The inspection took place on 29 August 2017 and was unannounced.
The Old Vicarage is a privately owned care home offering residential care and support for up to 37 people. One of the owners is responsible for the day to day management of the home. It is situated about two miles from the centre of Bolton, and is close to bus routes, shops, pubs and other amenities.
There was a registered manager in place. ‘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 we spoke with told us they felt safe at the home. There were sufficient, suitably trained staff and the recruitment process was robust. Good staffing levels and low staff turnover helped to ensure staff had good knowledge of people who used the service and could deliver person-centred care. Medication systems were safe and staff were trained in medicines administration.
The safeguarding policy and procedures were appropriate and up to date. Staff had undertaken safeguarding training and demonstrated a good knowledge of safeguarding issues. Staff we spoke with were aware of whistle blowing and assured us they would report any poor practice they may witness. The registered manager was committed to raising the profile of safeguarding within the home and on a wider level.
General and individual risk assessments were in place. Accidents and incidents were recorded appropriately. Health and safety measures were in place and equipment was maintained and serviced as required.
The induction programme was thorough. Training was on-going and refresher courses were undertaken as required. We saw records of regular staff supervisions and annual appraisals.
There were no malodours and the environment was homely, clean and uncluttered. The home had recently had an extension to the premises built and this had been done to a very high standard. There was a good choice of food for all meals and special diets were catered for.
Care plans included relevant health information. Communication between health professionals and the service were documented. The service was working within the legal requirements of the Mental Health Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).
We observed interactions between staff and people who used the service throughout the day and found them to be kind, courteous and friendly. People’s dignity and privacy was maintained at all times.
A service user guide was in place as well as a statement of purpose. Residents meetings were held regularly.
Care plans included advanced care planning if people had expressed their wishes for the end of their lives. The service endeavoured to respect these wishes and support people to remain at the home if they wished to do so, when nearing the end of their lives.
Care plans were person-centred and included information about people’s preferences, likes and dislikes. Staff communicated well with people who had difficulty with verbal communication and responded quickly to individuals who were unwell.
There were lots of activities and outings arranged by the service. People’s diversity was respected and there were visits to the home from leaders of various faiths.
There was an appropriate, up to date complaints procedure, which was outlined within the statement of purpose. There was a complaints book, but no complaints had been received.
All the people we spoke with felt the service was well run and the management were approachable. Staff observations took place to help ensure their competence remained at the correct level.
Audits were undertaken for issues such as falls, accidents and incidents, medicines, health and safety and feedback from people who used the service and staff. Care files were regularly audited and all audits included actions to address any shortfalls.
The service were committed to being a positive and active part of the wider community and were involved with a number of local initiatives to promote this. People who used the service, that we spoke with, were positive about this interaction and clearly enjoyed participating with the local community.
The service were involved with the National Citizens Service (NCS). This is a government funded initiative supporting community engagement and bringing together schools, businesses and communities. There was clear indication of the positive effects of this interaction on the moods of the people taking part and the initiative served to help keep people at the home integrated with the wider community.
There was evidence that management were committed to supporting staff in delivering an environment and culture focused on the continual improvement and wellbeing of both staff and people who used the service alike.