A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
This is a summary of what we found:
Is the service safe?
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). The provider told us they had not had a need to make an application to deprive anyone of their liberty but in light of recent changes in legislation, they would seek advice from the DoLS Supervisory body.
People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People told us they felt safe and had no concerns. Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. We viewed the staff training matrix which showed all staff were provided with safeguarding training. This ensured staff had the knowledge and skills to respond to any allegations of abuse appropriately.
These findings demonstrated to us that the service was safe.
Is the service effective?
A pre-admission assessment of people's needs had been undertaken before they moved into the home. The manager visited people in their own homes, or in hospital before they were admitted. This enabled the manager to discuss people's needs with them and/or their family and next of kin. This enabled people to discuss the services provided at Lime Tree Court and their individual needs and how they wished them to be met.
People received co-ordinated care. We saw evidence in people's care plans which demonstrated people had been visited by their GP and other health care professionals and appropriate advice sought when required
We found the care and support provided was reflective of people's needs detailed in their care plans. Where any changes in their health and social care needs were evident, their care plans had been updated to reflect the change in their needs and how they were to be supported to meet them. Any accidents or incidents were recorded appropriately detailing the actions taken and risk assessments had been updated documenting any further measures put into place to prevent a recurrence.
It was evident through discussions with staff and through observing their interactions with people that they had a good relationship and understanding of everyone's needs and knew them well.
These findings demonstrated to us that the service was effective.
Is the service responsive?
The provider was responsive to people's individual needs in relation to their health,social care and personal care needs. Records had been maintained of appointments with health care professionals and any advice given was recorded and care plans updated to ensure their needs were met appropriately. People were consulted with in relation to the choice of activities provided. This ensured their individual social needs were catered for according to their preferences and interests. Any accidents and incidents were recorded and investigated appropriately. They detailed the actions taken and risk assessments had been updated to document any further measures put into place to prevent a recurrence.
These findings demonstrated to us that the service was responsive.
Is the service caring?
Throughout the day we observed staff interacting with people living in the home. Staff were seen to be talking and supporting people in a kind, gentle and attentive way. Staff showed patience and encouragement when supporting people and had a good understanding of people's needs and knew them well. Comments from people who used the service included ''The carers are kind, sometimes I wonder how they put up with us all.'' ''We're safe, everything is fine...the food is good, the staff are good they look after us really well what more can you ask for.'' A relative we spoke with was happy with the care and support their relative received and told us '' We have no complaints and the staff are lovely.''
These findings demonstrated to us that the service was caring.
Is the service well led?
The provider was very much involved in the day to day care provided, by talking to people and their relatives, speaking with staff and observing their practices. This meant any issues raised or observed could be dealt with immediately.
People's views were actively sought through regular monthly reviews of their care and support, annual questionnaires and on a general day to day basis. This enabled people to review the quality of the services provided and make suggestions where improvements could be made.
People's care plans were reviewed on a monthly basis and updated where any needs had changed. This ensured the service maintained an accurate record in respect of each service user needs.
Systems were in place to log and record accidents, incidents and complaints and the actions that had been taken in response to these. This enabled the provider to assess the types of incidents and complaints and enabled them to learn from them to minimise the risk of any possible recurrence.
We saw various health and safety checks were undertaken. For example, we saw the lift, hoists and assisted bath were regularly checked and serviced. This ensured equipment was in good working order and safe to use. We saw systems were in place to regularly check the fire doors, the fire alarm system and regular fire drills were undertaken.
Daily cleaning routines were undertaken and daily checks were completed. This was to ensure the environment remained clean and free from risk of cross infection. This meant the service had appropriate systems and processes in place for gathering, monitoring. recording and evaluating the quality of services they provided.
These findings demonstrated to us that the service was well led.