Archived: The Limes Residential Care Home

Updated 1 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 5 January 2016 and was unannounced.The inspection team consisted of an inspector, a specialist advisor occupational therapist and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. They did not return a PIR and we took this into account when we made the judgements in this report. We looked at notifications we had received regarding this service

We spoke with seven people using the service, three relatives and one visiting health and social care professional. We interviewed three care staff and talked with the registered manager.

We looked at seven people’s care plan records and six people’s medicines records including controlled drug records and administration of medicines. We checked adaptive equipment and observed staff in particular when moving and handling of people and when they assisting people to eat their meals.

Updated 1 April 2016

The Inspection took place on 5 January 2016 and was unannounced. At our last inspection on 6 February 2015 we rated the service as Requires Improvement. We found breaches in four regulations relating to staffing, maintenance of equipment, person centred care and medicines administration. There were concerns about the number of adequately trained staff, there was poor management of the prevention of falls and care staff did not maintain equipment. There was a lack of meaningful person centred activities.

The Limes Residential Care Home is a residential care home providing accommodation with personal care for up to 25 elderly people with dementia. At the time of our visit there were 20 people using the service, two of the people were in hospital.

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.

We found that the provider undertook staff recruitment checks to ensure candidates were safe to employ. Staff received three days induction training and regular supervision sessions. The registered manager now kept a falls matrix and recorded falls and the cause. We saw referrals to the falls clinics. The service risk assessed and identified risks but did not always give staff clear guidelines to manage the risks. Care plans were detailed for some areas of people’s support but lacked detail in moving and handling and managing people’s behavior.

The environment still was not accessible to people with cognitive impairments. The service had made attempts to sign post uneven floors and orientate people to their rooms but the measures taken were not effective. The environment was not safe as there was broken furniture and environmental hazards that were not being addressed appropriately.

People required greater assessment and attention paid to their adaptive equipment as care staff did not use specific equipment designed for the individual person.

The registered manager had arranged two new activity sessions that people have enjoyed. However were not activities on a regular basis throughout the week to keep people engaged and active.

People we spoke with and relatives spoke highly of the care staff and we saw some caring interaction by the care staff who know peoples likes and dislikes. People who use the service said they felt comfortable complaining to the registered manager who kept a record of complaints made.

The registered manager undertook audits but they were not successful in addressing the environmental issues.

We found overall 2 breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We made a recommendation about more frequent auditing of the environment.

You can see what action we told the provider to take at the back of the full version of the report.