Limetree Care Home

Updated 25 December 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by three inspectors and a Specialist Advisor who was a registered nurse.

Service and service type

Limetree Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period of notice of the inspection, this was because we were responding to risk concerns, and wanted to be assured that no one at the home was symptomatic in light of the COVID-19 pandemic.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed all the key information providers are required to send us about their service, including statutory notifications. We used all of this information to plan our inspection.

During the inspection-

We spoke in-person with ten people who lived at the care home and 14 staff members, including, registered nurses, care workers, senior care workers, activities personnel, maintenance personnel, the registered manager and the regional quality and improvement manager. We also spoke with the nominated individual who is responsible for supervising the management of the service on behalf of the provider. We contacted a healthcare professional who regularly visits the service.

We reviewed a range of records. This included seven care plans, medicines administration records, four staff files in relation to their recruitment, rotas, policies and audits.

After the inspection

We spoke with four relatives to gather their views. We continued to seek clarification from the provider to validate evidence found. We looked at the maintenance file and additional audits.

Updated 25 December 2020

About the service

Limetree Care Centre is a nursing home providing personal and nursing care to 87 people aged 65 and over at the time of the inspection. The service can support up to 92 people in one adapted building over three floors.

People’s experience of using this service and what we found

People told us they were happy with the standard of care and support provided at this care home. The service was now adequately staffed and was no longer reliant on any temporary agency staff. This had helped drive up the standard of care provided because most of the staff were now permanent and were therefore more familiar with the needs, wishes and daily routines of people living at the care home. The suitability and fitness of staff to work in an adult social care setting continued to be thoroughly assessed.

People were cared for and supported by staff who knew how to manage risk and keep them safe. The premises were kept hygienically clean and staff followed relevant current best practice guidelines regarding the prevention and control of infection. Safeguarding concerns were appropriately managed and incidents and accidents were regularly audited to minimise repeat incidents. People received their medicines as prescribed.

People were supported to participate in activities that reflected their social interests and to maintain relationships with family and friends to avoid social isolation. People's care plans were person centred, which helped staff provide them with personalised care and support. Staff ensured they communicated and shared information in a way people could easily understand. People’s concerns and complaints were listened to and investigated by the provider. The service had systems in place to support people in line with their wishes when at the end of their life.

The provider recognised the importance of learning lessons when things went wrong and were keen to continuously improve the service. The quality and safety of the service people received was routinely monitored by managers and nursing staff at both a provider and service level. People’s views were sought to drive improvement and the registered manager placed a focus on working in partnership with stakeholders.

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 requires improvement (published 3 October 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We received concerns in relation to people’s nursing care needs and safety. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern.

Please see the safe section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Limetree Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.