The Old Vicarage

Updated 9 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

The Old Vicarage is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection we reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all of this information to plan our inspection.

During the inspection

During the inspection with spoke with three people who lived at the service. Staff supported us to communicate with one person. Some people were unable or chose not to tell us about their experiences. We used observation throughout our inspection to help us understand people’s experience. We spoke with three members of staff, as well as the registered manager, deputy manager and quality improvement lead.

We reviewed a range of records. This included three people’s care records and everyone’s medicines records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, audits and health and safety documents were reviewed.

After the inspection

During and after the inspection, we looked at training data, policies and quality assurance records. We spoke with the friends and family of three people who lived at The Old Vicarage.

Updated 9 August 2019

About the service

The Old Vicarage is a residential care home located in an adapted house over two floors. Some bedrooms are accessible on the ground floor, and some upstairs. There are communal areas and a garden.

The service provides personal care and accommodation for up to nine people who have learning disabilities and additional needs. Eight people were living at The Old Vicarage at the time of the inspection. This is larger than current best practice guidance, however, the size of the service was mitigated by the fact that it fitted into the residential area and other homes in the area were of a similar size.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People were safe and protected from avoidable harm or abuse at The Old Vicarage. Policies, procedures and checks were in place to protect people and staff. Risk assessments were in place, and the environment was clean and met people’s needs. Plans were in place to redecorate some areas of the building.

There were enough staff to meet people’s needs. Safe recruitment and selection procedures were in place and staff received induction and training to ensure they had the skills and knowledge to effectively support people. Some staff had not had supervision as frequently as the provider required, but this was being addressed and all told us they felt well supported.

People's medicines were administered as prescribed and managed safely by competent staff. People accessed routine and specialist healthcare services as required, and were supported to eat and drink enough to maintain a balanced diet which met their needs.

People were well supported and treated with dignity and respect. They were involved in decision making where possible. People and their relatives were positive about staff.

People had care plans which were personalised and identified what was important to them. Care plans gave guidance to staff about what people could do for themselves and how best to provide support. Records were being developed to ensure people’s preferences were respected in the event of serious illness or death.

People were supported to participate in a range of activities. A plan was in place to further develop more activities which were meaningful for the individual. People were supported to develop and maintain relationships with family and friends.

The service was well run and staff felt supported by the management team to provide high quality care. Checks and audits were carried out regularly to review quality and performance. Action plans enabled the provider to monitor changes and improve care for people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support usually focused on them having opportunities to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 15 March 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.