The Limes

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This was the first assessment of a newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice. Action was taken to understand why a person had become distressed or why an incident occurred and what could be changed to prevent further occurrences. Learning from incidents was a thread running through the governance systems and the management team were keen to identify any problems and improve the service and outcomes for people. Lessons learnt meetings took place following any safeguarding concerns or incidents. Discussions between staff and people took place to ensure practice was reviewed and changed made to improve the service. We observed members of the management team supporting staff interacting with people from a distance and providing practical guidance, support and learning. This helped staff feel supported and gave them the necessary knowledge to build new skills. The process also meant people were given time and space and were not overpowered by large numbers of staff.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People were consistently supported when they were distressed. Care plans were in place to support people to have a good day, and strategies were in place to prevent distress. Reactive strategies were available and followed by staff. Professionals working alongside the service were complimentary about the support people received. One professional said, “I have to say that the whole process of transition with the team from The Limes and the associated college was one of the best I have experienced. The team partnered with us, [person’s] family and their support team at their previous home to produce a robust and detailed support planned to ensure a successful transition to The Limes.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People were supported to develop skills to protect themselves from harassment and abuse in the community in a way that didn’t infringe on their independence. The provider could evidence working with local youth groups to ensure young people understood the needs of people using the service.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks associated with people's care and support had been identified and were carefully managed in a way which actively promoted people's independence, enhanced daily living skills and maximised people's choice and freedom. The ethos of staff was to ensure that people could work towards living the lives they wanted, whilst reducing the likelihood of people experiencing harm.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People and their relatives were consulted about the environment and adjustments were made to meet individual needs. For example, one person’s living room was a replica of their family home lounge. This provided the person with familiar surrounding which they were comfortable with.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Staff were matched to people’s needs and aspirations to enable them to achieve their potential. Staff were recruited safely, and pre-employment checks were carried out prior to new staff commencing their role.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The service was clean and well-presented and a team of ancillary staff ensured deep cleaning of the houses took place in an unobtrusive way.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Medicine management was overseen by the deputy manager who had systems and processes in place staff could easily follow. The management team told us medicines were regularly reviewed by GPs to ensure medicines were not prescribed unnecessarily.