CQC report explained · a residential care home
What the CQC found at The Limes
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Some risk assessments lacked useful detail, and fire evacuation plans and health and safety checks needed improvement. Medicines, staffing and infection control were found to be generally safe.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found clear improvement plans, supportive management and an improved atmosphere and culture in the home.
What inspectors found, August 2021
The Limes was rated Good overall, but Safe requires improvement because some risk assessments and safety checks were incomplete.
This was an unannounced, focused inspection. Inspectors visited on three dates, spoke with people, a relative and staff, observed care and checked care, medicine, recruitment and management records.
The home was rated Requires Improvement for Safe. Medicines, staffing and infection control were generally managed safely. However, some risk assessments lacked useful detail, night-time fire evacuation plans needed review, and health and safety checks were not always completed as often as required.
The home was rated Good for Well-led. Inspectors found an improved atmosphere, clear improvement plans and a positive approach from the management team. The overall Good rating also included ratings from earlier inspections for the questions not checked during this visit.
Medicines managed safely
People received their medicines as prescribed. Staff had their medicine administration skills checked, and plans explained how people received their medicines.
“People received their medicines as prescribed and had care plans to outline how they received their medicines.” from the report
Positive leadership
Inspectors found that management had improved the atmosphere and culture. There was a clear plan to make further improvements.
“The manager and nominated individual had produced a thorough, clear action plan to make required improvements in the service” from the report
Person-centred support
The home promoted people's independence, dignity and access to the local community. Staff were described as adapting support to individual needs.
“This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.” from the report
Infection control
Inspectors were assured about the home's arrangements for preventing and managing infections, including PPE, testing, visiting and outbreak planning.
“We were assured that the provider was using personal protective equipment (PPE) effectively and safely.” from the report
Risk records lacked detail
needs fixingSome risk assessments did not include enough useful information. Positive behaviour support plans did not always explain what people might be communicating or how they could develop skills.
“The level of detail varied and some lacked some useful information for staff, however staff we spoke with were aware of people's risks” from the report
Fire and safety checks
needs fixingThe fire evacuation procedure was not clear enough, and night-time evacuation plans needed review. Some health and safety and fire checks were not completed as often as required.
“Not all health and safety and fire checks were completed as frequently as required.” from the report
Some training was overdue
needs fixingNight staff were not up to date with basic life support training. The provider agreed to address this.
“We highlighted that night staff were not up to date with basic life support training.” from the report
Incident reporting needed improvement
needs fixingThe home needed to improve reporting of incidents, particularly behaviours seen as routine, so that staff could learn consistently from them.
“Incident reporting was an area for focus of improvement, particularly for behaviours seen as "routine", to ensure this is always reported.” from the report
- 01Have all risk assessments and positive behaviour support plans been updated with the missing detail?
- 02Have the fire evacuation procedure and night-time evacuation plans been reviewed and tested?
- 03Are health and safety and fire checks now completed at the required frequency?
- 04Are all night staff now up to date with basic life support training?
- 05How are incidents and routine behaviours recorded and reviewed so staff learn from them?
This was a focused inspection of Safe and Well-led only; the other question ratings came from the previous comprehensive inspection. This explanation was written from the published report of 5 August 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2019
The Limes was rated Good in all five areas; inspectors found personalised, caring support with systems to keep people safe and involved.
This was an unannounced comprehensive inspection on 4 and 14 December 2018. One inspector spoke with two people, the manager, three care staff and one relative. The inspector also observed care and reviewed care plans, medicines, recruitment, complaints, incidents and quality records.
The inspectors found that people received personalised care from staff who understood their needs. People were supported with health care, food, activities, communication, relationships and daily routines. Staff treated people with dignity, respected their privacy and helped them stay as independent as possible.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The report says the service remained Good since the previous inspection in February 2016, with no serious risks or concerns identified.
Personalised support
Staff understood people's needs and arranged staffing around their preferred activities and routines.
“People received personalised care from staff who had a good understanding of their needs.” from the report
Support with anxiety
Care plans explained how to recognise changes in behaviour and reduce known triggers. Incident reviews were used to improve support.
“The registered manager analysed incidents involving people to identify triggers to people's anxieties.” from the report
Respect and dignity
People were treated with patience and respect. Staff supported privacy and helped people remain independent in daily life.
“People's dignity and privacy was respected by staff.” from the report
Activities and relationships
People were helped to follow their interests, keep in touch with important people and take part in community activities.
“People led an active life and were given choices about how they spent their time.” from the report
Health support
People had health action plans and were supported to use health services. Information from professionals was included in care plans.
“People had access to healthcare services as required.” from the report
Management checks
The manager used audits, feedback and regular reports to monitor care and safety.
“The registered manager had systems in place to monitor the quality and safety of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How will staff recognise and respond to my relative's early signs of anxiety?
- 02What activities and routines would be available for my relative, and how would staffing be arranged around them?
- 03How would my relative's communication needs be recorded and understood by new or temporary staff?
- 04How would you support my relative to maintain contact with family and friends?
- 05Has the planned sensory room been completed, and how would it be used to support residents?
This was an unannounced comprehensive inspection covering all five key questions, with records for three people and observations of care in communal areas. This explanation was written from the published report of 4 January 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The Limes
3 rated inspections over 5 years: the service has held its Good rating throughout.
- August 2021Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Goodstayed GoodSafe: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 17 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
26 live-in carers within about an hour of Hampshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.