- Care home
The Old Vicarage
Report from 16 September 2024 assessment
Contents
On this page
- Overview
- Kindness, compassion and dignity
- Treating people as individuals
- Independence, choice and control
- Responding to people’s immediate needs
- Workforce wellbeing and enablement
Caring
We found service was caring, and good standards of safe care was being provided to people living at The Old Vicarage. The manager and staff team demonstrated considerable action had been taken in response to our last inspection findings, to achieve an improved score and return to compliance with the breaches of the regulations.
This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Kindness, compassion and dignity
People were treated with kindness and compassion, with a focus on maintaining people’s dignity and maximising their levels of independence. People were supported to maintain preferred standards of personal presentation and appearance, for example 1 person told us they were assisted by staff to put on their jewellery and make up. We observed and heard caring interactions between people and staff.
Staff told us and demonstrated the pride they take in their role and responsibilities caring for people. Staff were clear they treated people like they would treat their own family members. There were audits and monitoring systems in place completed by the manager to source feedback from people and their relatives on their experiences of the care provided, and to identify any areas benefitting from improvement.
People’s relatives gave positive feedback about the caring nature and approach taken by the staff. Relatives were clear they felt people were treated with kindness, and staff ensured their dignity was maintained at all times. One relative told us, “The staff are great and they are very compassionate and caring towards my loved one, abide by their wishes, they are quite a caring bunch overall.”
We observed use of humour and laughter as effective methods of interacting with people. We observed staff were quick to provide people with comfort and support if they were showing signs of being upset or worried.
Treating people as individuals
People received individualised care tailored to their own wishes and preferences. People and their relatives were involved in the development of their care records, to ensure remained an accurate reflection of their current, and past wishes and life histories. People’s relatives told us they felt staff knew their loved ones well and maintained their individuality. One relative said, “I was involved in making a care plan for my loved one, detailing their preferences and likes and dislikes, and their life history.”
Staff and leaders demonstrated clear expectations around ensuring people were treated as individuals. Staff demonstrated warmth and understanding towards people and their relatives, welcoming visitors and encouraging people to maintain relationships and friendships.
We observed staff to treat people as individuals playing to their strengths, discussing areas of personal interest to engage them in activities, daily routines and completion of personal care tasks.
The service had training and competency checks in place to monitor staff engagement and provision of individualised care.
Independence, choice and control
People were encouraged to make their own decisions around all areas of their daily routines. People were encouraged to maintain levels of independence, with support in place as needed. People told us they were given choices around areas of their care such as the time they went to bed, where they ate their meals, and what activities they wished to participate in. People told us they also had the choice to say no, for example if they did not wish to participate in a group activity, and their decision would be respected. People’s relatives gave positive feedback about the choice and control people had in relation to their daily care experiences, food choices and participation in activities. Relatives gave positive feedback about the activity coordinator in post, who they felt was offering lots of varied group and 1 to 1 sessions to ensure people could choose to participate in events and activities they found interesting, as well as the opportunity to try new things.
Staff and leaders told us and demonstrated they encouraged people to be as independent as possible, and to be actively involved in their daily routines. Staff and leaders showed us examples of activities and events organised within the service which had been chosen by people through giving feedback and suggestions at resident meetings. Staff and leaders demonstrated clear understanding of mental capacity and best interest decision making and had applied for Deprivation of Liberty Safeguards as appropriate.
We observed staff and leaders to encourage people to have choice and control over their daily care and support. People were consistently treated respectfully, and encouraged to be as independent as possible
Audits and monitoring processes were in place to ensure feedback was sourced from people and their relatives, to ensure they were being offered choice and control over the care received.
Responding to people’s immediate needs
People’s call bells and requests for assistance were responded to in a timely way, with arrangements in place to ensure their needs remained prioritised e.g. during shift handover meetings. People told us there were sufficient numbers of staff to meet their needs and respond to them during the day and overnight. People’s relatives gave positive feedback about the level of responsiveness staff and leaders demonstrated, for example where their loved ones experienced a change in health status, or in response to pressing a call bell for assistance. Relatives told us they felt there was now sufficient numbers of staff on each shift, reducing the amount of time taken to respond to needs. Relatives told us, “Staff respond quickly to call bells and if loved one wants to go to the loo. Staff are good if I need to speak to someone about anything.”
Staff and leaders prioritised responding to people’s needs during the day and overnight and worked with enough staff on shift to ensure this could be consistent and timely. Staff and leaders gave examples of how they had responded to people’s changing needs and health presentations to source urgent and emergency care, and were demonstrating close team working relationships at the time of our inspection to support people and staff during their COVID-19 outbreak. The manager and deputy monitored staffing levels closely to enable them to plan coverage to meet changes needs and prioritise throughout each shift, and reduce the risk of staffing shortages on standards of care provided.
We observed staff to be attentive to people’s needs, ensuring those not seated in communal areas were also checked on regularly throughout our inspection visit. Staff breaks and attendance at shift handover meetings were appropriately managed to ensure sufficient numbers of staff remained available to respond to people’s needs.
Workforce wellbeing and enablement
People told us, and inspection findings supported, that they were supported by a staff team who were themselves well cared for by the manager and deputy. This had a positive impact on the standards of care people received, as the staff team had good morale and were able to focus their energies on the people living at the service. People’s relatives told us staff were always upbeat and in a good mood, which they felt in turn had a positive impact on their loved ones and helped to lift their spirits. From our observations and interactions with staff, we found them to be welcoming, and keen to engage with the inspection process, as they felt proud of their roles and responsibilities in supporting the manager and deputy to drive change and improvement within the service. We observed staff to work cohesively, and efficiently to ensure people received consistent standards of care and support. Our findings were confirmed from relative feedback received, which stated, “They are kind, caring and compassionate and approachable team.”
Staff gave complimentary feedback regarding the levels of care and support they received to maintain their well being, and to ensure they felt able to meet the requirements of their roles and responsibilities. Staff told us morale had greatly improved under the care of the current manager. The manager and deputy manager told us and demonstrated they worked well as a team, led by example, and ensured an open-door approach for the whole staff team. The independent consultancy team had built in additional support measures for the manager and deputy to aid their well being whilst working hard to turn the service around and return to compliance. From feedback we received, staff were empowered by leaders to take on additional responsibilities and delegated tasks to provide individual development opportunities and accountability for service improvement. Staff received regular supervision and performance appraisals, and were able to access the manager, deputy or member of the team on call 24-hours a day, to ensure they felt well supported.