The Old Vicarage

Updated 29 February 2024

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.

Inspection team

The inspection team consisted of 2 Inspectors 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

The inspection was unannounced.

What we did before the inspection

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 sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used all this information to plan our inspection.

During the inspection

We spoke with 6 people using the service and 1 relative about their experience of the care provided. We spoke with 5 members of staff including the registered manager who is also the nominated individual and deputy manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We viewed 3 people's care records and 5 people's medication records. We looked at a variety of records relating to the management of the service, including policies, procedures, and audits.

Updated 29 February 2024

About the service

The Old Vicarage is a residential care home providing accommodation and personal care for to up to 16 people. The service provides support to older people some of whom live with dementia. At the time of our inspection there were 13 people using the service.

People’s experience of the service and what we found:

People and their relatives told us they felt safe and were positive about the service, however, we found risks to people's health and well-being were not managed robustly. Practices did not always promote good infection, prevention and control.

Medicines were not always managed safely for people living at the service.

There were enough staff to meet people’s needs and staff were recruited safely.

Not everyone was supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests as the provider had not ensured all requirements under the Mental Capacity Act (MCA) and authorisations under the Deprivation of Liberty Safeguards were fully met.

Some areas of the home were in need of refurbishment. Improvements could be made to the environment to support people living with dementia.

Care was not always person-centred and did not promote people's dignity, privacy and human rights.

Systems to monitor and improve the quality and safety of the service were not always effective. The provider had not always sent us statutory notifications which is their legal responsibility to do so for notifiable incidents. Policies and procedures were not always in line with current legislation and guidance. The registered manager informed us they were looking at introducing a new quality assurance system.

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

Rating at last inspection

The last rating for this service was Good (published 8 September 2019).

Why we inspected

We undertook this inspection due to the length of time since our last comprehensive ratings inspection. We undertook a focused inspection to review the key questions of Safe and Well-led. During the inspection we found there was concerns with the environment, storage of confidential information, dignity and respect, so we widened the scope of the inspection to include Effective and Caring. For the key question not inspected, Responsive, we used the rating awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘All inspection reports and timeline’ link for The Old Vicarage on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to management of risks, medicines management, dignity, safeguarding and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow Up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.