3 March 2022
During a routine inspection
Limegrove is a residential care home providing accommodation and personal care for up to a maximum of 55 older people, some of whom may be living with dementia or other age-related conditions. The service is divided into five living areas over three floors. Each living area has its own lounge and dining room. At the time of inspection, 41 people were living at Limegrove.
People’s experience of using this service and what we found
Although some people told us staff responded to them in a timely manner when they required support and our observations supported this, staff told us they felt rushed and did not have time to spend with people. Staff rotas showed staffing levels fell below the amount they should be on several occasions. Although call bell audits demonstrated people’s bells were responded to in a timely manner, there was a risk that people may not receive prompt care from staff and staffing levels may be unsafe.
Risks to people had not always been identified or recorded in a way that may assist staff to provide responsive care. This meant people may be at risk of harm. In addition, some incidents of potential abuse had taken place, but these had not always been reported to CQC in line with requirements.
Although there were governance arrangements and systems at Limegrove these were not always effective in identifying shortfalls or areas requiring improvement. Such as care records or actions from audits. Staff told us, that despite a clearly recognised structure in place, they did not always feel supported or valued.
The registered manager was aware that work was needed to improve activities for people in order to help ensure they were not socially isolated. Our observations on the day were that little was going on and some people told us they would like to see more happen within the service. People said they spent their time in a variety of ways and the registered manager was working hard to reinstate activities following a recent COVID-19 outbreak.
People told us they were happy living at Limegrove. They said staff were kind and caring towards them and showed them respect. We observed this during our visit. People were enabled to make choices around how they wish their care and to retain their independence as much as possible.
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 were supported to see a healthcare professional when needed and they were provided with sufficient food and drink to help ensure they maintained a healthy weight. People received the medicines they required.
People lived in a service that was well maintained and homely and they were cared for by staff who had received sufficient training and supervision for their role. Staff knew people well and read people’s care plans to help ensure they provided person-centred, individualised care. People said they spent their time in a variety of ways and the registered manager was working hard to reinstate activities following a recent COVID-19 outbreak.
People knew how to make a complaint and felt comfortable doing so. Where complaints were raised, these were addressed.
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 14 August 2019).
Why we inspected
This inspection was prompted in part due to concerns received around poor infection control practices, lack of staff, poor medication records, a high number of falls within the service and people not receiving adequate drinks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.
We have found evidence that the provider needs to make improvements, although we did not find anyone was at immediate risk of harm. Please see the key questions of Safe and Well-led of this full report.
You can see what action we have asked the provider to take at the end of this full report.
The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We found breaches of regulation in relation to recognising potential safeguarding concerns, staffing and good governance within the service. You can read what action we have asked the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.