Archived: Vicarage Home Care

Is the service safe?

Three of the relatives we spoke with told us they felt their relatives were safe. We found the provider had improved their policies and guidance about safeguarding vulnerable people since our previous inspection but that staff were not aware of the provider's guidance. We found allegations of financial abuse had not been responded to appropriately. This meant that people may have been at risk of harm.

We found the provider was not meeting the requirements of the Mental Capacity Act 2005 (MCA). The provider did not have a policy in place that described how the service would implement the requirements of the MCA when people may have lacked the capacity to consent to their care and support. The provider had not assessed people's capacity to make decisions about their care and support. This meant that people's rights were not protected.

We found staff were not always aware of people's risk management plans and that care was not always delivered in line with people's individual care plans. This meant people were at risk of unsafe or inappropriate care.

Systems were not in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and checks made on the service. This increased the risk to people.

Is the service effective?

People's care needs were assessed with them. We saw evidence that people's relatives were involved in their care planning. We found care plans had detailed information about people's care needs and how staff should support them. We saw that care plans were regularly updated. However, we found staff were not always aware of people's care plans or health needs. This meant people were not always receiving the care that was planned for them.

Is the service caring?

Relatives told us staff were kind and caring.

People's preferences, interests and diverse needs had been recorded, however, care was not always provided in accordance with people's wishes.

Is the service responsive?

Relatives were asked to give their views about the service. One relative told us the provider responded well to any comments made. One relative found the provider had not been able to improve the service provided.

Is the service well led?

The provider had some risk management systems in place. Staff were aware of service improvement plans.

We found that audits undertaken by the provider did not always identify shortfalls in the service. This meant not all risks to people were managed effectively.

Staff told us they were well supported by the provider and training schedules were in place and up to date. However, we found that the provider had not checked to ensure that training had been effective and that staff delivered care to an appropriate standard.

The provider did not have relevant policies and procedures in place to ensure people's rights and choices were protected at all times.

We found the provider had not kept a record of complaints or comments made about the service. Relatives told us the provider did not always respond to complaints they had made.

People we spoke with were complimentary about the care and support that they received. A relative said: 'It makes a difference; every single day X [relative] knows someone is coming to help.' Another relative said: 'They are always on the end of a phone.'

We found that steps had been taken to ensure that people received the care and support they needed. Care had been planned and risk assessments had been completed. Daily care records had been updated and when necessary other medical professionals had been involved in people's care.

Staff had been trained to recognised abuse. However, the provider did not have suitable guidance for staff and arrangements in place that ensured appropriate action if abuse had been suspected.

Staff had been recruited in an appropriate way and checks had been undertaken that ensured they were suitable to care for vulnerable people. The provider had audit systems in place to enable them to monitor the quality of the service provided to ensure that people received appropriate care and treatment.