The Limes Retirement Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked at 4 quality statements for Caring at this assessment. We found the service was not caring. There has been a decline in the service since the last inspection. During our assessment of this key question, we found concerns about person-centred care, which resulted in a breach of the legal regulations. You can find more details of our concerns in the evidence category findings below. The provider did not have effective systems in place to deliver a consistently caring service. Staff were seen to have some positive interactions with people and spoke about them in a kind and caring way. However, people’s individual needs and preferences were not well understood. Staff also did not have sufficient guidance to respond to people’s immediate care needs and reduce the risk of avoidable distress and discomfort. People’s dignity and independence was compromised by insufficient staff deployment, support, direction and training. There was a lack of user involvement in care planning, including information on people’s life histories, pastimes, interests and hobbies.

This service scored 35 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Thought had not been given as to how people's dignity could be promoted and supported. There were not enough staff to provide the right level of care and staff were not deployed in a way that ensured people’s safety, comfort and dignity. Some people were left in an unhygienic and undignified manner because they were not supported routinely or regularly to go to the toilet.

Staff told us they were committed to the people living at The Limes; whilst they spoke about people in a kind and caring way, they had little guidance on best practice in their delivery of care, especially in relation to people communicating and expressing themselves through behaviours.

Whilst we saw some positive interactions between staff and people using the service, people’s needs were not always responded to quickly and efficiently. Best practice in respecting and promoting people's dignity, choice and independence was not consistent. People’s continence and toileting needs were not met in a dignified and respectful way. Planned and consistent support was not given to a person regularly seen urinating in the communal areas which was not only undignified for the person but was also distressing to others and contributed to the mal odour of the home.

People’s individual needs and preferences were not always understood and reflected in their care, treatment, and support. Insufficient attention was given to appropriately engaging with and involving people who had dementia. In general people living in the home had complex needs which had not been continuously explored or reviewed to ensure they could experience a meaningful, tailored and inclusive life as far as possible.

One staff member told us, “We have singers coming in and exercise once a week”, another said, “Some people just like walking around, if I talk too much to one person, they just get agitated.” We raised our concerns with the provider about the lack of individualised care.

Care delivered was task led and people did not have access to a wide range of leisure activities personalised to their interests to help prevent boredom and support independence. Staff did not show understanding or competence in how to effectively communicate, interact, engage with or support people living with dementia in a meaningful way.

Processes were not in place to promote and take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics such as disability. Dependency assessments, care planning and calculations for staffing numbers did not consider people’s emotional and cognitive needs or social and wellbeing engagement. Partner agencies had offered support and training to develop a more personalised approach including dependency mapping, but this offer has not yet been taken up by the provider.

We received some positive feedback from people and relatives about visiting entertainment, events and physical exercise sessions. However, there was a lack of meaningful activity throughout each day to keep people occupied, reduce boredom, promote interest, and support independence. Staff did not use accessible means of communication to enable people to express their choice or preference.

Staff were unable to tell us how they would engage meaningfully with individuals to promote independence and wellbeing. Whilst staff spoke about choice, we did not see this in practice. Staff did not consider if people were comfortable or wanted to mobilise or have a change of scenery.

We saw people were able to have visitors in line with national best practice guidance, to keep relationships with family and friends. However, people did not have choice and control in relation to flexible access to the community and leisure activities both inside and outside of the home. We saw people left mostly to their own devices, which heightened anxieties and caused avoidable distress for people. People were walking continually around the service during our visits to the service, at times in the kitchen or in the office alone. Staff did not provide consistent or effective support to these individuals and their experience of day to day living at the service was poor. People were not supported to go to bed when they wanted to go.

There was a lack of user involvement shown in care planning. We also did not see people having a choice. Care plans did not provide detailed information on how staff should support people’s choices, new relationships or to meet people’s ambitions and goals. Care records did not say how the service was supporting people to be more independent.

People’s needs, wishes and comfort were not a priority and were not always anticipated quickly to reduce discomfort or distress.

Whilst well meaning, staff told us there were not enough staff to respond to people’s needs.

We observed people to be visibly distressed, anxious, upset and left in an unsafe way during our visits and staff not being available to address this in a timely way.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.