The Old Vicarage

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Care plans and risk assessments now reflected relevant details of equipment people used to transfer with. This included details of the sling loops that had been assessed as safe for staff to use with people. We found one person’s care plan required further clarity to help ensure their safety in their wheelchair. We discussed this with the provider, and they provided updated care plans and risk assessments to help ensure their safety.

Care plans and risk assessments were personalised and systems were in place to regularly check and update people’s care plans to ensure they remained accurate and up to date. Care plans and risk assessments were personalised and reflected people’s views and wishes.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Assessments were in place that supported people in line with evidenced based care and treatment. For example, people were assessed for any risks around eating and drinking including how to reduce risks from choking, falls and pressure areas and they received appropriate care in line with these assessments. Staff understood any dietary requirements people had including any modified texture diets and thickened fluids.

People enjoyed their meals, and they were offered alternatives if they wanted something different to the choices being offered. One person told us, “Yes, the food is good. Today is shepherd’s pie and it’s very nice. Afterwards I am going to have fruit crumble. The food is fine.” Another person told us, “Staff know what I like to eat.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us they worked well together. One staff member told us, “We have good relationships, and it feels like we are pulling together as a team,” while another staff member said, “We are a really good team, if there are any problems we try and sort them out between us.” We observed staff working well together, asking each other for help when needed, and valuing each other’s contributions.

We observed staff shared relevant information on people’s changing needs with other health and social care professionals. This included sharing health assessments on people’s changed needs and resulted in changes to their care plans to help ensure they received care and treatment that was effective.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Care plans contained information on people’s health conditions including any signs of potential deterioration in health. This helped staff to identify any signs of potential deteriorations in health quickly and seek appropriate advice.

People told us they felt well looked after. One person told us, “I love it here. Every one of my family and friends say they have never seen me look so well.” People had appointments with their GP when needed, and other appointments such as with opticians and audiology. This helped people maintain their health and independence.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Monitoring was in place and actions taken to help prevent weight loss and prevent the risks from malnutrition. Staff completed observations on people’s changing health needs during our inspection and sought advice from the relevant healthcare professionals to ensure people received appropriate care.

The registered manager and the nursing staff team completed regular reviews of people’s healthcare needs. This identified when people needed increased monitoring to help identify any further actions needed. Staff understood what actions to take to improve people’s health outcomes and any changes from reviews of people’s health. For example, staff knew how frequently different people needed assistance to change their position to help reduce the risk of pressure sores.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

We observed staff explain to people what care they were there to help with. For example, staff explained people’s medicines to them and asked how they preferred to take these. This made sure people understood their care choices and they were able to provide their consent.

Records showed when people had declined offers of care from staff, this had been respected, and staff asked them again later. This helped to promote and respect people’s rights and choices.