Lime Trees

People's experience of the service and what we found: Medicines were given as prescribed, however some record-keeping practice required improvement. The provider acted on this feedback straight away. We have made a recommendation about medicines records. There were sufficient numbers of staff suitably deployed to meet people's needs. Staff were recruited safely. Checks were carried out on the environment and equipment, including by external professionals. Risks were assessed and recorded in people's care plans. Staff understood their safeguarding responsibilities and there was evidence of a proactive learning culture.

People received an initial assessment, which was used to create personalised care plans. Staff received an induction, supervision, and some specialist training. We identified an issue with healthcare related tasks but the provider took prompt action to address the concerns raised. We have made a recommendation about competency assessments relating to delegated healthcare tasks. The need for consent clearly underpinned staff practice. The service was well designed and decorated. The service worked well with other professionals to support people to lead healthy lives.

Staff were caring and kind, and spoke about people with dignity, respect, knowledge and understanding. This included using language which respected and considered people's strengths, and not just their needs. People's views were considered by staff. This included those who could not communicate verbally with words. Equality and diversity were considered as part of care planning and provision.

People could enjoy meaningful leisure and social activities. Care provision was regularly reviewed to ensure it met people's preferences, choices and people could meet their ambitions and goals. People's communication needs were known and recorded. The service had a system in place for responding to complaints openly and transparently. Good partnership working supported joined up end of life care.

There were systems in place for oversight of the service, although the provider told us of plans to further strengthen and formalise this through additional auditing. There was a positive staff culture, which promoted good outcomes for people. People and staff had opportunities to share their views and make suggestions about the running of the service. People and staff told us they found the management team approachable, open, and transparent. Effective partnership working with a range of stakeholders was seen to be taking place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported

this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk