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Inspection Summary


Overall summary & rating

Good

Updated 12 December 2018

The inspection took place on 04 November 2018 and was unannounced. We last inspected The Old Rectory in May 2017, during that inspection we found people’s legal rights were not always understood and upheld. This was because the service did not work in accordance with the Mental Capacity Act 2005. We also found risks around the environment were not being managed effectively and the governance systems were not fully effective. At the last inspection in May 2017, we found three breaches of the Health and Social Care Act 2018. This inspection evidenced that the required improvements had been made and the service was meeting their legal requirements.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective and Well Led to at least good. We found the provider had made the required improvements and the service is now rated as Good.

The Old Rectory 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 Rectory accommodates 10 people who have a learning disability and/or autism. The service is located in a large house in the rural village of Chewton Mendip.

Despite being a large service, it was operated in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service did not have a registered manager. 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. The previous registered manager had left the service in September 2018. The provider had placed an interim manager at the service whilst a new manager was recruited. The interim manager informed us the new manager was due to start work at the service the day after our inspection. They would then start the application process to become the registered manager.

Staff had been trained to administer medicines safely. The previous registered manager, interim manager and staff had worked with health professionals to review people’s medicines and ensure they were not being over-medicated. They had done this by working with the professionals to find alternative strategies to support people when they displayed behaviours that could challenge others.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the providers policies and systems supported this practice. The interim manager and staff understood and followed the requirements of the Mental Capacity Act 2005. They were committed to supporting people to achieve as much independence as possible, whilst ensuring each person was safe.

We found there were adequate numbers of staff working at The Old Rectory to support people effectively. The staff were well trained and supported well by the interim manager and provider.

The atmosphere of The Old Rectory had a friendly, calm atmosphere and people living in the home told us they got on well with both staff and other people at the home. People accessed the community regularly and were supported to plan their days and activities.

Risks to people were assessed and measures taken to keep people safe, without impacting on their rights to make choices and take some risks.

The home was clean and tidy and effective infection control procedures were in place to keep people safe. We did note that the decoration o

Inspection areas

Safe

Good

Updated 12 December 2018

The service was safe.

People were supported safely to manage behaviours that could be challenging to others.

People were supported safely to reduce the amount of medicines they were prescribed, therefore reducing potential side effects of these medicines.

People benefitted from being supported by an adequate number of staff who were suitable to work with vulnerable people.

People were protected from environmental risks because adequate checks were made by the provider and action taken to reduce the risks.

Effective

Good

Updated 12 December 2018

The service was effective.

People�s capacity to make decisions was assessed and actions were taken in line with the Mental Capacity Act 2005.

People�s physical, mental and social needs had been assessed and care plans described how to support them to achieve effective outcomes.

People were supported by staff who were trained and experienced to deliver effective care and support.

Caring

Good

Updated 12 December 2018

The service was caring

People were supported to express their views and be actively involved in decisions about their care and support as far as possible.

People were given privacy, respect and staff described The Old Rectory as people�s home and not a place of work.

Families were able to visit when they wanted. Staff also supported people to maintain relationships with friends and relatives.

Responsive

Good

Updated 12 December 2018

The service was responsive

Each person had a personalised care plan which supported them to be as independent as possible.

People were supported by staff who understood their communication needs and preferences.

There was a complaints policy and procedure. People could use advocates to support them raise a concern if they needed to.

Well-led

Good

Updated 12 December 2018

The service was well led.

The provider had put in place measures to ensure consistent management support following the departure of the registered manager.

People benefitted from good systems being in place to check and monitor the quality of the support being provided.