The Old Vicarage Care Home

Updated 9 June 2023

Service and service type

The Old Vicarage Care Home 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 Care Home 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 not a registered manager in post. An interim manager had very recently commenced at the service, who told us they had commenced the registered manager application process.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we received about the service since the last inspection. We sought feedback from local authority care commissioners 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 5 people who used the service, 10 relatives and 7 care staff, including 4 senior and the deputy manager. We also spoke with the cook, 2 external senior managers and the nominated individual for the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We observed how staff interacted with people and we reviewed a range of records. This included 6 people's care plans, multiple medicines records, complaints and staffing records. The provider sent us a range of quality assurance and management records we asked for, which we reviewed off site. This included audits, meeting minutes and some of the provider’s operational policies for people’s care and safety. Following the inspection, we continued to seek clarification from the provider, to validate evidence found.

Updated 9 June 2023

About the service

The Old Vicarage Care Home is a care home providing accommodation in one adapted building, for up to 44 adults who require personal care. At this inspection, there were 34 adults receiving care at the service.

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

The registered provider’s accountability and oversight arrangements were not wholly effective, to consistently ensure timely and sustained service improvement when needed. Action had recently commenced to rectify this. A range of management, staffing and care improvements were either recently made or in progress. However efficacy was not yet demonstrated, as the improvements were either not yet fully embedded, or demonstrated as sustained and ongoing for people’s care.

There was no registered manager for the service and a history of high manager turnover. Recruitment had commenced to address this, and suitable interim management arrangements were confirmed. Overall staff understood their role and responsibilities for people’s care, but remedial measures recently introduced for their supervision and support where not yet wholly assured.

People, relatives and staff were somewhat confident in the management of the service, following the recent appointment of a deputy manager. However, most held reservations due to the high manager turnover and the impact previously experienced from this in relation to staffing, complaints and concerns handling.

For the most part, the provider was able to demonstrate effective partnership working, information handling and communication with external professionals, agencies, authorities and other care providers when needed for people’s care. Action was taken to notify us of important events when they happened at the service, although this was not always without delay.

Complaints and concerns, including those raised by staff, were not always effectively handled and responded to in a timely manner. Remedial management action had commenced to rectify this, to help inform and improve people’s care when needed.

People were protected from the risk of harm or abuse at the service. Overall, risk management strategies for people’s care, environment and emergency contingency planning, were effectively informed and understood by staff. The service was suitably adapted and designed to promote people’s safety, choice and independence.

People’s medicines were safely managed to ensure people received them when they should. We were assured the provider was meeting with requirements and nationally recognised government guidance, concerned with the prevention and control of infection, including COVID-19. People, relatives and staff were confident people were safe when they received care within the service.

Staff were trained and safely deployed for people’s care. 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 received care from kind, caring staff who knew people well, how to communicate with them and had good relationships with people and their families. Nationally understood care values were promoted and understood by staff. This help ensure people’s equality, rights, independence and choice in relation to their care and daily living arrangements.

People were effectively supported to maintain or improve their health and nutrition. People received care from staff who were trained and informed to provide this in accordance with the law and nationally recognised care standards, including end of life care principles.

The provider was meeting the accessible information standard, to enable people to agree their care and daily living arrangements within the service in a way they could understand.

Overall, people received timely, individualised care, which they and their families were happy with at the time of this inspection. People’s equality characteristics were taken account of, to help enhance their care and daily living experience.

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 October 2017).

Why we inspected

The inspection was prompted in part due to concerns received about the quality and safety of people’s care in relation to staffing and management arrangements at the service. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Effective and Well Led sections of this full report. You can also see what action we have asked the provider to take at the end of this full report.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

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

Follow up

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