The Vicarage Residential Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

There was a continued breach of legal regulation in relation to person centred care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Staff knew and were well-intentioned towards people. However, people’s individual needs and wishes were not always met. People were not provided with meaningful activities and opportunities to socially engage both within the home and out in the community. People commented they were bored and we observed when staff engaged with people these interactions were mostly task based. There was an activity coordinator in place. However, they did not work every day which meant people had no access to structured activities throughout the week.

Whilst activity plan were advertised within the home it was unclear which was a current plan and there was limited evidence that the plan was being followed, or alternative activities were being offered.

During our first day of the assessment there was no activities throughout the whole day, and all the residents were sat in the lounge watching TV or falling asleep in their chairs. During the second day of our visit there was a singing activity organised during the morning, and physiotherapist visited later in the day. However, there was a notable lack of engagement with people outside these events.

The immediate environment did not always meet people’s individual needs. There was no evidence consideration was given to signage to assist people living with dementia to orientate themselves within the home or how space was arranged and decorated to aid people in navigating it safely and independently.

We observed some people’s bedrooms only contained furniture and lacked personalisation. These rooms did not feel homely, and care plans did not include any information regarding peoples’ choice of décor. Some bedroom’s door had people’s name on it but not all.

We saw staff speaking to residents in a kind caring manner and they always asked permission before they provided any care. People told us that they could get help with washing and getting dressed each day if they needed it and they would be comfortable to ask for help as the staff and management were very approachable. However, during our visit, we observed some people would benefit from assistance with meeting their personal care needs for example washing their hair, cutting and cleaning nails or brushing teeth. People did not always have access to drinks in their room and the staffing levels impacted on their outcomes. For example, during the lunch time we observed 1 staff member needing to support multiple people to eat.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The provider overall worked and collaborated with stakeholders and partners to ensure people’s outcomes were met.

Staff knew who to contact when required and people told us, they received support when needed. One person told us, “If I’m unwell they would call the doctor.” There was a weekly GP visit in place, and we observed one conducted during our visit.

Feedback from stakeholders and visiting professionals was mixed. Some told us staff were caring and others told us staff did not always act on advice given to them in a timely manner.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communication needs were outlined and detailed in their care plans.

The provider told us that staff used Google Translate to communicate effectively with people whose first language was not English. However, we did not observe staff using this.

We saw a list of basic English words and their translation into other languages in the office and the provider told us cards had been used previously for communication. Staff told us one person had a translator come in weekly, but this was not documented.

Staff overall had good understanding of people’s communication needs. For example, one staff member told us when one person was in pain, they would be very vocal and pointing to their head. However, we also observed staff did not always communicate effectively with people who may have more complex needs or whose first language was not English.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and their relatives were provided with opportunities to share their views and feedback regarding care and support they were receiving. For example, the registered manager organised a periodical meeting for relatives and people to attend. We saw evidence of service reviews taking place including both people and those important to them.

There was information on a notice board on how to raise any issues, complaints, or compliments. Contact details were given for management so people had the choice to email.

The manager told us that a monthly newsletter was emailed to families updating them on what had been happening within the home and what was planned along with any changes that were taking place at the home.

The provider made sure that people could access the care, support, and treatment they needed when they needed it.

People were supported with medical appointments. We observed a nurse visit and a video call with a GP during our assessment. People told us they could access help from a GP and other professionals easily and when they needed it. Staff knew how to access help and advice for people. One family member told us, “Communication is really good, they ring straight away if there is anything and are really on the ball for bringing the Doctor in, they look after my loved one well.”

The deputy manager told us that a physiotherapist/massage therapist had started visiting the service. We observed one of these visits on inspection and some people completed exercises with them.

People were supported to stay connected with friends and family. During our assessment we observed visits from several family members.

One person told us “My (family member) brings our dog in to see me which is nice and my family take me out for a walk and a trip back home now and again.” Another told us “My daughters come to visit me and sometimes take me out.”

Staff and leaders did not actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People did not always receive person-centred care that was meeting their individual needs such as people diagnosed with dementia, other complex needs or coming from different cultural background. For example, there was one person whose English was not their first language. During the lunch time they were presented with the same meal as everybody else which they refused. This meant the person did not have lunch that day.

Staff were kind and well-intentioned towards people and knew them well but did not always know or have opportunities to meet people’s needs for example due to the low staffing levels.

There was a policy in place for Equality, Diversity and Human Rights, staff were made aware of this policy on induction to the service.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s care plans included information regarding people’s future wishes including end of life care. People’s care plans were updated when people’s needs were changing. Staff involved people and their relatives in decisions about their care and agreed a plan of support with them.