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Inspection carried out on 20 September 2019

During a routine inspection

About the service

The Old Rectory 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. The Old Rectory accommodates 28 people in one adapted building which is set over three floors. There were 18 people living at the home at the time of our inspection.

People’s experience of using this service

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 did not support this practice.

People continued to tell us they felt safe and well supported. Staff had a good understanding in how they protected people from harm and recognised different types of abuse and how to report it. Potential risks to people’s health and wellbeing had been identified and people had been involved with decisions in how to reduce the risk of harm. There were enough staff on duty to keep people safe and meet their needs. People’s medicines were managed and stored in a safe way. Safe practice was carried out to reduce the risk of infection.

People’s care continued to be assessed and reviewed with the person involved throughout. People were supported to have a healthy balanced diet and were given food they enjoyed. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people following best practice.

Staff treated people as individuals and respected the choices they made. Staff treated people with respect and maintained their dignity.

People’s care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People were supported and encouraged to maintain their hobbies and interests. People had access to information about how to raise a complaint.

The registered manager was visible in the home, listened and responded to those who lived in the home and the staff who worked there. The checks the registered manager made to ensure the service was meeting people’s needs focused upon people’s views and experiences. The providers checks were basic, and they discussed plans with us to put more robust checks in place and develop clear action plans with the registered manager so that improvements could be clearly reviewed.

Rating at last inspection

The last rating for this service was Good. The last report was published 21 March 2017.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 30 January 2017

During a routine inspection

The Old Rectory is registered to provide accommodation and care for up to 28 older people who may have support needs owing to dementia and physical disabilities. There were 25 people living at the home at the time of our inspection.

This inspection took place on 30 January 2017 and was unannounced.

A registered manager was in post at the time of our inspection, who had recently been appointed. 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 on 15 October 2014 we asked the provider to take action to make improvements to the way people’s medicines were managed. At this inspection, we found the improvements required had been made to the way people’s medicines were managed.

People told staff helped them to feel safe. Staff knew what action to take to protect people from the risk of potential abuse. Staff understood the risks to individual people’s safety and communicated information with other staff so people’s safety needs would be met. There were enough staff employed to care for people and people told us staff knew their care and safety needs well.

Staff had opportunities to develop the knowledge and skills they needed to care for people. Further training for staff was being planned, so to people’s needs would continue to be met. People’s right to make their own decisions was respected by staff. People enjoyed their mealtime experiences, and had enough to eat and drink to remain well. Staff took action to support people if they required medical assistance, and advice provided by health professionals was implemented. As a result, people were supported to maintain their health.

Caring relationships had been built between people and their relatives and the staff who supported them. Staff took action to show people they were valued and knew about their histories and preferences. Staff offered people reassurance in the ways they preferred when they were anxious. People’s right to privacy was taken into account in the way staff cared for them and people were encouraged to make their own day to day decisions about their care.

People were involved in deciding how their care should be planned and risks to their well-being responded to. Where people were not able to make all of their own decisions their representatives and relatives were consulted. Relatives told us their suggestions for developing their family member’s care further were listened to. People’s care plans and risk assessments were updated as their needs changed. People and their relatives understood how to raise any concerns or complaints about the service. Systems for managing complaints were in place, so any lessons would be learnt.

People and their families told us the registered manager and senior staff were approachable and were positive about the way the home was run. The registered manager had introduced changes to benefit people living at the home. The registered manager was in the process of developing plans to refurbish areas of the home, with the involvement of people living at The Old Rectory. The provider will need to facilitate resources for this to be achieved.

The registered manager checked the quality of the care provided and people and their relatives were encouraged to give feedback on the care provided.

Inspection carried out on 15 October 2014

During a routine inspection

The inspection took place on 15 October 2014 and was unannounced. There were no areas of concern identified on the previous inspection.

The Old Rectory is registered to provide accommodation for 28 people who require personal care.

There were 23 people living at the home when we visited and there was a registered manager in post. 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.

People told us that they felt safe and well cared for. Staff were able to tell us about how they kept people safe. During our inspection we observed that staff were available to meet people’s care and social needs.

People received their medicines as prescribed and at the correct time. However, we found systems and processes to keep people’s medicines safe required improvement.

People told us they liked the staff and felt they knew how to look after them. Staff were provided with training which they felt reflected the needs of people who lived at the home.

People were supported to eat and drink enough to keep them healthy. People had access to drinks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were met. We found that people’s health care needs were assessed, and care planned and delivered to meet those needs. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs.

People told us and we saw that their privacy and dignity were respected. The care provided took into account people’s views and input from the people who were important in their lives. Staff told us that they would raise concerns with the nursing staff, the duty manager or the registered manager and were confident that any concerns were dealt with.

The provider and registered manager made regular checks to monitor the quality of the care that people received and look at where improvements may be needed.

Inspection carried out on 25 April 2013

During a routine inspection

At this inspection, we found that improvements had been made in the areas where we had previously found concerns. The provider had taken steps to ensure all staff had received training in identifying and reporting suspected abuse. There were ongoing improvements to the quality and accuracy of records relating to the care of people who lived at the home.

During our inspection we spent time at the home watching to see how staff supported people, and talking with people about life at the home. We spoke with four people living at the home. We also looked at records, spoke with four staff and the manager.

People were very positive about the home. One person said "You'd have difficulty finding anywhere better" and another told us "I like my room, the meals are good and I can go for a walk in the garden as I choose".

We saw that staff were kind and caring when they provided support for people. Staff were respectful in the way they spoke with people. Staff had a good knowledge of the people they were caring for. They also showed empathy and were sensitive in the way they talked about people.

People said that they felt safe at the home. The manager was able to demonstrate that systems for monitoring the quality of the care and treatment were effective.

Inspection carried out on 27 June 2012

During a routine inspection

We spoke with one person who used the service and they told us that they thought the care they received was �absolutely right�. Another person told us that they did not have to wait long when they needed support from staff.

We spoke with relatives visiting at the time of our inspection. One person�s relative told us that they had no doubt that staff were �caring, kind, vigilant and careful�.

We spoke with several relatives who were visiting one person who used the service. One relative told us that often people would be told to wait to be supported as staff were busy or were �on a break�.

When we spoke with one person�s relatives we found that they hadn�t been informed that their relative had been found unconscious after a recent just two weeks prior to our inspection.

Reports under our old system of regulation (including those from before CQC was created)