The Old Vicarage

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We found the service was responsive, with good standards of care 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.

People received care tailored to their individual needs and preferences, with current and past wishes reflected in their care records. People were placed at the centre of the care provided, with staff and leaders ensuring their voices were fully heard, and value was placed on their feedback. Adjustments were made within people’s bedrooms and the wider care environment to ensure their needs were met. People were supported to maintain their religious and spiritual beliefs, and their personal characteristics were recognised and respected. People’s relatives told us they felt the care their loved ones received was person-centred, and that staff were familiar with their needs and treated them as individuals.

Staff demonstrated and discussed with us their passion and commitment to providing person-centred care and support to people and their relatives, recognising the impact this had on people’s quality of life. Leaders told us about collaborative working with the local church to support people’s religious and spiritual care needs, as well as reducing social isolation, and building networks within the local community. Audits and quality checking processes were in place to monitor the quality of people’s care records and daily notes to ensure these remained person-centred, and upheld people’s individual rights and wishes.

We observed staff interactions and approaches to be person-centred, demonstrating clear understanding of each person’s needs, wishes and abilities. Staff showed particular skill when supporting people living with dementia, to ensure their care continued to reflect their wishes and ongoing involvement in making choices and decisions.

People were supported and encouraged to build friendships and be part of the community within the service. There was also the opportunity for people to access the local community, and participate in external events, as well as spending time with family. Where people were new to the service, or admitted for short term respite, the service worked collaboratively with external health and social care professionals to ensure the transition moving into, and out of the service was as seamless as possible.

Staff and leaders recognised the importance of maintaining a consistent core team of staff, to maintain continuity in care and approach. This was of particular importance for those people living with dementia, who benefited from getting to know and trust consistent and familiar faces. We observed staff to know people and their relatives well and be at ease talking with visitors to the service. Staff, including the manager and activity coordinator were working with people to develop and improve relationships with external entertainers and members of the local community.

People’s relatives highlighted the importance of continuity in leadership to drive improvement in the standards of care provided. Relatives told us past changes in leadership and differing approaches had de-stabilised the service and staff team. The overall condition of the service, and care provided was felt to have greatly improved due to the current manager, and the efforts they had made to build lasting relationships with people and their relatives.

The manager and deputy manager maintained regular oversight of staffing levels to ensure consistency of the core staff team. If needing to use agency staff, the service used the same agency to ensure staff were familiar with the service and people’s needs.

People received information in line with accessible information standards. Information was provided in varying formats, and staff would spend time speaking and explaining information too people to aid understanding. People’s care records contained guidance for staff in relation to effective communication methods and approaches to meet people’s individual requirements. People’s relatives felt communication standards overall had improved within the service, and this had improved relationships and ensured relatives were kept updated in a timely way. We observed there was signage and pictorial information throughout the service, including menus for use at meal times, and information to assist people with their orientation within the service.

Staff and leaders demonstrated skills and abilities in tailoring their communication styles and approaches to meet people’s individual needs. Staff and leaders worked with external health and social care professionals to ensure people had access to regular access to sight and hearing checks.

The service had arrangements in place to maintain clear and open lines of communication with people, their relatives and staff. Regular relative and resident meetings were held, offering opportunities to give feedback and raise any concerns face to face, this was confirmed from feedback received, relatives told us, “Relatives' meetings are interesting and helpful, you can ask things.”

People were actively encouraged to give feedback, raise complaints and share compliments with the manager, deputy and whole staff team. People told us they felt listened to, and that if they needed to raise any concerns they were acted upon and addressed in a timely way. People were involved in the planning of their care, as well as the activity and events timetable within the service. People’s relatives told us they felt lines of communication, and opportunities to speak to staff and leaders had greatly improved under the current manager.

The manager was clear their office needed to be accessible to all visitors, people and staff to ensure they had direct contact with them when needed. Staff and leaders ensured all staff afforded people the time and opportunities to spend time talking and making sure people did not feel socially isolated. Resident meetings and other forums were used to give people and their relatives ways to feed into the day to day running of the service, staff and leaders placed value on the information received to drive improvement and change. The manager and deputy demonstrated they valued any feedback and were keen to continue to improve the service, whilst recognising this was only possible through working collaboratively with, and listening to all involved with the service.

Communication plans were in place in people’s care records. This included ensuring people could maintain regular contact with relatives for example by telephone and video calls.

People received 24-hour care and support, with a clear focus on ensuring access to care was consistent at all times. For example, people had a 24-hour food and snacks menu available, to support nutritional intake for example if people felt hungry overnight. This was particularly important for people living with dementia, or who were potentially more active in the evenings and overnight rather than during the day to ensure equitable nutritional support.

Staff and leaders gave examples of collaborative working completed with external health and social care professionals to ensure people had access to specialist services, and support, including in relation to end of life care planning. Where required, staff and leaders advocated on people’s behalf to ensure they received the care, services or equipment needed to maintain their quality of life.

We received positive feedback from the GP surgery in relation to the timeliness of onward referrals made to the GP surgery by the service.

The service had good working relationships with the GP surgery, as well as other heath ad social care professionals to ensure systems were followed for sourcing onward referrals to specialist services when assessed to be required.

People had access to specialist equipment, and environmental adaptations where required to ensure they had full access to areas of the service and were able to access the local community with support when needed. People’s individuality, protected characteristics and human rights were upheld through staff working practices and approaches, as well as adherence to guidelines and legislation. We could see examples of where concerns had been raised with the service and acted upon to achieve positive care outcomes for people, such as adding a ramp to one of the exit doors of the service in response to feedback by the ambulance service.

Staff encouraged feedback from people, and had clear approaches in place to ensure each concern or complaint raised was thoroughly looked into and addressed. Where people chose to raise a high volume of concerns, these were professionally handled, and written response provided. Staff were encouraged by leaders to see all feedback as positive for driving improvements within the service, and as freedom of expression by the people living and using the service. The manager and deputy manager fostered an open and honest culture within the service, to ensure people, their relatives and staff felt comfortable to speak up or share concerns without fear of discrimination or reprisals.

We could see feedback from concerns and compliments was discussed with staff during team meetings, to explore ways to learn lessons and continue to review and improve service provision.

People’s care records showed involvement in the planning of their end of life care, where they wished to be involved in the process. People’s past wishes and preferences were reflected in their care records so this information was clear and accessible for staff. We observed people to be kept warm and comfortable, ensuring regular visits and care tailored to their needs and wishes to make them feel safe and secure when receiving end of life care.

Staff and leaders gave examples of working closely with external health and social care professionals including specialist palliative care teams where appropriate to plan and achieve positive, dignified and comfortable end of life care provision. We discussed examples of where staff and leaders advocated on people and their relative’s behalf and contributed their feedback to specialist assessments to ensure a detailed overview of the person’s care and support was provided.

The service had developed good working relationships with health and social care professionals to provide good standards of end of life care and ensure people and their relatives were as involved as they wished to be in the planning process to ensure their wishes were clearly reflected.