We carried out a review of the data available to us about The Old Vicarage Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Old Vicarage Residential Home, you can give feedback on this service.
The Old Vicarage Residential Home is a residential care home providing personal care to 12 people aged 60 and over at the time of the inspection, some of whom were living with dementia. The service can support up to 15 people.
People’s experience of using this service and what we found
People received safe support with their medicines from staff members who had been trained and assessed as competent. Staff members followed effective infection prevention and control procedures when supporting people. People were supported by enough staff who were available to assist them in a timely way.
The provider had assessed the risks associated with people’s care and support. Staff members were knowledgeable about these risks and knew what to do to minimise the potential for harm. People were protected from the risks of ill-treatment and abuse as staff had been trained to recognise potential signs of abuse and understood what to do if they suspected harm or abuse.
People were supported to have maximum choice and control of their lives and the provider supported them in the least restrictive way possible and in their best interests; the application of the policies and systems supported good practice.
The provider supported staff in providing effective care to people through person-centred care planning, training and one-to-one supervision. People were referred to additional healthcare services if needed and staff were knowledgeable about any recommendations or treatments. People were supported by staff members who were aware of their individual protected characteristics like age, religion, gender and disability.
The provider, and management team, had good links with the local communities within which people lived. The provider had effective systems in place to identify improvements and drive good care.
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 19 November 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the location is now rated good.
Why we inspected
This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. 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.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Old Vicarage 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.
The Old Vicarage Residential Home is a residential care home providing personal care and accommodation to 10 people aged 65 and over at the time of the inspection, some of which were living with dementia and/or a physical disability. The service can support up to 15 people in a single adapted building.
People’s experience of using this service and what we found
People’s risk assessments were not always being followed. Some improvements to medicines management had been made, however further improvements were needed to ensure they were always managed safely. Systems were being embedded to ensure improvements were ongoing, however they had failed to identify some omissions, such as care plans not being updated and gaps in recording. People had access to other health professionals, however plans were not always updated with their advice. People’s protected characteristics were not always explored further to ensure people were supported with these.
People were protected from abuse by staff understood their safeguarding responsibilities. There were sufficient numbers of suitably-recruited staff to support people. People were protected from the risk of cross infection. Lessons were being learned as feedback was being acted upon. Checks were taking place on the building and equipment to ensure it remained safe.
Staff received training to be effective in their role and felt supported. People were supported to have enough food and drinks of their choice, appropriate for their needs. 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 practice. The environment had been partially redecorated and physical improvements had been made, with further plans in place.
People were supported by a kind and caring staff team. People were helped to remain independent and make choices about their care. Staff treated people with dignity and respect.
There were basic end of life plans in place, with improvements planned following our feedback. People were supported with their communications needs. People were able to partake in activities of their choice and staff were keen to develop this further. People were supported by staff who knew them well. There had been no complaints since our last inspection, but the manager was aware of their responsibilities.
Staff felt the manager was approachable and that they were effecting positive changes to the home. The home worked in partnership with other organisations. The manager was aware of their responsibilities in relation to duty of candour, the previous rating was being displayed and notifications were being submitted as required.
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 20 July 2019). It continues to be rated as requires improvement overall although there were some improvements to the rating for caring and responsive, which were now rated as good.
The provider updated us monthly about improvements they were making to the service following previous inspections.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Old Vicarage Residential Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Old Vicarage Residential Home is a residential care home providing personal care to 10 people aged 65 and over at the time of the inspection. The service can support up to 15 people in one adapted building.
People’s experience of using this service and what we found
Though improvements had been made, peoples medicines were still not safely managed. Risks were managed and staff knew how to keep people safe. People were supported by enough staff to keep them safe and meet their needs. People were protected from abuse by staff who had been trained to recognise signs for concern.
Improvements were still needed to ensure that systems in place identified areas for improvement and encouraged continuous improvement.
Improvements were needed to ensure people had care plans for all areas of need, although staff were trained and knew how to support people.
People who had pureed food did not always have choice or variety in their diet though other people told us they enjoyed the food and had choices.
People’s diverse needs were not always assessed and considered.
We have made a recommendation about the Accessible Information Standard, to ensure people’s communication needs are consistently met.
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.
Staff were kind and caring towards people and had time to spend with them. People were happy with how staff treated them.
People, relatives and staff felt the manager and provider were approachable and supportive and involved people in the running of the service and their care and support.
People had access to activities that interested them and had been asked for their preferences.
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 inadequate (supplementary report published 3 April 2019) and there were three breaches of regulation. At this inspection, though some improvement had been made, not enough improvement had not been made or sustained and the provider was still in breach of some regulations.
This service has been in Special Measures since September 2018. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating and to follow up on action we told the provider to take at the last inspection.
Enforcement
We have identified breaches in relation to medicines management (safe care and treatment) and governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service: People were not kept safe because all their risks were not assessed and planned for and their medicines were not safely managed. These were continued issues from the last inspection. Not enough improvements had been made since the last inspection to ensure people received a safe and good quality service.
There were not enough staff to safely meet people’s needs. The provider acted to increase staffing levels following our feedback but they had not identified this issue for themselves.
The providers systems to monitor and improve the quality and safety of the service were still not effective. Lessons had not always been learned when things had gone wrong.
People’s choices and preferences were not always respected because there were not enough staff on duty to facilitate people’s choice. People were not always involved in their care planning so did not have the opportunity to voice their preferences.
Improvements had been made to ensure people consented to their care.
People enjoyed the food on offer and had choices of meals. People were happy with the way staff treated them.
There was a new manager since the last inspection and they were in the process of registering with CQC. People knew the manger and staff felt supported.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: At the last inspection the service was rated Inadequate. The report was published 14 September 2018 and the supplementary report (including enforcement action taken) was published 1 December 2018.
Why we inspected: This was a planned inspection based on the previous rating.
Enforcement: Full information about CQC’s regulatory response to the more serious concerns found in inspections is added to reports after any representations and appeals have been concluded.
Follow up: The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.
The Old Vicarage Residential Home 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. Care and support is provided in one building with a communal lounge and dining room. The Old Vicarage Residential Home is registered to provide care and support for up to 15 people. At the time of this inspection 15 people were using the service.
There was a registered 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 2008 and associated Regulations about how the service is run.
This was the first inspection since this service was registered on 25 February 2017. The home was rated ‘Inadequate’ and the service is therefore in ‘special measures’.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Risks to people's safety, health and wellbeing were not always suitably assessed and managed.
There was not always enough suitably skilled staff deployed at night time to administer medicines to people if this was required. Staff were not always trained to provide safe and effective care.
People were not always protected from the risks of avoidable harm and abuse because incidents of possible abuse were not always identified and reported to the local authority as required. Action was not always taken to protect people from further occurrences.
We found that medicines were not managed safely and people were at risk of not receiving their medicines as directed by the prescriber.
Safe recruitment processes were not always followed when employing new staff members and volunteers.
Systems in place to consistently assess and monitor risks to people and the quality of care provided were not operated effectively. This meant that issues with the safety and quality of the care were not reliably identified and rectified.
People were not supported to have maximum choice and control of their lives and staff do not support them in the least restrictive way possible.
People did not always receive an apology when things had gone wrong.
We were not always notified of events that are required by law.
People told us they had access to healthcare professionals when they required them however, we found that professional advice was not always incorporated into people’s plans of care.
People had choices of food and drinks. However, people’s nutritional risks were not always managed.
The provider did not have effective infection prevention and control practices in place.
People’s privacy and dignity was not always respected and promoted.
People told us that staff treated them with kindness and compassion. People had choices though they were not always enabled to share their views.
People did not have access to activities they enjoyed.
We identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.