Archived: The Limes 2

Updated 24 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection was carried out on 04 October 2016 by one adult social care inspector from the Care Quality Commission.

At the time of our inspection there were seven people who were living at The Limes 2. We were told that three of these people had lived at The Limes 2 for more than thirty years and another for over twenty years. We received positive comments from those people we spoke with.

We spoke with two members of staff and the deputy manager of the home. We also communicated with two relatives. We toured the premises, viewing private accommodation and communal areas. We observed the day-to-day activity within the home and we also looked at a wide range of records, including the care files of two people who used the service. This enabled us to determine if people received the care and support they needed and if any risks to people’s health and wellbeing were being appropriately managed. We also looked at the personnel records of two staff members, which helped us to establish the robustness of the recruitment practices and the level of training provided for the staff team. Other records we saw included a variety of policies and procedures, training records, medication records and quality monitoring systems.

Prior to our inspection we reviewed all the information we held about the service, including notifications the provider had sent us about important things that had happened, such as accidents and safeguarding incidents. We also looked at the information we had received from other sources, such as the local authority and community professionals involved in the care and support of those who lived at the home.

Updated 24 December 2016

The Limes 2 is located in a residential area of Brierfield, near to the town centres of Burnley and Nelson. The purpose of the service is to provide accommodation and personal care for up to seven people who have a mental disorder. There are some amenities close by, such as shops and pubs. . Public transport links are nearby and on road parking is permitted.

The last inspection of this location was conducted on 08 January 2014, when all five outcome areas assessed at that time were being met. This inspection was conducted on 04 October 2016 and it was unannounced, which meant that people did not know we were going to visit the home.

A registered manager was in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated regulations about how the service is run. The deputy manager was in charge of the home on the day of our inspection. However, the registered manager attended the inspection later in the day.

The care planning system was person centred providing clear guidance for staff about people's needs and how these needs were to be best met. The plans of care had been reviewed periodically.

Risks to the health, safety and wellbeing of people who used the service had been appropriately assessed and managed effectively. Where risks were identified these were addressed through robust care planning.

Fire procedures were easily available, so that people were aware of action they needed to take in the event of a fire and records we saw provided good information about how people needed to be assisted from the building, should the need arise.

A range of internal checks were regularly conducted and environmental risk assessments were in place, showing that actions taken to protect people from harm had been recorded.

Records showed that equipment and systems within the home had been serviced in accordance with the manufacturer’s recommendations. This helped to protect people from harm. Evidence was available to demonstrate that good infection control protocols were being followed in day-to-day practice.

Records showed that Mental Capacity Assessments had been conducted, in order to determine capacity levels.

The rights of people were protected as the service worked in accordance with the Mental Capacity Act and associated legislation. People's privacy and dignity was consistently respected.

The service had reported any safeguarding concerns to the relevant authorities and suitable arrangements were in place to ensure that sufficient staff were deployed, who had the necessary skills and knowledge to meet people's needs safely. A range of training for staff was provided. However, some areas of learning could have been completed by a higher percentage of the staff team. We have made a recommendation about this.

Recruitment practices adopted by the agency were robust. Appropriate background checks had been conducted, which meant that the safety and well-being of those who used the service was adequately protected.

There were effective systems in place for monitoring the safety and quality of the service. Audits viewed had identified any areas which were in need of improvement and action was taken to address these shortfalls.

Complaints were managed well and people we spoke with were aware of how to raise concerns, should they need to do so. Systems were in place to ensure that any complaints received were responded to in a timely manner and a thorough investigation was conducted.

During the course of our inspection we assessed the management of medications. We found that, in general these were satisfactory. However, we made recommendations in relation to recording of staff competencies, PRN [as and when required] protocols and the processes for the dispensing of medications. The service worked well with a range of community professionals. This helped to ensure that people's health care needs were being appropriately met.

People we spoke with were highly complementary about the staff team. They felt that they were treated in a kind, caring and respectful manner. People expressed their satisfaction about the home and the activities, which they were supported to enjoy.

Regular meetings were held for those who used the service. This enabled people to discuss topics of interest in an open forum and people's views were also gained through processes, such as satisfaction surveys.

We did not find any breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.