in 2017 we rated the service as requires improvement. At this inspection we found that many improvements had been made, although some improvements were still required to ensure that medicines were consistently safely managed and all people’s risk management plans contained accurate and up to date information.
Limewood Nursing and Residential Home 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.
Limewood Nursing and Residential Home accommodates up to 59 people over seven ‘clusters’. At the time of the inspection, the service supported 57 people.
Limewood nursing and residential home was specifically designed by a team of clinical specialists, architects and designers at the University of Sterling who have been promoting the importance of the design for people living with dementia. The home has seven ‘clusters’ which are spread across three floors. On the ground floor, there is a high street which was made to replicate the town of Stafford and includes a pub, a picture house, a hairdressing salon and a large area for social activities.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Some improvements were required to ensure that medicines were consistently managed safely to ensure that people received their medicines as prescribed. Risk assessments were in place and most were very detailed and specific to each person, to provide staff with the information they need to manage people’s risks. However, we have a made a recommendation about ensuring consistency for all risk management plans.
People were protected from the risk of harm and staff were trained to recognise the signs of abuse. There were enough suitably skilled staff to meet people’s needs. People were protected from the risk of infection by robust prevention and control measures. Reflective practice and analysis meant lessons were learned when things went wrong.
People’s needs were suitably assessed before the moved to the service and staff were inducted and trained. People had their nutritional needs met and there were systems in place to ensure people received consistent care and support. People were supported to have healthier lifestyles by having timely access to healthcare services and professionals. People had their consent sought in line with the principles of the Mental Capacity Act 2005. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People received support that was delivered in a caring and compassionate way and people were treated with dignity and respect. People, where possible were consulted about how their care was provided and people’s care was regularly reviewed and adapted in accordance with their needs.
The service delivered care that was person centred. Staff knew people very well and they had access to activities. The provider had plans in place to further improve the provision of activities for people. There was a complaints procedure available to people and their relatives and people were supported at the end of their life to have a dignified and comfortable death.
People, relatives and staff felt the management team were approachable and supportive. There were opportunities for all to be involved in the development of the service and feedback was used to make improvements. The registered manager and provider had effective systems in place to monitor the quality and safety of the service and had plans in place to make improvements where these were required.
The service worked in partnership with other organisations to improve outcomes for people. They participated in innovative partnership working schemes to help improve the services provided.