The Old Vicarage is registered with the Care Quality Commission (CQC) to provide care and accommodation for a maximum of 14 adults who have a learning disability. It is situated in the village of Stallingborough near to Grimsby.
The service had 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.
This inspection was unannounced and took place over two days. The previous inspection of the service took place on 27 January 2014 and was found to be compliant with all of the regulations inspected.
Medicines were kept safely and were stored securely. A locked controlled drugs cupboard was attached to the wall for medicines requiring tighter security. Records confirmed medicines were handled only by suitably trained staff.
The registered provider had policies and procedures in place to safeguard vulnerable people from harm and abuse.
Risk assessments clearly identified hazards people may face and provided guidance to staff to manage any risk of harm.
Staff told us they had been recruited into their roles safely. Records confirmed references were taken and staff were subject to checks on their suitability to work with vulnerable adults.
Staff told us they felt there were enough staff on duty and that they were well trained and supported by the management.
The care plans we reviewed contained assessments of the person’s capacity when unable to make various complex decisions. When people had been assessed as being unable to make complex decisions there were records of meetings with the person’s family, external health and social work professionals, and senior members of staff.
We saw lunch being prepared by the care staff in the main kitchen. Fresh ingredients were being used and the meal looked appetising. In all cases people’s intake of food and drink throughout the day and night was recorded using an electronic recording system.
We reviewed the staff training records and found the registered manager used an electronic system to monitor and plan training for all 40 members of staff. We saw staff received training which was relevant to their role and equipped them to meet the needs of the people who used the service.
People who used the service were supported to be as independent as possible. Although people who used the service had limited communications skills, care plans were written with maintaining and developing independence in mind.
Records showed each person who used the service was invited to the monthly meeting of their core team of care staff.
We observed high levels of interaction from staff. Staff spoke with people in a calm, sensitive manner which demonstrated compassion and respect.
Care plans provided staff with a summary about the person they were supporting including communication methods, diagnoses, allergies, and relations’ birthdays. Care plans were written around the specific levels of care each person required.
Each person had an activity plan which had been discussed with them at their monthly meeting. People who used the service were supported to participate in a number of activities which included visits to the local theatre, football matches, shopping, and going to discos and other social clubs.
The registered provider had a complaints and compliments policy in place which was displayed in pictorial format around the service and was issued to people’s relatives.
There were monthly records of accidents, incidents, injuries, and safeguarding referrals. These had been evaluated and action plans created to address any shortfalls.
Records showed people who used the service and the relatives were frequently asked for their views at the various monthly meetings and at the ‘my review, my say’ meetings held every six months.
Staff meetings were held monthly in which the care for each person who used the service was discussed.
There were systems in place to monitor the quality of the service. Monthly audits included: medicines management, pressure care, infection prevention and control, and care plans. Again, action plans had been created to address any shortfalls.