Archived: Limber Oak

The home has not had a registered manager since the 7 December 2015. The provider had commenced the process to recruit a manager who would apply to CQC to become the registered manager. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our comprehensive inspection of Limber Oak on the 26 and 27 January 2015, we had found the provider had not protected people against the risks associated with safeguarding people from abuse. Additionally we had recommended that the service finds out more about best practice in supporting staff development and seek guidance of best practice in quality assurance and monitoring procedures. Our rating of the service at that time was required improvement.

We revisited the service on 20 July 2015, and inspected the service against one of the five questions we ask about services: is the service safe. This was to check that the provider had followed their plan and to confirm that they had met the legal requirements to keep people safe.

At this inspection 8 February 2016, we inspected the service against the five questions we ask about services: is the service safe, effective, caring, responsive and well led.

People who use the service had a range of communication abilities that ranged from limited verbal communication and use of pictures and symbols to indicate their needs and wishes. These were understood by staff and enabled staff to support those individual’s to make choices and express their views. Staff treated people with kindness and respect and had regular contact with people’s families to make sure they were fully informed about the care and support their relative received.

People’s safety was promoted within the home. The recruitment and selection process helped to ensure people were supported by staff of good character. There was a sufficient number of qualified and trained staff to meet people’s needs safely. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse. People’s medicine was managed safely.

People were provided with effective care from a staff team who had received support through supervision, staff meetings and training. Their care plans detailed how they wanted their needs to be met. Risk assessments identified risks associated with personal and specific behavioural and or health related issues. They helped to promote people’s independence whilst minimising any risks.

The service had taken the necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people and their care.

Improvements had been made to the environment to promote people’s privacy. This had included refurbishment of two bathrooms, and additional office space to store people’s records and promote confidential meetings about people’s care.

People were encouraged to live a fulfilled life with activities of their choosing. Further staff hours had been authorised by the provider. This was to minimise the risk of social isolation for the people who lived in the home. People’s families told us that they were very happy with the care their relatives received.

The provider had an effective system to regularly assess and monitor the quality of service that people received. There were various formal methods used for assessing and improving the quality of care. This had resulted with improved records to make sure staff had access to the information they needed to support people the way they wanted to be supported.

People were spoken to and treated with respect. We noted that their dignity was maintained and staff supported them to maintain their level of independence.

There were appropriate arrangements in place for the management of medicines.

Staff recruitment and selection was effective. Appropriate checks were undertaken before staff began work.

There was a system in place to regularly monitor and assess the quality of the service that people received.

People living in the home had individual communication, and behavioural needs and no one was able to provide their views about their experiences of living in the home. However we saw that people were involved with their care and the running of the home as far as they were able. We observed people being offered choices including whether to be involved in an activity.

We were told that independence and individuality were promoted within the home. People living there were supported and enabled to do things for themselves as far as they were able. They were encouraged to express their views using their preferred individual communication styles and to participate in making decisions relating to their care and treatment.