Background to this inspection
Updated
2 February 2023
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was undertaken by one inspector.
Service and service type
The Old Rectory 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 Rectory 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 a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we held about the home and contacted the local authority. 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 6 people and 3 relatives about their experience of the care provided. We received feedback from 8 members of staff including the registered manager and operations director. We contacted 4 health and social care professionals.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included 5 people's care and support records and 4 people’s medicine administration records. We looked at 2 staff files in relation to recruitment and training. We also reviewed a variety of records relating to the management of the home, including policies and procedures, accident and incident records, safeguarding records and reports.
Updated
2 February 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
The Old Rectory Nursing and Residential Home is a 'care home' registered to provide personal and nursing care to up to 34 older people. At the time of inspection, the home was supporting 22 people, including people with a learning disability and people with dementia.
People’s experience of using this service and what we found
Right Support
The provider had made improvements to the home following our previous inspection, to ensure it was safe for people. People had control of how their care and support was arranged. The registered manager had reviewed the governance and auditing system following the previous inspection. Audits were up to date and identified any lessons learnt following incidents and accidents so that they could take action to keep people safe. Risks to people's health were assessed so staff could support them safely. People's medicines were managed safely.
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 and support in an environment with specialist equipment to meet their physical needs. People and their relatives were able to personalise their bedroom. People were supported by appropriate numbers of staff who provided kind, caring, person-centred care and support. Staff communicated with people in ways that met their needs.
Right Care
Care plans and risk assessments were detailed, and person-centred ensuring people were supported to live full, active lives and encouraged to maintain their independence. One person told us, “Staff are always telling me to do my exercises. I’m very complex, they all try their best to keep me exercising and moving.”
Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to raise concerns.
Right Culture
People and those important to them, were involved in planning their care. People's needs were assessed before they moved into the home. The home worked together with healthcare professionals who provided specialist support to people to ensure people's needs could be met. One health and social care professional told us, “We get communication, they never ring after the person has arrived, they always let us know beforehand when a person will need a wellbeing plan so we can plan that support.”
Staff demonstrated good understanding around providing people with person centred care and spoke knowledgably about how people preferred their care and support to be given. Feedback was sought from people to help make continuous improvements to the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was requires improvement (published 13 September 2021).
At our last inspection we made recommendations about risk, environmental safety checks, ongoing improvements to the home and the manager’s oversight of audits and systems in place to monitor the environment. At this inspection we found the provider had acted on the recommendations and had made improvements.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they met legal requirements. This report only covers our findings in relation to the key questions Safe, Effective and Well-led which contain those requirements.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Old Rectory Nursing and Residential 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.