Archived: Old Vicarage Residential Care Home

People who used the service had access to three communal areas, a lounge, dining room and conservatory. During our visit we saw people choosing where they wished to spend their time. Some people had chosen to spend time in communal areas and others in the privacy of their own rooms.

We saw that people had been able to personalise their bedrooms and bring in their own furniture if they wished.

One person told us that they thought the home was a good place to live and that 'the owners seem to keep it nice'.

When we spoke with care staff they had a good understanding of the people they cared for and their individual likes and dislikes.

We spoke to two people who used the service and they told us that care staff cared for them well and we saw care staff supporting them in a calm and attentive manner.

One person told us that they like to go out and visit local shops and that care staff supported them to make the necessary arrangements.

The relative of one person told us that they felt care staff cared for the person well and responded appropriately to their needs or requests and that they were kept up to date with any changes in the person's well being.

At lunchtime we saw that people could choose where they wished to eat their meal, with some people eating in the dining room and others choosing to eat in the communal lounge or their own bedrooms. The manager was very clear that it was peoples' home and that there was no expectation that all meals should be eaten in the dining room.

We saw that people were offered a choice at lunchtime but care staff also responded to people's individual need and preferences and provided meals that were not included on the menu if necessary. The atmosphere at lunchtime was very calm and relaxed and care staff were offering people assistance as necessary and in accordance with their individual needs.

The relative of one person described care staff as being 'pretty good ' and said that there always appeared to be care staff visible in the home when they visited. They said care staff were friendly and helpful towards them and that they responded promptly when people used their call bells to summon help.

We were not able to speak to care staff on the day we visited as there were only two members of care staff on duty that afternoon. This meant that there may have been a risk to people who used the service if we had taken care staff away from providing care.

Correspondence with people who used the service or those acting on their behalf about the cost of their care was not available during our visit. There was no evidence that people who used the service or those acting on their behalf had been involved in a discussion about charges. There was no correspondence about changes to fees for us to look at. This meant that people who used the service or others acting on their behalf may not have known how much they were expected to pay or what the service would provide for the fee paid.

One person told us that they were waiting to find out what fees that they were going to have to pay when a placement became permanent. This information had not already been made available to them.

At our previous visit we saw that carpets in two bedrooms were not clean. When we visited this time we found that although these carpets had been cleaned or replaced as necessary there were unpleasant smells in several bedrooms, the dining room and the conservatory.

We revisited these areas after cleaning had taken place and although there was some improvement the smells were still apparent. One visitor told us that they too had noticed unpleasant smells when they had visited the home.

Medication storage cabinets and the drug fridge were located in the dining room. When we spoke with the Manager they told us that they planned to review the storage arrangements and relocate them away from communal areas. During our visit we found that arrangements to ensure medication was stored at the correct temperatures had not been followed.

The relative of one person told us that they were not aware of the complaints policy but expected there would be one in place. They said that they if they had any concerns they were are able to raise them directly with the home manager who was usually available in the home and they felt these were dealt with appropriately.

They spoke positively about the manager and the fact that when they visit they usually see the manger who they felt was very approachable.

Since our last visit to the home there had been a change in the management arrangements and a new Manager was employed in February 2012. The Manager had not submitted an application to register with us at the time of our visit.

During the course of the visit we spoke at length with the Manager about the service. They had already identified and prioritised areas for improvement and were working with the provider and other agencies to make plans to address these. These will be followed up at future visits.

We saw staff engaging positively with people who lived in the home and staff we spoke to showed a good understanding of the individual likes and dislikes of people who lived there.

People who live in the home were offered the opportunity to participate in recreational activities and staff supported people to access day care centres or local befriending services.

People we spoke to felt that they were able to raise any concerns with staff or management and that they would be taken seriously.

When we walked around the home we saw that the environment was generally clean and tidy. We looked at some bedrooms and the rooms we saw were all homely in appearance and had been personalised to reflect the preferences of the people who lived in the room. We saw that people were able to bring in their own furniture if they wished.

During our observations we saw that aids and equipment had been made available to people when they needed it and staff supported them to use as necessary.

All of the equipment we saw was clean with the exception of one commode which had some stains to the underside of the frame.

During our visit we looked at the care and support people were given at lunchtime. People were being offered a choice at lunchtime and alternatives being offered when necessary.

The lunchtime routine appeared quite rushed. We saw staff supporting people to go to the bathroom before lunch. We observed staff assist one person who had been incontinent of urine. Staff attended to the person's hygiene needs but failed to remove the wet protective pad from their armchair which was left in place until sometime after lunch. When we pointed it out to staff they took action to remove it.

We saw two people who required assistance from staff at mealtimes. We saw that one person was assisted by three different carers over the course of lunch. At one stage a carer was stood up to feed a resident and then leaned across the table to support another person. There was no provision for ensuring dinner plates and food being served was being kept warm and food was standing for some time before everyone received their meal.

We saw staff offering people their medication in a caring manner and taking time to support them with it as necessary.

People we spoke to told us that they were able to decide when and if they wanted their medication and that staff responded promptly if they asked for pain relief.