Background to this inspection
Updated
28 March 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 14 December 2017 and was unannounced.
The inspection team consisted of two inspectors and one expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
Before our inspection we reviewed information held about the service. We looked at our own system to see if we had received any concerns or compliments about the home. We analysed information on statutory notifications we had received from the provider. A statutory notification is information about important events which the provider is required to send us by law. We contacted representatives from the organisations that commission care from the service, the local authority and Healthwatch for their views about the home.
During the inspection we spoke with four people who lived at the home and nine relatives. We spoke with 15 staff which included care and nursing staff, housekeeping, kitchen and maintenance staff, the manager and a senior manager. We viewed five care records, six medicine records and records relating to how the service was managed.
We observed people's care and support in the communal areas of the home and how staff interacted with people. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
Updated
28 March 2018
The inspection took place on 14 December 2017 and was unannounced.
At the last inspection in November 2016 we rated the service as Requires Improvement. At this inspection we have changed this rating to Good.
The Vicarage Nursing Home provides nursing care to up to 52 older people, most of whom are living with dementia. At the time of our inspection, 36 people lived at the home.
The Vicarage Nursing Home 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.
People’s bedrooms are on the ground and first floors and these are accessed by stairs or a passenger lift. People have access to communal areas within the home and access to the home’s gardens.
No registered manager was in post. The last registered manager had deregistered with us but was now continuing at the home. They had re applied to be registered with us and their application was being assessed at the time of our inspection. They were present during our inspection. 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.
Staff had received training in and understood how to protect people from any harm and abuse. Systems were in place for staff to follow which protected people and kept them safe. Staff knew how to and were confident in reporting any concerns they may have about a person’s safety.
Risks to people were assessed and kept under review, and staff acted to manage identified risks safely.
Medicines were managed, administered and stored safely. There were systems in place to ensure people were protected from the risk of infection. Accidents and incidents were recorded and acted on appropriately.
People were supported by sufficient numbers of staff to safely meet their needs. Although some agency staff had been used recently, they understood how to support people safely. Checks were completed on potential new staff to make sure they were suitable to work with people living at the home. New staff were waiting for these checks to be completed before they commenced work at the home.
People’s needs and choices were assessed. Staff had the skills and knowledge to understand and support people's individual needs and support them effectively. These skills were kept up to date through regular training and staff were also supported in their roles by managers and their colleagues.
People’s consent was sought by staff before they helped them with any care or support. People’s right to make their own decisions about their own care and treatment was supported by staff. Where people were unable to make their own decisions these were made lawfully and in their best interests.
People's nutritional needs and preferences were met. Staff worked with other health and social care professionals as required to deliver effective care and support to people.
People were supported by staff who knew them well and had good relationships with them. Staff made sure people were involved in their own care and made sure they understood information that was given to them. People were treated with dignity and respect.
People received care and support that was responsive to their individual needs. People were encouraged by staff to express their views, preferences and wishes in regard to their care, support and treatment. Pathways were in place to help ensure people received appropriate support at the end of their life.
People and their relatives knew how to raise concerns or complaints. They were comfortable to do so and felt staff and managers listened to them and took action as needed.
The improvements to the service since the last inspection were reflected on by the relatives and staff, who praised the leadership and management of the home. Staff were confident in their roles and received the support they needed to provide good care. Systems were in place which continued to identify and drive improvement within the service provision.