What life is like for people using this service:

• People were kept safe and secure from risk of harm. Potential risks to people had been assessed and managed appropriately by the provider. People received their medicines safely and as prescribed and were supported by sufficient numbers of staff to ensure that risk of harm was minimised.

• Staff had been recruited appropriately and had received relevant training so that they were able to support people with their individual care and support needs.

• Staff sought people’s consent before providing care and support. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

• People were treated with kindness and compassion. People’s rights to privacy were respected by the staff that supported them and their dignity was maintained. People were supported to express their views and be actively involved in making decisions about their care and support needs.

• People’s choices and independence were respected and promoted. Staff responded appropriately to people’s support needs. People received care from staff that knew them well.

• People using the service, their relatives and staff were confident about approaching the registered manager if they needed to. The provider had effective auditing systems in place to monitor the effectiveness and quality of service provision. The views of people and their relatives on the quality of the service, were gathered and used to support service development.

At the last rating inspection in December 2015, the service was rated Good. At this inspection we found the service remained Good.

Rating at last inspection: Good. The last report for Lime Court was published on 12/03/2016.

About the service: Lime Court is registered to provide care for 18 people. The service cares for people with learning disabilities and at the time of our visit they were providing care and support for 18 people.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

We inspected the service on 21 and 22 December 2015. The inspection was unannounced.

Lime Court provides accommodation for up to 18 people with a learning disability that require nursing or personal care. The location is made up of four connecting bungalows, with five people living in each one. On day one of the inspection there were three people at Lime Court, thirteen were attending an external activity and two were in hospital. On day two there were twelve people at the location, three were at a day centre and three were in hospital.

The service had a registered manager in place at the time of our inspection. ‘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.’

We saw that people at Lime Court were kept safe by the staff and that they knew how to protect people and minimise the risk of abuse.

People were protected from the risk of abuse because the provider ensured that staff had received the training they needed to recognise and respond to the risk of abuse.

People were protected from the risk of harm because risks to people were assessed and the provider had put steps in place to minimise them.

People received flexible and responsive care because they were supported by sufficient numbers of staff.

People received their medicines at appropriate times and accurate records were maintained.

People felt that they had choices at meal times. People felt they had good access to health care support when required and that staff responded to health care issues in a timely manner.

People who we spoke with felt listened to by staff and that their requests were acted upon in a timely manner.

People were happy living at the home and felt that staff treated them with dignity and respect.

People were involved in the development of their care plans and were able to express how they preferred to received care although this was not always recorded effectively.

Staff were supportive in helping people to maintain their independence as far as was practicable.

People were supported to make decisions about their lives and discuss things that were important to them. People felt that they were supported to maintain and develop hobbies and interests.

People were involved in residents meetings and were able to influence how the service was run.

There was a positive relationship between the people, staff and the manager.

People were confident that the manager would respond positively to their requests and staff were happy working at the home.

Staff had regular supervision and appraisals and felt valued by the manager.

On the day of our inspection 17 people lived at the home and most of them required nursing care. We spoke with four of the people and two relatives of people who lived there. All people told us they were very happy with the home and the staff. One person said, “I’m really pleased to be living here.”

We also spoke with an external medical professional and a health care professional who had visited the home, the manager and five members of staff.

We found that people were able to give their consent before support was given. One person said, "Staff support me the way I want.” This meant that staff acted in accordance with people's wishes to ensure that people received care and support the way they like.

We saw that people's care needs were assessed and clearly identified so that their health and wellbeing was promoted and met. People told us that they were happy with the care they received.

We found that people were given their medicines as they had been prescribed by their doctor to ensure their health and wellbeing.

We saw that the provider had systems in place to support staff to enable them to provide care and support that meet people’s needs and keep them safe.

We found that the provider had a system to regularly assess and monitor the quality of the service that people receive but it was not being maintained to ensure it was fully effective at all times.

During our visit to Lime Court we were able to speak to people using the service and staff, in addition to reviewing documentation relevant to the outcomes inspected.The information collected from these different mechanisms, when combined with our observation of the care and support provided, enabled us to conclude that the services provided both respected and involved people.

At Lime Court we found a programme of care that clearly supported individual's (or others acting on their behalf) with their needs both within and outside the home environment. This care programme ensured that people who used the service were protected from the risk of abuse.

All the evidence collected about staffing demonstrated that there were enough qualified, skilled and experienced staff to meet people’s needs and staff were positive about the training they had received and the usefulness of this in their role.

From the evidence collated it was also clear that people who used the service were asked for their views about their care and treatment and they were acted upon. In addition there was a clear system in place to assess and monitor the quality of the service provided which included provider inspection visits.

We visited the four bungalows and met several members of the staff team and people who lived there. The people who lived in the bungalows had limited verbal communication and relied on staff to interpret their gestures and expressions. They indicated that they were happy. The people who lived in the home looked relaxed and comfortable with the staff.

We spoke to relatives of people who lived in the bungalows. They told us that they were pleased with the care and had no concerns about the safety or welfare of their relatives.

Professional visitors to the home told us that staff contact them appropriately and work with them to make sure that people receive a good quality of care.

Relatives told us that there were enough staff, who knew the people well and made sure that people have enough stimulation and activity.

Staff told us that they enjoyed working at Lime Court. They said that they had good access to relevant training so that they knew how to care for the people who lived there.