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Inspection Summary


Overall summary & rating

Good

Updated 29 August 2019

About the service

The Old Vicarage is a care home providing personal care to nine people with mental health conditions, learning disabilities and/or autism at the time of the inspection. The service can support up to 10 people in one adapted building. This is one of three care homes located on one site, within the village community of Baschurch, outside of Shrewsbury.

The service has been developed 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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 10 people. Nine people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by people’s integration into the local and wider community, as well as the planning and delivery of person-centred support. The service needed to ensure that consistent staffing ensured this, as we have noted below. When we visited, staff were not wearing uniforms, which helped to create an atmosphere of partnership working.

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

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way. We found that review of restrictive practices, as well as the application of Positive Behaviour Support (PBS) principles to promote proactive support, could at times be improved. We made a recommendation regarding this.

The effective planning and deployment of staff required review to ensure a consistently safe service that was supportive of and flexible around people’s needs. We received mixed feedback around this and made a recommendation.

People told us, or showed us in their own ways, that they felt safe and liked living at The Old Vicarage. People and relatives spoke positively about the staff team, felt listened to and gave examples of what had been achieved with their support. One person told us, “They do a good job”. A relative said, “It is nice to be able to say [my relative] is in a ‘safe haven’.”

Staff felt that despite some staffing difficulties, the team worked well together. Staff described a family-like atmosphere, gave examples of how well people and staff knew each other and how staff ensured people were always put first. We heard examples of how the service applied the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People, relatives and staff were involved in the development of the service through regular meetings and reviews.

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 sy

Inspection areas

Safe

Requires improvement

Updated 29 August 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 29 August 2019

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 29 August 2019

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 29 August 2019

The service was responsive.

Details are in our responsive findings below.

Well-led

Good

Updated 29 August 2019

The service was well-led.

Details are in our well-led findings below.