Enter and view: The Lime Trees Care Home

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Summary of report content

Healthwatch Enfield conducted an announced enter and view visit, to The Lime Trees Care Home, on 24 May 2016, following some concerns received from a member of the public. The visit is part of an ongoing project to find out from service users and their relatives about the nature and quality of care in local care and nursing homes. The home had a relaxed and homely atmosphere with kind a well-intentioned staff. Most residents and relatives, HW spoke to, said they were satisfied with the care received, although some said the care was not so attentive overnight and at weekends. Efforts were being made to modernise the premises and there was easy access to a pleasant garden. Residents were encouraged to maintain their independence as far as possible by helping with simple household tasks, or the garden, and some managed their own medication. The programme of activities provided was limited. The HW team observed that the housekeeping was not up to an acceptable standard, posing a risk of infection e.g. soiled linen was not kept separate from other linen. Residents also complained that personal laundry took a long time to be washed and returned, and that items of clothing sometimes went missing. Although the care home was set up originally to care for frail elderly people including those with dementia, it had recently accepted younger ‘step down’ clients who are recovering from a stroke or from an episode of mental ill health. This presented additional challenges to the staff team, who would benefit from further training. Several recommendations were offered by HW Enfield to The Lime Trees Care Home: - Medication management to be reviewed by GPs. - Staff receive additional training in how to support residents with eating and drinking with dignity and care. - Staff should receive training in end of life care. - The key worker system should be fully implemented, and residents (and families where appropriate) should be informed who their key worker is - Effort should be made to ensure that clothes are laundered quickly and promptly returned to the rightful owner and call bells should always be placed within easy reach of residents. - Extend the range of activities available to residents, especially for outings - Upgrading of the property needs to continue and work needs to be done to improve hygiene and infection control. - Clearer distinction between the roles and responsibilities of the owner and the registered manager with due regard for different functions such as housekeeping, maintaining care standards, staff supervision, staff training, property management, finance, compliance etc. Recommendation for BEHMHT : Efforts to be made to improve continuity of care within the district nurse service. The home responded positively saying “I can confirm that I will comply with all aspects of your recommendation.” HW Enfield commented that they are pleased to see the care home management have already implemented some of the recommendations and have undertaken to implement more of the recommendations in the near future.

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General details

Report title 
Enter and view: The Lime Trees Care Home
Local Healthwatch 
Healthwatch Enfield
Date of publication 
Tuesday, 24 May, 2016
Date evidence capture began 
Tuesday, 24 May, 2016
Date evidence capture finished 
Tuesday, 24 May, 2016
Type of report 
Enter and view
Key themes 
Building and facilities
Cleanliness hygiene and infection control
Communication between staff and patients
Continuity of care
Food and nutrition
Quality of care
Quality of staffing
Staff training
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
Primary research method used 
Unstructured Interview
How was the information collected? 
Visit to provider
If an Enter and View methodology was applied, was the visit announced or unannounced? 

Details of health and care services included in the report

Social care services 
Nursing care home
Residential care home

Details of people who shared their views

Number of people who shared their views 
Age group 
Specific ethnicity if known 
Sexual orientation 
Not known
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
Types of health and care professionals engaged 
Care / support workers
Service manager
Does the information include other people's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Yes action has been taken or promised
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
What type of impact was determined? 
Implied Impact
Tangible Impact (cost related)
Tangible impact (not cost related)

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.