Archived: The Old Vicarage

Updated 28 March 2017

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 16 December 2016 and was announced. A second day of inspection took place on 5 January 2017.

The inspection team consisted of one adult social care inspector and one expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience who supported this inspection was experienced in providing care for older people and people living with dementia.

Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was completed and returned within the required deadline.

We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales. We contacted the local authority commissioners of the service, the local authority safeguarding team and the clinical commissioning group.

We spoke with three people who used the service and two relatives. We also spoke with the manager, one senior care worker and three care workers. We looked at the care records for four people who used the service, medicines records for five people and recruitment records for three staff. We also looked at records about the management of the service, including training records and quality audits.

Updated 28 March 2017

The inspection took place on 16 December 2016 and was unannounced. A second day of inspection took place on 5 January 2017. We last inspected the service on 19 November 2014 and found the service was in breach of regulations as windows weren’t fitted with appropriate restrictors. We completed a focussed inspection in June 2015 and found the service had made improvements.

The Old Vicarage is a home providing personal and nursing care to a maximum of 28 people, including those living with dementia. At the time of the inspection there were 12 people living in the home.

During the inspection we found the service had breached a regulation. The training matrix demonstrated that not all staff had received training in areas such as moving and handling, safeguarding, Mental Capacity Act 2005, Deprivation of Liberty Safeguards and infection control. There was very little evidence of training for the permanent nurses and no evidence of training for agency nurses currently providing cover in the home.

The manager was not registered at the time of the 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.

Staff had not received annual appraisals to discuss their performance and development. Staff had attended some up to date training but other training required updating. Staff received regular supervisions to discuss any issues and their performance in their roles as well as identify specific training.

Staff had an understanding about safeguarding people and were confident in their roles. People’s medicines were administered and managed in a safe way.

Risks to people’s health and wellbeing were identified, assessed and managed. People had care plans in place to manage risks and reduce the likelihood.

People and relatives told us there were enough staff to meet people’s needs. The registered provider was in the process of designing a dependency tool to enable a more effective analysis of staffing requirements to ensure people’s needs were met. There was no timescale for implementation at the time of the inspection.

New staff members were recruited in a safe way. All necessary checks were carried out including references and checks with the Disclosure and Barring Service.

There were appropriate Mental Capacity Act (2005) assessments, best interest decisions and Deprivation of Liberty Safeguard authorisations in place for people who lacked capacity to make specific decisions in relation to their care needs.

People were supported to meet their nutritional needs where required. We observed a mealtime experience and saw staff provided verbal prompts and physical support, where required, to assist people with their meals.

Records showed that people accessed a wide range of health care professionals including GPs, district nurses, chiropodists and audiologists.

Staff treated people with dignity and respect. They interacted with people in a warm and friendly manner.

People had care plans in place that were personalised to their individual needs and included personal preferences and wishes.

People and relatives knew how to raise any concerns they had about the service and felt confident to do so. The manager had a complaints file in place but no complaints had been received at the point of the inspection.

The service provider had quality audit processes and procedures in place to monitor service provision.