Archived: The Old Vicarage

The inspection took place on 13 November and was unannounced. We carried out a second announced visit to the service to complete the inspection on 20 November 2015.

A new provider took over the service in January 2015. This was our first inspection of the service under the new provider.

The Old Vicarage provides accommodation and personal care and support for up to 18 older persons, some of whom are living with dementia. There were 16 people living in the home at the time of the inspection and one person was receiving respite care. The home also provides day care for up to five people. We did not inspect the day care service since it was out of scope of the regulations.

A new manager had been appointed five weeks before the inspection. Since the inspection took place, the manager has now been registered with the Care Quality Commission (CQC). People, relatives and staff spoke positively about the new manager. 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 and associated Regulations about how the service is run.

People told us they felt safe. There were safeguarding policies and procedures in place and there were no ongoing safeguarding concerns. This was confirmed by the local authority’s safeguarding adults officer. Staff knew what action to take if abuse was suspected.

People said they liked living at the service and that it was homely. We saw that overall, the building was well maintained although the décor in some areas was in need of updating. Cleaning schedules and infection control procedures were in place. We found that the premises were clean and there were no malodours. Equipment had been regularly serviced and maintained.

There was a system in place for the safe management of medicines. Medicines were stored in different areas of the home. The manager told us of her plans to centralise the storage of medicines.

People, staff and relatives told us there were enough staff to meet people’s needs. This was confirmed by our own observations. Staff told us that safe recruitment procedures were followed. We noted that records did not always evidence that recruitment procedures had been followed. The manager told us that she would address this.

People spoke highly of the staff who supported them and said they felt well cared for. There was a training programme in place and a new e learning training package was in the process of being introduced. Staff were trained in safe working practices and to meet the specific needs of people who lived at the Old Vicarage. The newly appointed manager had carried out supervision with all staff and was in the process of implementing a new appraisal system which she planned to complete by the end of the year. A plan was in place to ensure appraisals were completed when due. We saw that people were treated respectfully and that staff were knowledgeable about the people they cared for.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure that people are looked after in a way that does not inappropriately restrict their freedom. The manager had submitted DoLS applications for authorisation to the local authority.

People told us that they were happy with the meals provided at the home and were supported to meet their nutritional needs. New menus were in the process of being implemented. Special diets were catered for and people enjoyed their meals and were appropriately supported by staff.

People and their relatives told us that staff were caring. Staff responded kindly to people and treated them with respect. People told us they were supported to be as independent as possible and received help whenever they needed it. We observed that staff knew people well and had a good understanding of their individual needs.

People were supported to maintain their hobbies and interests. An activities coordinator was employed and a varied activities programme was in place. We saw planned and spontaneous activities taking place.

There was a complaints procedure in place. The manager told us that no complaints had been received. Feedback mechanisms to obtain the views from people, relatives and staff were being introduced by the new manager but were not in place. There were no satisfaction questionnaires or evidence of meetings with relatives or other relevant persons since the new provider took over. Some audits had been completed and a new detailed annual quality monitoring audit system had been developed but not yet implemented.

We found that although staff told us that the correct checks were carried out before they started work; records did not always evidence all the necessary recruitment information.

The provider’s statement of purpose was out of date and did not contain details of the new provider.

CQC had not been notified of authorisations to deprive three people of their liberty. These had been granted under the previous provider and registered manager and have now been forwarded.

An incident involving the police had not been notified since the new provider took over. This has now been forwarded.

We found one breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. (Good governance). People and their representatives can see what action we told the provider to take at the back of this report.