1 October 2020
During an inspection looking at part of the service
The Limes is a residential care home providing personal care to up to 40 people with a range of support needs. There were 24 people living at the service at the time of our inspection. The service provides support to older people some of whom are living with dementia.
The Limes is purpose built. It is split over two floors with communal areas on each floor.
People's experience of using this service and what we found
Care plans and risk assessments were not updated in a timely manner and lacked clarity. As a result, people were put at continued risk of harm.
Infection prevention and control procedures were not following expected guidance and requirements. Staff did not always wear the recommended protective personal equipment when in direct contact with people. There was a cross contamination risk when disposing of clinical waste. This meant people were put at increased risk especially during the COVID 19 pandemic.
There were widespread and significant shortfalls in service leadership. Leaders and the culture they created did not assure the delivery of high quality care.
Staffing numbers were not sufficient to meet people's needs or keep them safe. New staff did not receive adequate induction and training before they started work at the home.
There were risks that people would not get their prescribed medicines at the right time. Medicine trained staff were not available on every shift and night staff had not had their competency to manage people's medicines assessed.
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 inadequate (report published 28 July 2020).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
Why we inspected
We undertook this targeted inspection to check whether appropriate action had been taken since our last inspection in relation to the breaches of Regulation 10, 12, 13, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
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 coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Limes on our website at www.cqc.org.uk.
Enforcement
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.