Background to this inspection
Updated
4 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 checked 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.
This inspection took place on 17 and 24 January 2018 the first day was unannounced and the second day was announced.
This inspection was carried out by one inspector and an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed the information that we had about the service including safeguarding records, complaints and statutory notifications. Notifications are information about specific important events the service is legally required to send to us.
We used a number of different methods such as undertaking observations to help us understand people’s experiences. We spoke with eight people who used the service and four people’s relatives. We also spoke with five members of staff. This included the manager, care staff, activities co-ordinator and cook.
During the inspection, we looked at five people’s care and support records. We also reviewed records associated with people’s care provision such as medicine records and daily care records. We reviewed records relating to the management of the service such as the staffing rotas, policies, incident and accident records, recruitment and training records, meeting minutes and audit reports.
Updated
4 May 2018
We undertook an unannounced inspection of The Old Rectory on 17January 2018 and 24 January 2018. When the service was last inspected in August 2016 there were two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found improvements were needed in the environment of the home and in the recruitment of staff.
The Old Rectory provides care and accommodation for up to 24 people in one adapted building. At the time of our inspection there were 12 people living in the home.
The Old Rectory is a “care home”. People living in care homes receive accommodation and nursing or 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.
Currently there is no registered manager for the service this is a legal requirement. However, a manager has recently been appointed and is planning to make an application to be the registered manager of this service. 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.
At the last inspection a breach of Regulation15 was found in relation to the environment of the home. At this inspection improvements had been made in the environment which had been appreciated by people living in the home, particularly making outside space more accessible and pleasant to use. One person said, "The garden is lovely now they have done it and we used it a lot in the summer it is much better now we can get out."
At the last inspection we had found concerns about recruitment practices of the service. On this inspection we looked at recruitment records and were satisfied the correct procedures had been followed.
There was a failure to ensure all staff had completed necessary training in order for them to demonstrate their knowledge and help in meeting people's care needs in a safe and effective manner.
There was a lack of governance of the service around the provider having oversight of the quality of care being provided specifically having robust and effective audits of the care arrangements so they could identify and drive improvements.
Staff had a good knowledge of people as individuals but this was not always reflected in care plans to ensure care was consistently being provided in a person centred way.
Medicines were administered at the time required and we found no concerns around storage and administration, other than where given covertly. We have made a recommendation in relation to some aspects of the current medicines management.
The service had been subject to an inspection by the fire service. They had found that the service was not fully complying with fire safety legislation and had made some conditions. We asked the provider to provide us with full information as to how they had and were planning to meet the conditions. They had failed to provide us with this information. We have contacted the fire service to advise them of this failure.
People described the service as caring and a number of people spoke positively about the relationships they had with staff and how they were treated with respect. One person said, "I’m happy and get on well with all the staff, they’re very kind, it’s such a nice atmosphere and you can ask them anything." Another said, "I get treated how I like to be treated with respect."
People told us they felt safe and staff recognised and were confident about reporting any concerns about the safety and welfare of people.
The service was responsive to people's changing care needs and had good arrangements for getting support from outside professionals such as community nurses. People received good support from health professionals.
Activities provided by the service were varied and people said how they enjoyed the, "Opportunity to do something." The home had made real efforts to improve the opportunity for people to use the village facilities and be part of the local community.
People enjoyed a varied and nutritious menu and said how much they enjoyed the food. One person said, "The food is lovely and I always get a choice."
People and staff spoke of an open and approachable management and provider.
We have identified two breaches of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.