This inspection took place on 20 February 2018 and was unannounced.

We had previously inspected this service on 26 and 27 November 2015. At which time the service was registered at a previous location and was known as The Limes Rest Home. Following the inspection we rated the provider ‘requires improvement’ and made a recommendation that the registered provider’s quality assurance arrangements were improved to identify any areas of concern and to ensure the home was compliant with the regulations.

At this most recent inspection we found the provider and registered manager had made the required improvements and the service is now rated as ‘Good’.

The Limes Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Limes Care Home is registered to provide accommodation for up to 76 people who have dementia or mental health needs and caters for both younger and older adults. On the day of the inspection there were 44 people living at the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People told us they felt safe. Staff received training in protecting people from harm and knew how to escalate any concerns for people’s safety and well-being. Risks were assessed and managed to reduce the risk of harm and there were sufficient numbers of staff to respond to people’s care and support needs. The provider had safe recruitment practices which ensured only staff safe to work with vulnerable people were employed.

People received their medicines as prescribed and systems used to manage and store medicines were safe. People were protected from the risk of infection by a clean home environment and the provider had established systems to monitor the standards of cleanliness throughout the home. Where incidents and events took place the provider and registered manager learned from these and where appropriate implemented changes to raise standards within the home.

People needs and preferences were assessed prior to them moving into The Limes. People were supported by staff who had received an induction and training for their role and who were supported by the provider and registered manager. People received food and drink that met their nutrition and hydration needs and where people required specific dietary support, this was provided by staff. The staff team worked well with other agencies to ensure people’s holistic needs were met and referrals to external agencies about people’s health were made in a timely way.

People were asked for their consent before care was provided and where people’s rights were restricted to protect them from harm, this had been done lawfully. The home environment was well maintained and appropriate for the needs of people living at the home. Some opportunities to better meet the needs of people living with dementia had been missed due to a lack of reminiscence areas throughout the home.

People were supported by staff who were kind and caring. People were supported to make their own decisions about their daily lives and staff were aware of people’s life histories and diverse needs. Staff treated people as individuals and recognised that each person’s needs were different. People’s privacy and dignity was maintained by staff and visitors were welcomed into the home by staff who knew them.

People and relatives were involved in the assessment, planning and review of their care and support. Where people’s needs changed the care provided by staff was responsive to the changes