When we visited The Old Rectory there were 21 people living at the home. We spoke with six people and watched how staff provided care and support to others. This was because some people had problems with their memory and could not tell us their experiences of the care they received. We also spoke with a relative and the manager. A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?
Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and staff told us.
If you want to see the evidence supporting the summary please read the full report.
Is the service safe?
People we spoke with told us they felt safe living at the home. One person we spoke with said, 'They [staff] make sure we're safe and comfortable.'
We saw staff used the right ways to move people around the home with equipment such as hoists and wheelchairs. Up to date risk assessments were in place for issues such as falls, fire evacuation and nutrition.
Accidents and incidents were appropriately recorded and body charts were in place to identify any injury to a person.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. There were no applications needed or made by the home under this legislation since our last inspection. People's personal records contained a check list for DoLS which showed whether an application was needed or not. Records showed staff had received training about this subject.
Staff demonstrated a good understanding of how to support people to make decisions and how the Mental Capacity Act (2005) should be used to protect people's rights.
Good infection control arrangements were in place throughout the home. People we spoke with told us the home was always clean and tidy, and staff took good care of their bedrooms. One person said, 'It's [the home] always spotless.'
There were arrangements in place to monitor whether staff members were suitably immunised against infectious diseases for their own protection and that of the people they cared for.
Disclosure and Barring service (DBS) checks were carried out before staff started work at the home. The Disclosure and Barring service makes sure people are safe to work with vulnerable children and adults and an employer is required to complete those checks prior to commencement of employment.
Maintenance and repair records showed regular checks were carried out for things like water temperatures and general fixtures and fittings. They also showed repairs were carried out in a timely way.
People's personal records were not always fully secured which meant that people's confidentiality was not fully protected. The manager took immediate action to better protect information.
Is the service effective?
People were involved in an assessment before they moved into the home and when they had moved in. Care plans were developed with people based on the assessment information. Assessments and care plans were up to date and regularly reviewed.
Guidance about people's privacy, dignity, well-being, culture, religion and independence were referred to in the plans. One person we spoke with told us their cultural and religious needs were always met and staff understood what they needed and wanted in regard to this.
People told us they thought staff were well trained and looked after them very well. One person said, 'They [staff] know what they're doing and they do it well.' From watching staff provide care for people it was clear they understood people's needs and wishes and provided care and support in the way people wanted. A relative told us staff knew their family member's needs and wishes very well.
People had their health needs met through support from their GP's, district nurses and local hospitals. Records of healthcare support were up to date.
Is the service caring?
People told us things like, 'I love it here, it's so homely and caring' and 'Don't think I could get much better than here.' A relative told us their family member was very happy and comfortable living at the home. They told us staff treated them with respect and dignity.
Staff encouraged people to make decisions and choices for themselves. People could choose to have their breakfast in bed, what they wanted to eat and drink and what activity they wanted to join in with.
Assessments and care plans included people's likes, dislikes and preferences. Staff were polite and friendly in their approach to people. They used respectful voice tones when talking with people and discussed personal issues in a private manner.
Is the service responsive?
People were asked for their views and opinions about the home through things like satisfaction surveys and meetings. Regular meeting dates were displayed so that people could choose to attend or not. Meeting minutes showed people were encouraged to talk about things like activities and meal planning. One person said, 'They [staff] always listen to what I've got to say and they help me to get what I want.'
The satisfaction survey results for 2013 showed people who lived at the home, their representatives, staff and other professionals who were involved in their care were happy with the care and support provided. The action plan from the survey showed the provider had listened to people. For example, a better range of snacks and drinks had been provided.
People and a relative we spoke with said they knew how to make a complaint. They all said they had never had cause to make a formal complaint. One person said, 'The staff would listen to me if there was something I wasn't happy with, I know they'd put it right.'
There was an up to date complaints policy available for people and records showed no complaints had been made about the home since our last inspection visit.
Is the service well-led?
There was a system in place which helped to assure the provider and manager that the quality of the service provided within the home was of a good standard.
A range of audits were carried out regularly by the provider and manager, and action plans were in place to address any issues highlighted.
People who lived in the home were consulted about how they liked their care to be delivered and were asked for their views about how the home was run. Staff and other professionals were also asked for their views about how the home was run.