The Old Rectory Nursing Home

Updated 4 June 2020

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 Care Act 2014.

Inspection team

The inspection was conducted by one inspector, an assistant inspector and a specialist advisor on the first day and one inspector on the second and third days.

Service and service type

The Old Rectory is a ‘care home’ in one adapted building providing personal and nursing care to 42 people at the time of the inspection. The service can support up to 47 people. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We also reviewed the information we held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law. We used all of this information to plan our inspection.

During the inspection

We spoke with eight people receiving a service, seven relatives and 17 members of staff. We spent time talking with people and observing the interactions between them and staff.

Some people living at the service were unable to communicate their experience of living at the home in detail with us. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people, who could not comment directly on their experience.

We reviewed seven people’s care files, five staff files, staff training records, various medicine records and a selection of policies, procedures and records relating to the management of the service.

After the inspection

After our visit we sought feedback from health and social care professionals and relatives to obtain their views of the service provided to people. Unfortunately, we did not receive any feedback.

Updated 4 June 2020

About the service

The Old Rectory is a nursing home in one adapted building providing personal and nursing care to 42 people aged 65 and over at the time of the inspection. The service can support up to 47 people.

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

People and relatives gave consistently positive feedback about the care provided at The Old Rectory. Comments included: “I can't give this home enough praise. You literally have got everything here. They (staff) are worth their weight in gold, outstanding. Warm, friendly welcome, beautiful atmosphere. I would recommend this home to anybody. If I needed looking after properly, I want to go to the Old Rectory. I would recommend it to the queen. For everybody here they give you support in their own unique ways”; “Friendly staff. Kind, caring and compassionate”; “I am blown away. The level of compassion and care”; “Wonderful, wonderful nurses, they give me courage to get on, don’t know what we'd do without them.”

There was a strong, visible person-centred culture. This was evident from all staff within all roles. From care staff, domestic staff and management. The person-centred culture was embedded at all levels. The service ensured staff focussed on building and maintaining open and honest relationships with people and their families, friends and other carers. This really helped to promote and ensure the service was person-centred. A staff member commented: “It's about enriching people's lives. It’s amazing here. We are like a family here. Everyone wants to make the residents happy, if they aren't happy, we aren't. Lifelong friends with staff and relatives. I love making the residents smile.”

People were respected and valued as individuals, with staff thinking ‘outside of the box.’ For example, the staff were pro-active in ensuring care was based on people's preferences and interests, getting to know people as individuals, seeking out activities and opportunities in the wider community and helping people to live fulfilled lives, individually and in groups.

Staff were good at anticipating people’s needs. We observed this throughout the inspection. Sensory stimulation is a very important part of the care provided to people living at The Old Rectory to aid their well-being. The service had created a haven of relaxation and therapeutic opportunities, including sight, sound and smell. People were enabled to relax in a lavender garden populated by bees and butterflies in the summer, watch the ducks and listen to running water from the duck pond. This gave people a sense of enjoyment and engagement. A relative commented: “(Relative) had a lovely summer here last year. She loves the garden. Her health improved last summer.”

Staff were motivated to ensure people received care which was compassionate and kind. The atmosphere in the home was warm and friendly. We saw people had developed strong relationships with staff, and it was evident that this was an important ethos of the service. Staff told us they spent quality time chatting and building interpersonal relationships with people and saw this as a vital part of their role. They recognised how this gave people a sense of overall well-being and ensured the family feel of the home. This was evident throughout our inspection with the general conversations and banter which were observed.

Staff had an excellent understanding of people's individual needs which protected their values and beliefs in a way the person wanted to receive care and support. The approach to care and support meant there was a multi-professional process which aimed at maintaining continuity, independence and autonomy for the person.

The service supported people to learn new skills and maintain their independence. For example, one person had learnt to paint, something they thought they would never be able to do. Their relative commented: “My aunt has become a talented painter! In the past she always said she couldn't draw or paint, but a few months ago she painted a large Van Gogh Sunflowers picture, which the home framed and now hangs in her room. It’s amazing! Thank you to The Old Rectory for encouraging this latest talent.”

A number of methods were used to assess the quality and safety of the service people received and continuous improvements were made in response to the findings.

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.

The service provided safe care to people. One person commented “The staff are brilliant. I feel safe here and well cared for." A relative commented: “My (Mum) is very safe here. I feel reassured.”

We did find certain issues with regards to medicines management, repositioning times and recruitment. However, these had been promptly addressed by the registered manager and provider following our inspection.

Staff ensured infection control procedures were in place. Personal protective equipment was readily available to staff when assisting people with personal care. For example, gloves and aprons. Staff had also completed infection control training.

Care files were personalised to reflect people’s personal preferences. People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

People received effective care and support from staff who were well trained and competent.

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 Outstanding (published 4 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.