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Inspection Summary


Overall summary & rating

Good

Updated 11 October 2017

The Old Vicarage is an old stone house adapted for use as a care home. The home is situated over two floors and there is a lift and stair lift available for access to the first floor. The home is registered for fifteen people who require accommodation and personal care. It is set in its own grounds in the village of Hornby in the Lune Valley between Lancaster and Kirkby Lonsdale. The home is close to local shops, churches and public houses. At the time of our inspection visit, there were thirteen people residing at the home.

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.

The service was last inspected on 04 October 2014 and was rated overall as good. We had rated the service as ‘Requires Improvement’ under the safe and responsive domain. This was because improvements were required to ensure staff were suitably deployed and activities were considered for people who lived at the home.

At this inspection, carried out in August 2017, we found all improvements had been made and the service was meeting the fundamental standards. The registered manager had reviewed staffing levels to ensure there were suitable numbers of staff on shift to meet the needs of the people who lived at the home. People told us staffing levels met their needs. Staff were not rushed and had time to sit with people.

In addition, staff had been deployed to ensure people had the opportunity to take part in activities on a daily basis. People and relatives told us activities took place. We saw evidence of activities occurring during our inspection visit.

We reviewed systems in place for managing medicines. We found good practice guidelines were implemented when administering regularly prescribed medicines. However, documentation relating to ‘as and when’ medicines was sometimes unclear. We have made a recommendation about this.

People and relatives told us staff had the required skills and knowledge to provide effective care. The registered manager maintained a training matrix so that training could be planned effectively. Although training was provided we noted staff did not always receive refresher training to ensure their skills were up to date. We have made a recommendation about this.

We looked at fire evacuation procedures at the home. Whilst procedures were in place these were not always fully documented to show all risks had been considered. We have made a recommendation about this.

People told us they felt safe at the home. Procedures were in place to protect people from harm. Staff told us they had received training in this area and were able to describe abuse and their responsibilities for reporting this.

The registered manager assessed individual risk and developed risk assessments to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes were recorded. Risk was suitably managed.

We reviewed staff records. Suitable recruitment checks were in place to ensure staff recruited possessed the correct characteristics and experiences for working with vulnerable people.

We looked around the building. We found it was hygienic and suitably maintained. We reviewed documentation relating to health and safety at the home and found suitable maintenance checks had been carried out.

People and relatives spoke positively about the quality of service provided. They praised the caring nature of staff, constantly referring to them as ‘kind’ and ‘caring.’ We found there was a warm and welcoming atmosphere at the home. People repeatedly described the home as homely and described it as a home from home.

We received positive feedback about the qual

Inspection areas

Safe

Good

Updated 11 October 2017

The service was safe.

People who used the service and relatives told us people were safe.

Processes were in place to protect people from abuse. Staff were aware of their responsibilities in responding to abuse.

The service had suitable recruitment procedures to assess the suitability of staff.

Arrangements were in place for management of all medicines. However, PRN medicines were not always suitably documented. We have made a recommendation about this.

The service ensured there were appropriate numbers of suitably qualified staff on duty to meet the needs of people who lived at the home.

Effective

Good

Updated 11 October 2017

The service was effective.

Relatives told us the service provided good care and treatment. The service worked proactively to promote health and wellbeing.

Staff had an understanding of the Mental Capacity Act 2005 and the relevance to their work.

Staff were provided with suitable training to enable them to carry out their roles proficiently.

Caring

Good

Updated 11 October 2017

The service was caring.

People who lived at the home and relatives were positive about staff.

Staff had a good understanding of each person in order to deliver person centred care. People�s preferences, likes and dislikes had been discussed so staff could deliver personalised care.

People told us staff treated people with patience, warmth and compassion and respected people�s rights to privacy, dignity and independence.

Responsive

Good

Updated 11 October 2017

The service was responsive.

Improvements had been made to ensure people were offered the opportunity to participate in regular activities.

People told us they were involved in making decisions about what was important to them. People�s care needs were kept under review and staff responded when people�s needs changed.

The registered manager had a complaints system to ensure all complaints were addressed and investigated in a timely manner. This was readily available to people who used the service.

Well-led

Good

Updated 11 October 2017

The service was well led.

Staff described the home as a good place to work and commended the skills of the registered manager.

We saw evidence of people being consulted with in order to develop and improve the service.

The registered manager had a variety of quality assurance processes in place to ensure safe, effective, high quality care was provided.