The Limes Retirement Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question Inadequate. At this assessment the rating has changed to Requires Improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 45 (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 always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

The care and support delivered by staff did not always meet expected standards to ensure people’s privacy and dignity were upheld. At times staff were seen completing care in a task focused way, rather than meeting people’s needs and preferences in a personalised way. This led to a lack of privacy, avoidable distress and discomfort. For example, 2 staff were seen waking a person up, to hoist them into a wheelchair ready for lunch. The hoist was brought up to the person quite abruptly after waking with no real time given for them to come around and be ready to take part safely in the transfer. A person’s catheter bag was visibly hanging from their leg near their feet. Although attempts had been made to cover with a blanket, it was in view throughout the visit which did not preserve the persons dignity.

Staff were seen to have some positive interactions with people and spoke about them in a kind and caring way. Some relatives spoke positively about the care and support their family members received. Comments included, “The carers are amazing. They take time to talk to [family member] and they put their arms round her, so she has a sense of security. They have a lovely relationship with her. It was her birthday recently and they made her a cake. They are always laughing,” and “I am happy with the care [Family Member] gets. Sometimes they look disheveled, but they can be difficult and resist being showered. Staff seem to understand their expressions, even though they are non-verbal and they can distract him when necessary.”

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s individual needs and preferences were not always understood or reflected in the care treatment and support they received. At times, insufficient attention was given to ensuring people were treated as individuals. The registered manager told us, 3 people using the service had a hearing impairment and staff routinely checked their hearing aids to ensure they were clean and working. However, review of complaints, feedback from relatives in questionnaires and discussions with relatives, all raised concerns about people’s hearing aids not working, or missing. A relative told us, “[Family Member] hearing aids are broken. We mentioned it to the staff, and they said they would deal with it, but they didn’t.”

People were not always treated with dignity and respect. Bedding and accommodation provided, did not consider people’s specific needs, or promote their dignity and comfort. This included the base of a bed cut to fit over the stairwell where there was not enough space in the room for a full-sized bed and furniture. Since raising this with the registered manager the person has now moved rooms, but this was unsafe practice, due to a significant gap between the base and the stairwell with the potential for the bed to move. Additionally, the quality of the bedding throughout the service was poor, with very thin sheets and blankets and lumpy pillows, which did not promote people’s dignity and comfort.

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.

People, especially those living with dementia were still not being supported to take part in activities that promoted and supported their independence, health and wellbeing. Although people were supported to have access to friends and family, relatives provided mixed feedback about access to activities and the local community. Comments included, “They do exercises and they have other stimulating activities including music,” and “There are some things to do but there is still not enough going on. There are not enough stimulating activities or personalised care.” Keeping active and mentally stimulated is an important part of living well with dementia and reduces triggers for distressed behaviours. We saw people’s access to activities was still limited. There was a lack of visual, memory or sensory aids to help people experiencing memory loss communicate their needs, feelings, reduce stress and live well with dementia.

People’s sensory needs and opportunities for engagement were not always considered to promote a sense of independence and control. People were not routinely asked how they wished to spend their day. We saw people sat in the lounge, with the television on with little engagement. During an evening visit to the service, we saw the TV on with a programme about failings in a care home which contained some quite distressing footage. The registered manager and staff confirmed no one had been asked if they wanted to watch the programme. No residents’ meetings were held for people to have a say about what events, including activities they would like to take part in, which would have a positive impact on their self-esteem and overall well-being.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We noted staff were not always alert to incidents requiring immediate attention. For example, staff failed to notice where a person had spilt their drink on their clothing. This was of particular concern where 3 people had recently spilt hot drinks in their laps. Failure to recognise quickly when people needed help placed them at risk of harm or serious risk of avoidable harm occurring. However, relatives told us, with the increased staffing numbers there were more staff available to respond to people’s needs, such as supporting them to manage their continence and toileting needs. We saw some positive examples of staff responding to people’s needs. For example, a member of staff noticed a person appeared to be in discomfort, rubbing their stomach talking about their hernia, and offered them paracetamol, which they declined.

The provider cared about and promoted the wellbeing of their staff. Staff told us they felt valued, respected and supported within their roles. A staff member said, “I receive supervisions, and these are done individually with the manager, these are a great opportunity to discuss anything necessary, they are very supportive and a great time to talk about personal progression and development.” Staff described working as a family to improve the service and it was a lovely place to work, describing the registered manager and provider as supportive, approachable at any time and fair to all staff. A member of staff told us; they had been provided with opportunities to balance their home and work life to “become the best version of myself.” They told us, “The support I have received from the registered manager is second to none”.