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Inspection on 23/07/09 for The Limes Registered Care Centre

Also see our care home review for The Limes Registered Care Centre for more information

This is the latest available inspection report for this service, carried out on 23rd July 2009.

it is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Excellent.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Annual service review Name of Service: The Limes Registered Care Centre The quality rating for this care home is: The rating was made on: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Susan Hall Date of this annual service review: 2 3 0 7 2 0 0 9 Annual Service Review Page 1 of 7 Information about the service Address of service: Brent Lane Dartford Kent DA1 1QN 01322224584 01322284702 Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : old age, not falling within any other category Conditions of registration: Kent County Council Number of places (if applicable): Under 65 Over 65 0 16 The maximum number of service users to be accommodated is 16. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whos eprimary care needs on admission to the home are within the following categories: Old age, not falling within any other category - (OP) Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service The Limes is a purpose built unit, which was reopened after major refurbishment on 9th December 2002. It is a detached property on three floors. There are gardens to the front and rear and car parking is available at the front. It is owned and run by Kent County Council and is located close to Dartford town centre. The Limes offers recuperative and step down care for 16 residents from the Livingstone Hospital, and a local NHS Hospital in the Dartford, Gravesend and Medway area. Residents are admitted for short stays of around 6 weeks. The purpose of the service is to return Annual Service Review Page 2 of 7 service users to their own homes after a period of rehabilitation and confidence building, or once adaptations have been completed to their homes, or to move to a permanent residential setting elsewhere. Occupational Therapists are on site from Monday to Friday, and access to Physiotherapy, Nurses, and other health professionals is available from the neighbouring Livingstone Hospital. The Limes also employs Care Managers who are on site from Monday to Friday. The rehabilitative facilities include a therapy kitchen, bedroom, bathroom and treatment room. There is also a shop and a 20-place day centre on site. The service is free for the first six weeks. Charges may be incurred if the stay exceeds six weeks, subject to means testing of savings and income; which will be assessed on an individual basis. Annual Service Review Page 3 of 7 Service update since the last key inspection or annual service review: What did we do for this annual service review? The Inspector reviewed all the information that the Commission has received, or asked for, since the last Annual Service Review in June 2008. This includes: Formal notifications about things which have happened in the service, which the care home is legally required to send to CQC. The Annual Quality Assurance Assessment (AQAA), which was sent in by the service. AQAA is a self assessment that focuses on how well the home is meeting outcomes for people who live there. It also provides detailed information about how the home is running. Information about any concerns or complaints; or referrals to the Social Services Safeguarding Adults department. Details from the last key inspection and report. Relevant information obtained from other organisations. Information obtained from phone calls and letters received since the last inspection. What has this told us about the service? A key inspection was carried out at The Limes in August 2008, and the service was assessed as excellent 3 stars. The manager has reliably informed us of legal notifications during the past year, and sent in the AQAA within the required timescale. This was well completed, providing the Commission with plenty of updated information about how the service is running. As people are admitted to this home for short term rehabilitation care, it is important that enquirers and new residents are provided with good information to help them to know how the home runs on a daily basis. During the past year, the Residents Guide and the homes brochure have been updated, and are now available in large print and audio versions so that it is more accessible to people. All prospective residents have a needs assessment prior to moving into the home, to ensure that the home will be able to meet their individual needs. Residents are provided with the terms and conditions of the home, and individual contracts. Residents may be admitted from hospital for recuperation prior to going back home; or may be admitted from home if they are in poor health, for some additional and respite care. The service has good links with local health professionals, including GPs, physiotherapists and district nurses; and an occupational therapist is on site five days per week. Residents are involved in their care planning, and work together with the staff and health professionals to achieve their individual goals. Care plans are reviewed and updated every week, and include relevant risk assessments, and ongoing health assessments. Review meetings are carried out between the resident, their families, and health professionals, so that the best course of action can be determined for each Annual Service Review Page 4 of 7 individual person. The AQAA states that the staff are very aware of the importance of retaining residents dignity, and of enabling residents to uphold their own religious and cultural needs and beliefs. Religious services are available inside or outside the home, and transport is arranged for residents to attend places outside the home if they wish to do so. The service is equipped with everyday items such as stairs and a kitchen, so that residents can have the opportunity to ensure they can, for example, manage stairs before going back home. A falls prevention exercise class is held in the home; and residents are enabled to manage their own medical conditions (e.g. diabetes, arthritis) where possible. Residents are encouraged to be as independent as possible, and can make their own decisions about attending planned activities and social events. The AQAA informs us that the home has recently purchased a Nintendo Wii, and a flat screen television, to promote residents fitness, and assist with their mobility. The home has implemented a new menu planning system, known as the nutmeg system, which promotes healthy eating; and residents are provided with a wide choice of menus, and home cooked meals. There are regular meetings with residents and relatives, and the home gives out questionnaires every six months, to help to analyse where ongoing improvements can take place. Residents are confident that their viewpoints are listened to, and any concerns or complaints are taken seriously and addressed by the management. The manager stated in the AQAA that there have been four complaints to the home during the past year, and all of these have been satisfactorily resolved. These are also used to inform the home as to how they can further improve their standards. The home provides a comfortable and safe environment, and was totally refurbished in 2003. It is kept clean and tidy, and there are ongoing improvements throughout the year. Specialist equipment is provided to help residents to become more independent, and this includes beds with adjustable heights. There are wide corridors with handrails, and a nine person passenger lift. The home has a range of baths suitable for meeting different needs; and in the last year, one of the bathrooms has been altered into a shower room at residents requests. The home has a high commitment to staff training, and all care staff study for NVQ level 2. The percentage of staff who have completed this training has increased in the last year, and is now over 82 per cent, which is excellent. The manager states that staff are enthusiastic about their roles, and work well together, providing an efficient and caring work force for the residents. Other staff also study for NVQ training in their respective roles, such as catering and administrative staff, so that the team as a whole is well trained and competent. The manager has completed the Registered Managers Award and NVQ level 4, and has many years of managerial experience in care. He provides a lead in ensuring that staff and residents are well treated; and that their health and welfare is of the first importance. There are good administrative procedures in place, enabling the home to run smoothly and efficiently. The AQAA helpfully provides some recent comments from residents who have been Annual Service Review Page 5 of 7 discharged home, such as Thank you for helping me to get back my independence; and Thank you for your loving care and attention while I have been here. I am sure that it has been a great help in making my recovery. What are we going to do as a result of this annual service review? The Commission is confident that this home is continuing to operate to a good standard, and we will continue to monitor the home through ongoing processes. A key inspection will be carried out by 21st August 2010. However, we can inspect the service at any time, if we have concerns about the quality of the service, or the safety of people using the service. Annual Service Review Page 6 of 7 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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