We carried out a review of the data available to us about Vicarage Road (A) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Vicarage Road (A), you can give feedback on this service.
We found the following examples of good practice.
When people tested positive for COVID-19 they were supported to isolate and were restricted to specific areas away form others. Additional stations for PPE were also placed outside people’s bedroom doors to minimise the spread of infection.
Furniture had been removed and spread out in communal areas to promote social distancing. For example, the dining room table was changed from one large table to smaller tables with only two people allowed at each table.
The home was clean and tidy throughout. All areas were cleaned twice per day with the areas touched more often cleaned at regular intervals throughout the day and night.
People had regular contact with family through phone and video calls with staff support. Pictures and post correspondence were also utilised to maintain contact between people and their families.
Staff encouraged and supported activities such as movies, exercise sessions on the Wii and yoga to support peoples wellbeing while they were unable to access the community during the government’s current lockdown restrictions.
Changes had been made to staff working hours to reduce the number of days staff were working each week. This reduced the frequency of travel for staff.
Further information is in the detailed findings below.
Vicarage Road provides accommodation and personal care for a maximum of six people. At the time of our inspection there were six people living at the location. 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:
People were kept safe and secure from risk of harm. Potential risks to people had been assessed and managed appropriately by the provider. People received their medicines safely and as prescribed and were supported by sufficient numbers of staff to ensure that risk of harm was minimised.
Staff had been recruited appropriately and had received relevant training so they were able to support people with their individual care and support needs.
Staff sought people’s consent before providing care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were treated with kindness and compassion. People’s right to privacy was respected by the staff who supported them, and their dignity was maintained. People were supported to express their views and be actively involved in making decisions about their care and support needs.
The provider had auditing systems in place to monitor the effectiveness and quality of service provision.
There was a positive emphasis on continually striving to improve the service and maintain high sustainable standards of care. The vision and values of the service were embedded in a person-centred culture which placed people firmly at the heart of the service.
The views of people on the quality of the service were gathered and used to support service development.
The provider worked in partnership with other organisations to ensure they were following current practice and providing high quality care.
Rating at last inspection:
The last rating for the service was good {published June 2017}. At this inspection we found the service has remained as good
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
People at the home were safe. Staff demonstrated that they were aware of the action to take should they suspect that someone was being abused. Staff knew the risks associated with people’s specific conditions and the actions required in order to minimise the possibility of harm. There were enough staff to meet people’s care and support needs promptly. People received their medicines when they needed them although action was needed to accurately record medicine storage temperatures.
People were supported by staff who had the skills and knowledge to meet their needs. People were supported to have the maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Menus had been developed in response to people’s preferences and nutritional needs. When necessary people were helped to eat by staff. People in the home were supported to make use of the services of a variety of mental and physical health professionals.
People told us that the registered manager and staff were caring. People were supported by regular staff who spoke fondly about the people they supported. People had key workers who understood people’s preferred communication styles and assisted them when necessary to express their views. Staff promoted people’s independence however staff sometimes used infantile language when recording how people required supporting. The registered manager told us they would take action to address this.
Staff supported people to engage in activities they enjoyed. On occasion some people were left without stimulation or meaningful interactions from staff. People’s care and support was planned in partnership with them so their care plans reflected their views and wishes. People told us that the nominated individual, registered manager and staff were approachable and would take action if they were not happy or had a complaint. The registered manager was developing a process to review and assess informal complaints and comments for any trends and themes.
People told us that the home was well run. The registered manager was aware of their responsibilities to the commission and they were knowledgeable of the type of events they were required to notify us of. Staff told us that the registered manager was supportive and led the staff team well. People had the opportunity to influence and develop the service they received. The provider and registered manager made checks to help ensure that the standard of care was maintained.
Further information is in the detailed findings below.
This inspection took place on 26 March 2015 and was unannounced. At our last inspection in April 2013 the provider was meeting the requirements of the regulations we looked at.
Vicarage Road (A) is a residential home which provides care to people who have learning disabilities. The service is registered to provide personal care for up to six people, however at the time of our inspection only four people were using the service There was a registered manager at this location. 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 and associated Regulations about how the service is run.
We observed staff continually ask people how they wanted their care to be delivered and supported them in line with their requests. People were relaxed with staff and confident to approach them for support. Staff said they enjoyed supporting people and how to assist them to pursue the interests they said they liked. Staff were knowledgeable about the individual support people required in order to maintain their privacy and dignity. People were also supported to be as independent as they wished such as helping with tasks around the home and going out to places of interest.
People were supported to maintain relationships which were important to them. Relatives regularly visited and people in the home had developed friendships with each other. People expressed their views about the service at regular meetings and were involved in discussing the care they received. Relatives told us they were involved in the planning and reviewing their relative’s care and were often invited by the provider to comment on the service when they visited or spoke to staff on the telephone. People told that they knew how to make a compliant and were confident that they would be responded to.
The provider had conducted assessments to identify if people were at risk of harm and if so had included guidance about how this could be reduced. The provider had taken action to reduce the risk of harm when people had been put at risk. Records which monitored people’s nutritional intake and weight were up to date so that people were supported to eat and drink enough to keep them well. These record however did not always record the quantities people had consumed. We saw that, when necessary, the provider had involved other healthcare professionals in people’s care.
All the relatives and staff we spoke with told us that they felt there were enough staff to meet people’s care needs. The provider told us they would review their staffing levels when additional people started to use the service to ensure people’s needs continued to be met. Staff were able to demonstrate they had the skills and knowledge to communicate effectively with the people who used the service. They expressed a good knowledge of what people liked to do and their individual preferences. Staff were supported with their personal development and to deliver what was required of their roles.
People were kept safe and staff knew how to recognise when people might be at risk of harm and were aware of the provider’s processes for reporting any concerns. Relatives told us that the provider took appropriate action when people had been at risk of harm. Records showed that the provider had worked with other agencies when they had received information of concern in order to keep people safe.
Medication was managed appropriately because staff were aware of the provider’s medication policy and people received medication in line with their care plans.
The provider understood their responsibilities under the Mental Capacity Act 2005 (MCA) They had conducted assessments when people were thought to lack mental capacity or held meetings to ensure decisions were made in the best interests of the people who used the service. The provider had ensured that staff were clear about the requirements of the Mental Capacity Act 2005 (MCA) and that people were supported with the least restrictions of their liberties.
Relatives told us the provider regularly sought their views when assessing the quality of the service and that the provider acted on their comments. Staff said the registered manager was approachable and responded to their concerns promptly. There were processes in place to enable staff to express their views and records showed that the provider had taken action in response to issues raised at regular meetings. The provider had ensured that staff were aware of the aims and vision of the service.
The provider had a system to assess the quality of the service and identify how it could be improved. The provider had developed an action plan to implement improvements at the service.
We found that people were comfortable with the staff that supported them and actively engaged with them. We noted that they were offered opportunities to go out during the day and supported to make decisions about how they wanted to spend their day. Staff understood how people communicated and interacted with them continuously.
People's needs were assessed to establish the care that they needed. There were systems in place to monitor people's health care needs. Health risks had been assessed and plans were in place to manage the risks. People had access to their GP and to other community and specialist healthcare workers. We found that staff quickly noticed when a person became unwell and took the necessary action to protect their health.
We found that people were cared for in a clean, hygienic environment and were protected from the risk of infection because appropriate guidance had been followed. The home was clean and tidy and there was a written policy and procedures in place for infection control and for cleaning. Records showed that staff at the service followed the provider organisation's procedures and that the manager monitored this regularly.
We used a variety of methods to gauge other people's experience of the service including reviewing records and talking to workers. We spent three and a half hours in
the communal areas of the home observing how workers cared for and supported people. We used the Short Observational Framework for Inspection method to understand how people who could not answer our questions experienced the service.
We saw that care workers and managers treated people with respect and spoke to them with warmth, friendliness and good humour. Workers were able to communicate with people because they knew them well and people looked at ease with their care workers. People were supported to actively participate in their daily living arrangements and they were engaged in what was going on in the home.
One person told us that they liked living at the home. Comparing their experience of living at Vicarage Rd with a large institution that they lived in some time ago they told us "staff are not bullies like they were at the old place."
We found that some opportunities were provided for people to be independent as much as they were able. We saw staff make some decisions for people which they could have made themselves.
We found people had been supported to see the health professionals they needed. We did not find that the records in the home about each person were as up to date as they should be, or that they had been updated as people's needs had changed.
People did have some opportunity to do interesting things. We were informed that these opportunities had decreased recently, and people who were able to speak about this were disappointed this had happened.