The Old Vicarage

Updated 29 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Old Vicarage is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Old Vicarage is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people, 13 relatives and 11 staff including the nominated individual, regional manager, registered manager, deputy manager, senior care staff, care workers, activities coordinator, housekeeper and laundry assistant. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with a health professional who was visiting the home.

Updated 29 December 2022

About the service

The Old Vicarage is a residential care home providing personal care for up to 28 older people, including those who are living with dementia. At the time of our inspection there were 24 people using the service.

People’s experience of using this service and what we found

People and relatives spoke positively about the staff and the care provided. Comments included, “They are really nice. [Relative] likes fun and carry on and they do have fun with her. She says they are lovely” and “We have the reassurance that she is being looked after well.”

There was a system in place to assess, monitor and manage risk. However, not all risks relating to the environment had been fully assessed. We have made a recommendation about this. Following our visits to the home, the registered manager took immediate action to address the issues we had identified relating to the environment.

There were sufficient staff deployed to meet people’s needs. Staff rotas were adjusted to take into account the change of seasons. During the summer months, staff started work at 7am, since many people liked to rise earlier when the mornings were lighter.

There was a system in place to manage medicines. The management of topical medicines did not follow best practice guidelines. The registered manager took immediate action to address this issue.

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.

People and relatives spoke positively about the "homely" environment. A new 10 bed extension had recently been built. Further adjustments were being made to communal and staffing areas to ensure these areas reflected the increase in people living at the home. One relative told us, “I think it is homely. There are no long corridors or locked doors. The transition from her own home was smooth. It felt welcoming. It has the smaller touches like keeping people together for meals. Things are kept small and it has the personal touch. It has the trust factor. I can 100% recommend this home.”

Staff were suitably trained and supported. People and relatives told us they considered staff knew what they were doing. One relative told us, “He is comfortable there and staff are confident looking after him.”

The home was part of the local community. Many of the staff lived in the same area as people and so they shared a common interest in amenities and events in the local community. One relative told us, “It is a small and homely place and it is kept as part of the community.”

Records were not fully available to demonstrate how the provider was meeting their responsibilities under the duty of candour. The duty of candour regulation tells providers they must be open and transparent with people about their care and treatment, as well as with people acting on their behalf. It sets out some specific things providers must do when something goes wrong with someone's care or treatment, including telling them what has happened, giving support, giving truthful information and apologising. We have made a recommendation about this.

The provider and management staff promoted a person-centred, inclusive culture which enabled people to achieve positive outcomes. Projects such as ‘Three wishes’ and ‘Resident of the day’ had been introduced to help ensure people achieved positive outcomes.

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

Rating at last inspection and update

The last rating for the service under the previous provider was outstanding (published 22 May 2018). The provider of the Old Vicarage changed on 8 September 2021. Most aspects of the company remained the same; with the exception of an additional director.

Why we inspected

This was a planned inspection based on the date the service was registered.

Recommendations

We have made recommendations in the safe and well-led key questions in relation to the assessment of environmental risks and duty of candour. Please see these sections for further details.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.