CQC report explained · a nursing home
What the CQC found at The Limes CHN
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safeguarding systems, suitable risk assessments, enough staff, safe recruitment, safe medicines arrangements and infection control procedures.
- Effective?
- Good
- This area was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found a clear management structure, regular checks, staff support and an open culture where people, relatives and staff could raise concerns.
What inspectors found, January 2021
The Limes CHN was rated Good; inspectors found safe care and good leadership after checking safeguarding concerns.
This was an unannounced, focused inspection on 8 December 2020. Inspectors looked only at Safe and Well-led because concerns had been raised about how safeguarding incidents were managed. They spoke with five people, 13 relatives and 11 staff, and checked care records, medicines, staffing, incidents and quality checks.
The home was rated Good for Safe and Good for Well-led. Inspectors found safeguarding systems, risk assessments, safe recruitment, enough staff, safe medicines arrangements and infection control measures. They found no evidence that people were at risk of harm from the concerns that led to the inspection.
The overall Good rating also used ratings from the previous comprehensive inspection for Effective, Caring and Responsive. Those three areas were not inspected during this visit.
Safeguarding
Staff understood different types of abuse and knew how to report concerns. Inspectors found that safeguarding incidents had been referred and responded to appropriately.
“The provider had safeguarding systems in place and staff had a good understanding of what to do to make sure people were protected from avoidable harm or abuse.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs. Recruitment checks, including references and DBS checks, had been completed.
“There were sufficient numbers of staff to meet people's needs.” from the report
Medicines
People received medicines as prescribed. Staff had medicines training and regular competency checks, and managers audited medicines each month.
“Medicines were managed to ensure people received them safely and in accordance with their health needs and the prescriber's instructions.” from the report
Learning from incidents
The home had increased spot checks and monitored accidents and incidents for patterns. Inspectors noted that falls had reduced after preventative equipment and room changes were introduced.
“We found accident and incident records were completed and monitored by the registered manager for trends to reduce the number of accidents and incidents.” from the report
Open management
People, relatives and staff described managers as approachable. Staff said they felt supported and able to raise concerns.
“There was an open culture where staff were encouraged to make suggestions about how improvements could be made to the quality of care and support offered to people.” from the report
Safeguarding concerns prompted the inspection
minorThe inspection took place because concerns had been raised about the management of safeguarding incidents. Inspectors found the concerns had been addressed and found no evidence that people were at risk of harm from them during this inspection.
“We received concerns in relation the management of safeguarding incidents.” from the report
- 01How are safeguarding incidents reported, investigated and reviewed now?
- 02How often are unannounced checks carried out on night staff, and what happens if a check identifies a problem?
- 03How do you make sure there are enough staff when people's needs change or staff are absent?
- 04How are medicines errors or concerns identified, recorded and followed up?
- 05How are infection control checks, including staff temperature checks and testing arrangements, kept up to date?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive carried over from the previous comprehensive inspection. This explanation was written from the published report of 1 January 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, April 2018
Rated Good; inspectors found safe, kind and personalised care, with some dementia-friendly improvements still needed.
The inspection was unannounced and took place on 20 February 2018. Inspectors spoke with people living at the home, relatives, staff, the management team and a visiting healthcare professional. They also observed care and checked care plans, medicines, staff records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, a clean environment and suitable staff training. People were treated kindly, involved in decisions and supported with activities that reflected their interests.
The home had improved since the previous inspection in November 2015, when the provider was rated Requires Improvement. Quality checks had been strengthened, and inspectors found that earlier concerns about people's rights, care planning and oversight had been addressed. Some opportunities to make the environment more dementia-friendly had been missed.
People felt safe
People and relatives said they felt safe. Inspectors saw staff respond promptly and calmly to people's needs and to situations that could cause distress.
“We observed that resident's rooms had a self-closing door that locked from the outside, to provide privacy and security for personal belongings” from the report
Kind and respectful staff
Staff were observed being patient, sensitive and reassuring. People were given time to make decisions and were treated with dignity.
“We observed interactions between people and staff throughout the day and saw that staff were kind, patient and sensitive.” from the report
Personalised care
Care plans included people's histories, preferences and interests. Staff knew this information and used it to tailor support.
“Care plans we reviewed included detailed information about people's care and support needs and also offered staff clear guidance about how to meet people's holistic needs” from the report
Activities and choice
The home offered group and individual activities linked to people's interests. People could choose whether to take part.
“Staff had a good knowledge about people's likes, dislikes and interests and encouraged people to take part in both group and individual activities.” from the report
More dementia-friendly areas needed
minorInspectors found that the home did not have reminiscence areas for people to use while walking around the building. The manager said there were plans to develop the environment further.
“Some opportunities for reminiscence had been missed as reminiscence areas for people to engage in while walking around the building were not available.” from the report
Menus were not accessible to everyone
minorMenus were written down, so some people might not have been able to understand the available choices. Inspectors suggested that pictorial menus could help.
“these were in written form and so would not be understood by some people.” from the report
- 01What reminiscence areas and other dementia-friendly changes have been added since this inspection?
- 02How do you make sure menus and meal choices can be understood by someone who cannot use written information?
- 03How do you decide whether there are enough staff for my relative's needs, especially as the number of residents changes?
- 04How will you keep my relative's care plan updated if their health, behaviour, preferences or interests change?
- 05How are medicines, incidents and quality checks reviewed, and how would you tell the family if a concern was found?
This was an unannounced inspection of the overall service and all five CQC questions, including care, the home environment, records, medicines, staffing and management systems. This explanation was written from the published report of 20 April 2018 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 CHN
2 rated inspections over 3 years: the service has held its Good rating throughout.
- January 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2018GoodSafe: GoodWell-led: Good
- April 2017
Registered with the Care Quality Commission on 4 April 2017.
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.
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