Background to this inspection
Updated
18 February 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
Day one of the inspection was conducted by two inspectors. Day two was completed by one inspector.
Service and service type
The Limes is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Before the inspection we reviewed the information we had received about the service, including previous inspection reports and notifications. Notifications are information about specific important events the service is legally required to send to us. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service about their experience of the care provided and four relatives. We also spoke with three visiting professionals, including two healthcare professionals and 13 members of staff including; a director of the company, the registered manager, two deputy managers, a member of the housekeeping team, a chef, an activities coordinator, administration support and five members of care staff. We observed the care being provided and reviewed a range of records, included five people's care records and multiple medication records. We looked at staff files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.
Updated
18 February 2020
About the service
The Limes is a residential care home providing accommodation and personal care for up to 32 older people. The service is based in a period property that has been adapted to meet the needs of the people living there. At the time of the inspection there were 23 people living in the service.
People’s experience of using this service and what we found
People told us they were very happy living at The Limes and that staff were respectful, kind, caring and went out of their way to provide person-centred care. Our observations confirmed this and we saw the atmosphere of the home was one of warmth, happiness and positivity. Staff consistently showed respect, patience and understanding when supporting people.
The providers, management team and staff were passionate about providing a service which was caring, compassionate and reflected the values of the organisation. These were based on an ethos of ‘Helping you to live the life you choose’ which was embedded into staffs' practice. The culture within the home supported a warm and friendly atmosphere.
People felt safe and they were provided with safe care. There were suitable systems in place to ensure that medicines were securely stored, ordered and disposed of correctly and safely and people received their medicines as prescribed. Recruitment practices were effective and there were sufficient numbers of staff available to meet people’s needs. People were protected from avoidable harm, and infection control risks were managed appropriately.
There was a strong emphasis at the home on the importance of supporting people to maintain their health, mobility and independence. The providers and management team were proactive in ensuring people's nutrition and hydration needs were met and measures had been taken to support people to remain active and experience optimum physical and emotional health.
The provider and managers were proactive in facilitating learning and development to benefit the people living in the home. For example, they held workshops and training sessions with staff and relatives and offered learning experiences to the local community to improve understanding of dementia. Staff were empowered to make improvements at the home that had a positive impact on the people living there.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People benefitted from a full programme of activities which was individualised, followed people’s interests and had a positive impact on their emotional and physical health.
People, visitors, staff and professionals were positive about the leadership of the home and told us the directors and managers cared about the people living there.
The management team were open and transparent. They understood their regulatory responsibilities. There were effective governance systems in place to identify concerns in the service and drive improvement. The registered manager and directors promoted the ethos of honesty, learning from mistakes and admitted when things had gone wrong.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.