Archived: The Vicarage

Updated 4 June 2019

This inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was prompted in part by wider concerns about the provider and risk management across their registered respite services. The information shared with CQC indicated potential concerns about the management of ligature risks. This inspection examined those risks and the safety of the premises.

Inspection team:

This inspection was carried out by an Inspector and an Assistant Inspector.

Service and service type:

The Vicarage is a registered care home without nursing. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

What we did:

Before the inspection, we reviewed information we had received about the service since the last inspection. This included any notifications we had received from the service and feedback we requested from external agencies including the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also spoke with commissioners and relevant teams for updates on their monitoring and oversight of this service.

Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We referred to this information to help plan our inspection.

During the inspection, we spoke with one person, a new support worker, and two support workers. We also spoke with two healthcare professionals, the service project lead and the registered manager. We also reviewed records related to three people’s care and records related to medicines management, health and safety and quality assurance.

Some information we requested was not available to view during our inspection, including the training matrix, recruitment files, incident records and the provider’s policies. We were told these records were stored at the provider’s head office. When we visited the provider’s head office the following day as part of our inspection activity, this information was not available. We confirmed our requests for information and received this information after the inspection.

Updated 4 June 2019

About the service: The Vicarage is a respite service offering accommodation and support for people with mental health support needs. Three people were supported at the time of the inspection.

People’s experience of using this service:

Overall people gave positive feedback about the service. People felt safe at the service. People carried on with their usual routines and their choices were promoted. There was not always an appropriate balance however between people’s independence and safety. One person did not always feel they had the privacy they needed. Action was not taken to keep another person safe when their needs could not be safely met. We identified a breach of the regulations because people’s medicines were not managed safely.

Staff told us they felt supported. Lone-working had been phased out, and improvements had been made to the premises to improve the safety of the service. Further improvements were planned, including to the premises, staff training and how incidents were logged. We identified a second breach of the regulations because systems and processes failed to effectively assess, monitor and improve the service.

More information is in the full report.

Rating at last inspection: Good (October 2017)

Why we inspected: This inspection was planned based on the previous inspection rating and was brought forward due to concerns known to CQC about the provider’s other registered services.

Enforcement / Follow up: We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment and governance. During our inspection, we prompted the provider to address our safety concerns.

We also shared our concerns with the commissioning team that arranges referrals to the service.

We did not take enforcement action on this occasion because shortly after our inspection, the provider submitted an application to de-register. We will continue to monitor this provider and service until the de-registration process is complete.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk