23 November 2015
During a routine inspection
The registered manager had resigned in the month prior to our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider had reviewed the service’s management structure and had at the time of our inspection decided to put forward both of the services existing care mangers for registration.
We carried out this unannounced inspection on 23 and 24 November 2015. The service was previously inspected in February 2014 when it was found to be fully compliant with the regulations.
Everyone we spoke with told us they were safe, comfortable and well cared for at The Old Vicarage. People told us; “I am safe here”, “the staff are wonderful, caring and compassionate” and, “They look after me beautifully. Relatives commented, “people are definitely safe here” and, “they are incredibly patient and caring with [my relative].”
People’s care plans were personalised, up to date and accurately reflected their individual care and support needs. These documents provided staff with clear guidance on the level of support each person required and comprehensive risk assessments designed ensure people’s safety while enabling people to take risks in order to maintain their independence. Staff provided care compassionately and respected people’s choices and decisions.
Each person’s care plan included highly detailed information about their life history, hobbies and interests designed to help staff see people as individuals with specific likes and preferences. The service’s activities team was working with volunteers on a project to develop interactive life history presentations.
We found there were sufficient skilled staff available at all times to meet people’s care needs. Staff received regular formal training and innovative techniques, designed to provide staff with an insight into what it was like to need care’ were included in the services induction training.
Staff and volunteers were highly motivated and demonstrated throughout our inspection a clear commitment to provide dignified and compassionate support. The provider was a strong role model and demonstrated both a detailed understanding of people’s care needs and evident concern for their individual welfare. People told us; “The positive atmosphere is created by the boss who is excellent” and, “[the provider] put us completely at ease.” While staff said; “[the provider] is a good boss, very fair” and, “I love [the provider] she is fab with the residents.”
People were involved in village life and the wide selection of activities available within the service. People told us; “it’s great fun here”, “the activities are fantastic” and, “We are very fortunate indeed with our activities coordinator.”
People told us the Old Vicarage was, “spotlessly clean” and we found the service was well maintained with light and warm communal areas. People were able to decorate their rooms with their own furniture and other personal items. The service had extensive well maintained gardens including areas designed to enable people who used wheel chairs to enjoy gardening.
Where people lacked the capacity to make specific decisions the service had consistently acted in the person’s best interests involving family members and heath professional in these decision making processes when appropriate.
Mealtimes were relaxed and social events at The Old Vicarage and people told us; “the cook is first class”, “we can have a nice little drink of wine when we want one” and, “if I don’t fancy what’s on the menu they will make me something else.” All meals were freshly prepared in the services kitchens from local ingredients. Where people required support with their meals this was provide discreetly by care staff.
The service worked well with local healthcare providers to ensure people’s care needs were met. All of the professional we spoke with were highly complementary of the service and told us; “I would choose to come here myself”, “It does stand out from those I visit”, “and, “I would recommend it and would be happy for one of my family to come here.”
The service had achieved “beacon” status under the Gold Standards Framework for its innovative and established good practice in meeting people’s needs at the end of their lives. Relatives described as “extraordinary” the care and support staff had provided their relatives at the end of their lives.
The Old Vicarage had won numerous national accolades. Recently received awards included, best menu, best arts activity, best apprentice and pet friendly home of the year.
None of the people we spoke had ever felt the need to complain about the quality of care they received. People’s told us; “I have absolutely no complaints” and, “there is nothing here to find fault with and you cannot say that about many places.” Responses to a recent survey of people who used the service were universally complimentary.