CQC report explained · a residential care home
What the CQC found at The Limes Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Medicines, safeguarding, infection control, equipment checks and staffing arrangements were found to be safe. Some staff files did not include the month of employment, but action was taken immediately.
- Effective?
- Good
- Staff supported people's health, mobility, nutrition and hydration. Inspectors found suitable training, healthcare links, personalised assessments and care that followed people's choices and best interests.
- Caring?
- Outstanding
- Inspectors saw exceptionally kind, respectful and person-centred care. People were supported to maintain relationships, make choices, stay independent and express their identities.
- Responsive?
- Good
- Care plans reflected people's histories, preferences and needs. The home offered a wide range of activities, outings and one-to-one support, and had systems for complaints, communication and end of life care.
- Well-led?
- Good
- Inspectors found open and supportive leadership, regular audits and action plans. Managers promoted learning from mistakes and involved people, relatives and staff in decisions and improvements.
What inspectors found, February 2020
Rated Good overall, with Outstanding caring; inspectors found warm, safe and well-organised care, with a minor recruitment records issue corrected during the visit.
This was an unannounced, planned inspection on 3 and 9 January 2020. Inspectors spoke with people living in the home, relatives, staff and visiting professionals. They observed care and checked care plans, medicines records, recruitment files, training records and management systems.
People told inspectors they felt safe and were treated with kindness and respect. Staff supported people's health, nutrition, independence and personal choices. There were activities seven days a week, including one-to-one options and outings. Inspectors also found good support for communication, complaints and end of life care.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were all rated Good. Caring was rated Outstanding, improving from Good at the previous inspection. The report says the home was consistently managed and that people's outcomes were consistently good.
Kind and respectful care
Staff consistently showed patience, kindness and respect. Inspectors described the home as warm, happy and positive.
“Staff consistently showed respect, patience and understanding when supporting people.” from the report
Personal choice and independence
People were involved in decisions about their daily lives and care. Staff supported people to remain active and take positive risks safely.
“People were empowered to make their own decisions and choices and confirmed they could make choices in relation to their day to day lives.” from the report
Activities and relationships
There was a full programme of activities, outings and one-to-one support. Relatives were welcomed and included.
“There were three activity coordinators working at the service and activities organised seven days a week, including some evenings.” from the report
Health and nutrition support
The home had a strong focus on nutrition, hydration, mobility and access to healthcare. Inspectors found evidence that chest infections and urinary tract infections had reduced.
“There was a strong emphasis at the home on the importance of supporting people to maintain their health, mobility and independence.” from the report
Open leadership
Managers and directors were closely involved in the home. They used audits, feedback and reflective accounts to improve care.
“The registered manager and directors promoted the ethos of honesty, learning from mistakes and admitting when things had gone wrong.” from the report
Incomplete employment dates
minorNot all staff records included the month when employment began. This could make it harder to identify gaps in a person's work history, although the home corrected the issue immediately when inspectors raised it.
“However, not all staff had written the month of their employment; this meant that the registered manager may not be aware of some gaps” from the report
- 01What changes were made to staff employment records after inspectors found that some months were missing?
- 02How are staffing levels reviewed if my relative's needs change?
- 03Which activities and outings would be suitable for my relative, including one-to-one options?
- 04How would you support my relative's food, drink, mobility and healthcare needs?
- 05How would my relative and our family be involved in care planning, reviews and decisions?
This was an unannounced inspection covering all five CQC questions and both the premises and the care provided; all five ratings were assessed. This explanation was written from the published report of 18 February 2020 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, June 2017
The Limes Residential Home was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection on 25 April 2017. Two inspectors spoke with people living in the home, visitors, health professionals, managers and staff. They observed care and checked care plans, medicines, staffing, accidents, policies and quality records.
The inspectors rated all five areas Good: safe, effective, caring, responsive and well-led. They found enough staff, safe medicines systems, suitable training, personalised care plans, good support with food and healthcare, and a positive approach to people's choices and dignity.
The home had improved since May 2016, when it was rated Requires Improvement. Problems with environmental risks and pressure area care had been addressed. The inspectors found the home was meeting the relevant requirements at this inspection.
Risk management
The home had improved its management of environmental and pressure injury risks since the previous inspection. Individual risk assessments gave staff clear guidance.
“At this inspection, we found action had been taken and the provider was meeting the requirements of this regulation.” from the report
Staffing and training
Inspectors found enough staff to meet people's needs without rushing them. Staff had induction, ongoing training and regular supervision.
“There were enough staff to meet people's needs and to enable them to engage with people in a relaxed and unhurried manner.” from the report
Kind and respectful care
Staff were seen communicating kindly, protecting privacy and supporting people to make choices and remain independent.
“Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect.” from the report
Personalised support
Care plans included people's preferences, communication needs and health requirements. Activities were offered individually and in groups, and were adapted to people's interests.
“Care plans and activities were personalised and focused on individual needs and preferences.” from the report
Open management
People, families and staff were encouraged to give feedback. The management team used meetings, surveys and checks to monitor the service.
“There were systems in place to monitor the quality and safety of the service provided and manage the maintenance of the buildings and equipment.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently decide whether there are enough staff, including when people's needs or staff availability change?
- 02How is the electronic medicines record system checked, and what happens if a medicine is missed or given late?
- 03How often are my relative's care plans and risk assessments reviewed, and how will I be involved in changes?
- 04What activities and outings would be available for my relative, based on their interests and abilities?
- 05What improvements were made after the May 2016 inspection, and how do you check that those improvements have continued?
This was an unannounced inspection of the overall service, including all five CQC questions. This explanation was written from the published report of 9 June 2017 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 Residential Home
5 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015Inadequatestayed InadequateSafe: Inadequate
- October 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2013
Registered with the Care Quality Commission on 6 September 2013.
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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