Archived: The Old Vicarage

Updated 22 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 27 March 2018. The inspection was unannounced and carried out by one inspector.

Prior to the inspection, we checked all the information which we had received about the service, including any notifications which the provider had sent us. Notifications are changes, events or incidents that the provider is legally obliged to tell us about. The submission of notifications is a requirement of the law. They enable us to monitor any trends or concerns within the service.

We contacted the local authority's safeguarding adults team and contracts and commissioning teams. We also contacted the local Healthwatch.

The provider completed a provider information return (PIR) prior to the inspection. A PIR is a form which asks the provider to give some key information about their service; how it is addressing the five questions and what improvements they plan to make.

We spoke with the nominated individual, regional manager, registered manager, deputy manager and four care workers. We spoke with 10 people and three relatives on the day of the inspection. We spoke with five relatives by phone following our inspection.

We talked with two care managers, a social worker, a podiatrist, a district nurse, a medicines management technician from the local NHS, a local entertainer, a member of the local Evangelical church, a member of staff from the local school and a registered manager from a local domiciliary care agency. We also emailed the local GP surgery for feedback.

We looked at three care plans, 13 people's medicines administration records, information relating to staff training, one staff recruitment file and audits and checks relating to the management of the service and the premises.

Updated 22 May 2018

The inspection took place on 27 March 2018. The inspection was unannounced and carried out by one inspector.

We last visited the service in December 2015 where we found a breach of the regulation relating to good governance. We rated the service as good. Following the inspection, the registered manager sent us an action plan stating what action they were going to take to improve.

At this inspection in March 2018, we found that action had been taken and the provider was meeting all the regulations we inspected against. In addition, the registered manager and provider had introduced a number of changes and had further developed the service. We rated the caring and responsive key questions as outstanding which meant the overall rating for the service is outstanding.

The Old Vicarage is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Old Vicarage accommodates 18 people over two floors. Some of the people living at the home had a dementia related condition. There were 17 people living at the home at the time of the inspection.

There was a registered manager in place. 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.

We found that staff were exceptionally caring. We observed kind, caring and thoughtful interactions between staff and people. Staff were highly motivated and committed and spoke with pride about the importance of ensuring people's needs were held in the forefront of everything they did. People, relatives and staff were able to give numerous examples about how staff went "above and beyond" to meet people's needs.

The service was extremely responsive. People and relatives described the responsiveness of staff as "Outstanding." Staff found inclusive ways to meet people's needs and enable them to live as full a life as possible. A creative activities programme was in place to help meet people's social needs. There was a complaints procedure in place and people knew how to complain.

People told us that they felt safe at the service. There were no ongoing safeguarding concerns. Medicines were managed safely. Checks were carried out to ensure that prospective staff were suitable to work with vulnerable people. There were sufficient staff deployed. Staff carried out their duties in a calm unhurried manner.

Staff told us, and records confirmed that training was available. There was an appraisal and supervision system in place and all staff told us they felt supported.

People's nutritional needs were met and they had access to a range of healthcare services.

Action had been taken following our last inspection with regards to monitoring the quality and safety of the service. Audits and checks were carried out to monitor the service. Our observations and findings on the day of our inspection confirmed that the provider now had an effective quality monitoring system in place. Staff were very positive about working at the home. We observed that this positivity was reflected in the care and support which staff provided.

We had been informed of all notifiable events at the service.