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Archived: Lime Gardens Good

Reports


Inspection carried out on 15 December 2017

During a routine inspection

The inspection took place on 15 and 18 December 2017 and was unannounced.

Lime Gardens is registered to provide personal care services to people in their own homes. This service provides support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s support and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care service. On the day of the inspection, 47 people were receiving support.

Not everyone using Lime Gardens receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in post. 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.

At our last inspection we rated the service as requires improvement due to there not being enough permanent care staff to support people on a consistent basis, people’s right to request the gender of care staff supporting them not being respected and we found that people’s choices and wishes were limited. At this inspection we saw that improvements had been made to how people were supported.

Care staff were able to get support when needed to ensure they had the appropriate skills and knowledge. The provider had the necessary systems in place to adhere to the requirements of the Mental Capacity Act (2005).

People were supported safely and care staff knew the actions to take when people were at risk of harm. Where people were supported with their medicines this was done as they were prescribed. There was sufficient care staff available with the appropriate understanding of infection control to support people safely.

People were supported by kind and compassionate care staff who respected their independence, privacy and dignity. People were involved in deciding how care staff supported them.

Assessments and reviews took place which people were involved in. Where changes were needed to how people were supported the provider ensured they responded in a timely manner. People were able to share any concerns they had by way of the provider’s complaints process.

People were able to share their views by completing a provider questionnaire. Spot checks and audits were carried out to ensure people received good quality support.

Inspection carried out on 15 September 2016

During a routine inspection

The inspection took place on 15 and 16 September 2016 and was announced. We gave the service 48 hours’ notice of the inspection because the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. This was the first inspection of this service since it registered with us on 20 March 2015.

Lime Gardens is registered to provide personal care services to older adults in their own homes as part of an extra care scheme. On the day of the inspection 35 people were receiving support. There was a registered manager in post who was on leave. There was a temporary manager covering the management of the service. 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.

People felt they were being supported safely. Care staff knew what the different forms of abuse were and how to ensure people’s safety. People received their medicines as it was prescribed. There was not always sufficient and consistent numbers of care staff to support people how they wanted.

Plans were in place to ensure that care staff would be supported by way of supervisions and being able to attend regular staff meetings. The provider had the necessary systems in place to ensure the Mental Capacity Act (2005) was being adhered to. The support people received was only given by way of their consent and their human rights were protected.

While people told us that care staff were kind and caring, they did not always feel they were supported how they wanted to be. People’s support needs were assessed and then in consultation with them a support plan was put in place to identify how support should be delivered. Reviews did take place but they were not consistent to ensure where people’s support needs had changed these could be noted and actioned appropriately. People’s privacy and independence was respected but their dignity was not always respected.

People knew who to complain to and were able to raise any concerns they had by way of the complaints process. Complaints that had been received had been responded to in a timely manner.

While the registered manager and provider had previously carried out checks and audits to ensure the quality of the service people received, they were not always effective and had failed to identify at an early stage issues that had later been identified. The provider used questionnaires and regular resident meetings to gather people’s views on the support they received and the information was analysed and actions taken where concerns were identified.