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

People were safe living at the service and risk assessments and care plans were detailed giving good guidance to staff about how best to support people. Staff kept the environment safe and followed good infection prevention control (IPC) practices. Staffing levels at the service were exceptional and staff were trained and supervised to give the best care possible to people. People had incredible support to safely transition between using different services.

This service scored 81 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager ensured there was a learning culture at the service. Processes were in place to look at incidents and accidents and put actions in place to help mitigate risks in the future. Staff also fed back what worked well when supporting people so other staff members could learn from this and support people in the best way. For example, a staff member found a positive way of supporting a person to try new things to eat and shared this with the rest of the staff team. This led to the person having a more varied diet which was important to them. Staff shared learning in various ways such as in daily handovers and in regular staff meetings. They told us the registered manager and provider shared best practice guidance with them and kept them up to date with what audits found to help foster a learning culture. A relative said, ‘‘[Staff] have got to know [family member] really well since they moved into the service. When they find a way of working that works for [family member] they continue to do this as they know it is what they want.’’

People showed us they felt safe living at the service as they were happy and relaxed being supported by the staff team. A relative said, ‘‘[Family member] is 100% safe at the service and I have every faith that the staff team know how to keep them safe in everything they are doing.’’ Staff were trained in safeguarding and knew how to report signs of abuse both internally and also to external bodies such as CQC or the local authority safeguarding team. The registered manager and staff team ensured safeguarding concerns were reported appropriately and followed any recommendations from the safeguarding team to help make things safer for people.

People showed us they felt safe living at the service as they were happy and relaxed being supported by the staff team. A relative said, ‘‘[Family member] is 100% safe at the service and I have every faith that the staff team know how to keep them safe in everything they are doing.’’ Staff were trained in safeguarding and knew how to report signs of abuse both internally and also to external bodies such as CQC or the local authority safeguarding team. The registered manager and staff team ensured safeguarding concerns were reported appropriately and followed any recommendations from the safeguarding team to help make things safer for people.

The registered manager had completed detailed risk assessments covering the areas of risk people may face and putting measures in place to mitigate those risks as far as possible. There was a focus on supporting people to take risks in a positive way fully enabling them to be independent and make their own choices. These risk assessments gave guidance for staff to help people keep people safe whilst supporting them in a positive way to do what they wanted to do. Staff were fully aware of the risks people faced and knew how to support them in the safest way possible. Staff told us the registered manager updated risk assessments based on their feedback and what they felt worked well for people. People and their relatives were regularly involved in discussions about care plans and risk assessments. One relative said, ‘‘We always have discussions about how staff can help [family member] be safe and the risk assessments are very thorough.’’

The environment at the service was safe and met the needs of people. For example, the service was large and spacious giving people plenty of space to be independent or to spend time by themselves when they needed this. One relative said, ‘‘One thing we love about the service is how it feels like a home and not a service. It is great [family member] has their own en-suite bathroom to use as they would find a communal area more difficult to use.’’ The staff and management team completed checks of the environment to make sure it was safe for people. This included fire safety checks. One person damaged their rooms walls as a way to show how they were feeling. The registered manager sourced a specific material that meant the person could now do this but be safe and not cause damage to their environment. This resulted in a positive outcome for the person.

Staffing levels at the service were exceptional and people always received the correct level of staff support. Staff were fantastically well trained and used this training to fully support people im all aspects of their lives. For example, staff had completed numerous training courses focused on supporting people living with learning disabilities and autistic people. As a result, they knew how to support people when they felt upset or anxious. For example, we observed occasions where people began to feel upset, and staff responded in a kind way to help them feel better. As a result of staff’s training and approach, people did not need to be supported with physical restrictions when they felt unhappy. This had a hugely positive impact on people’s quality of life. One relative said, ‘‘I cannot praise the staff enough. They are so professional and so well trained. When I think back to how upset [family member] used to get and now [staff] just know how to help them before it gets to that point. It is incredible.’’ The registered manager and provider continuously reviewed staffing levels to help ensure people had the support they needed to do what they wanted when they wanted to do so. This meant people had the full flexibility to do what they wanted at any time of the day. We observed people making the decision to leave the service and this was able to be supported immediately. One relative told us, ‘‘There are plenty of staff about every time of the day so [family member] can go out and about whenever they choose. It amazes me every day when staff tell me what they have been up to. They have such a full and exciting life.’’ Another relative said, ‘‘I have never had to worry about staffing levels. I know all the staff well and they know how important it is for [family member] to be busy as this helps them focus. I can’t remember the last day they were not out and about.’’ The provider had processes in place to help ensure staff were recruited in line with legislation.

The service looked fresh and clean. Staff supported people to take part in keeping the service clean if they chose to do so. One person happily showed us how they stripped their bedding every day. One relative said, ‘‘I can’t believe how the staff have the time to keep the service so clean, but they find a way.’’ The staff and management team completed regular checks to help make sure the service was clean and good IPC measures were in place. Staff were trained in IPC and followed good IPC practices.

People were supported safely with their medicines. Staff understood the principles of ‘Stopping over medication of people with a learning disability, autism, or both with psychotropic medicines’ (STOMP) and were working with people and health professionals to help people stop taking medicines they may not need anymore. One relative said, ‘‘[Family member] used to take a lot of medicines as this was how it was felt best to make them feel happy and relaxed. [Staff] have proven they didn’t need these. It is all about having staff help them to stay focused on things they enjoy so they do not feel upset.’’ Staff were trained to administer people’s medicines and had their competency to do so checked regularly. Staff were knowledgeable about medicines people were taking and the possible impact this may have on them. The management and staff team completed audits in all areas of medicines to ensure they were being administered safely.