We last visited the service in December 2015 where we found a breach of the regulation relating to good governance. We rated the service as good. Following the inspection, the registered manager sent us an action plan stating what action they were going to take to improve.
At this inspection in March 2018, we found that action had been taken and the provider was meeting all the regulations we inspected against. In addition, the registered manager and provider had introduced a number of changes and had further developed the service. We rated the caring and responsive key questions as outstanding which meant the overall rating for the service is outstanding.
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 Old Vicarage accommodates 18 people over two floors. Some of the people living at the home had a dementia related condition. There were 17 people living at the home at the time of the inspection.
There was a registered manager in place. 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.
We found that staff were exceptionally caring. We observed kind, caring and thoughtful interactions between staff and people. Staff were highly motivated and committed and spoke with pride about the importance of ensuring people's needs were held in the forefront of everything they did. People, relatives and staff were able to give numerous examples about how staff went "above and beyond" to meet people's needs.
The service was extremely responsive. People and relatives described the responsiveness of staff as "Outstanding." Staff found inclusive ways to meet people's needs and enable them to live as full a life as possible. A creative activities programme was in place to help meet people's social needs. There was a complaints procedure in place and people knew how to complain.
People told us that they felt safe at the service. There were no ongoing safeguarding concerns. Medicines were managed safely. Checks were carried out to ensure that prospective staff were suitable to work with vulnerable people. There were sufficient staff deployed. Staff carried out their duties in a calm unhurried manner.
Staff told us, and records confirmed that training was available. There was an appraisal and supervision system in place and all staff told us they felt supported.
People's nutritional needs were met and they had access to a range of healthcare services.
Action had been taken following our last inspection with regards to monitoring the quality and safety of the service. Audits and checks were carried out to monitor the service. Our observations and findings on the day of our inspection confirmed that the provider now had an effective quality monitoring system in place. Staff were very positive about working at the home. We observed that this positivity was reflected in the care and support which staff provided.
We had been informed of all notifiable events at the service.