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Inspection carried out on 9 October 2017

During a routine inspection

The Limes’ is a domiciliary service operated by ‘Methodist Homes’ in a large purpose built complex that includes ‘Westbury Grange’ care home. The domiciliary support service provided by staff from ‘The Limes’ enables people to live independently in their own flats within the complex and not as residents within the separately registered and inspected care home. The Limes provides a service for up to 45 people and is purpose built over two floors. At the time of our inspection four people were receiving personal care.

At the last inspection, the service was rated Good.

At this inspection on 09 October 2017 we found the service remained Good.

People felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and knew how to report abuse, protecting people from avoidable harm. People had risk assessments in place to enable them to be as independent as they could be whilst being kept safe. There was sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service to ensure all staff employed at the service were suitable for the role.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Some people were supported to administer their own medication.

Staff received a comprehensive induction programme and a variety of training to ensure they were able to provide care based on current practice when supporting people. They were supported by the manager and had regular one to one time for supervisions and annual appraisals.

Staff gained consent before supporting people with their care. People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005. People were able to make choices about the food and drink they had, and staff gave support when required. People were supported to access a variety of additional health professionals when required.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People were given choices about their day to day routines and about how they wanted their care to be delivered. People’s privacy and dignity was maintained at all times.

People’s needs were assessed before they were provided with a care package and the care plans reflected how their needs were to be met. Records showed that people and their relatives were involved in the assessment process and the on-going reviews of their care. There was a complaints procedure in place to enable people to raise complaints about the service.

People and staff were positive about the new manager and staff told us they felt well supported. A variety of quality audits were carried out, which were used to drive improvement and allowed people and staff to express their views about the delivery of care.

Inspection carried out on 22 September 2015

During a routine inspection

This inspection was carried out on 22 September 2015 and was announced.

The inspection was carried out by one inspector.

‘The Limes’ is a domiciliary service operated by ‘Methodist Homes’ in a large purpose built complex that includes ‘Westbury Grange’ care home. The domiciliary support service provided by staff from ‘The Limes’ enables people to live independently in their own flats within the complex and not as residents within the separately registered and inspected care home. At the time of our inspection nine people were using the service.

Some people in the complex were receiving domiciliary support from other regulated agencies external to 'The Limes', but these agencies are subject to their own separate inspection.

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.

People felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report them.

People had risk assessments in place to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, to support the people with their needs.

Effective recruitment processes were in place and followed by the service.

People were assisted with ordering and taking their own medication.

Staff received a comprehensive induction process and on-going training. They were supported by the registered manager and had regular one to one time for supervisions.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff always gained consent before supporting people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were very knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required.

People were supported to access a variety of health professionals when required.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well.

People had been involved in the planning of their care and support.

People’s privacy and dignity was kept at all times.

People were supported to follow their interests.

A complaints procedure was in place and accessible to all. People knew how to complain.

Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Inspection carried out on 2 October 2013

During a routine inspection

When we inspected there were only a few people living independently in the flats that required varying levels of support with their personal care. With their prior agreement we met and spoke with five people in their own flats who received domiciliary support with their care needs. We asked them to tell us about their experience of receiving a service and they all confirmed they were very happy with the quality of the care and support provided by the domiciliary care staff. Their comments included; “Having the help we need means we can live in our own flat. They do a really good job.”

We found that the domiciliary support people received was provided by competent and appropriately trained care staff. We saw that the agency office was efficiently organised and managed so that people consistently received a safe, reliable, and effective service as and when they needed it.