The Old Vicarage

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People were confident to raise any concerns. One person told us, “Any of the staff would listen but it’s the manager who I would go to, and I know they will sort things.”

Staff felt they were listened to, and actions were taken to follow good practice. One staff member told us they knew they could make suggestions, they said, “Managers want us to, and they want us to improve all the time. The service has improved, and it seems more efficient now.”

Staff completed incident forms to record any safety incidents, and these recorded the actions taken by staff including any on-going monitoring needed to help promote people’s safety. This helped to demonstrate a positive culture around reporting safety incidents and concerns.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

We observed staff were now consistently in the communal lounge with people and were readily available to help people who were at risk of falls. Regular well-being checks were made when people were cared for in their own bedrooms. This meant staff were present to monitor and manage people’s safety effectively.

People’s care needs had been assessed prior to them joining the service and this helped ensure their care needs could be met safely.

Staff told us how they helped people settle in when they first joined the service. One staff member told us, “We just all tried to make [name of person] feel really welcome. We told them they were safe and showed them how to use the buzzer and that there was nothing that we wouldn’t do to help them.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People felt safe living at The Old Vicarage. One person told us, “I feel very safe and I’m not just happy here, I’m over the moon.” Staff had been trained in safeguarding and knew the potential signs of abuse that if identified, would need to be referred to the local authority safeguarding teams.

When people had not able to make informed decisions about their care, ‘Best Interest Decisions’ were made in line with the Mental Capacity Act. This helped safeguard people and helped to promote their rights.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. However, we observed one member of staff misunderstood what a person had asked for help with, and another occasion when a quietly spoken person’s request for assistance was not heard by staff. We discussed this with the registered manager who told us they would undertake observations to ensure people’s communication needs were met.

All our observations of staff assisting people to transfer now showed this was completed in line with good practice. For example, we saw staff were careful, people had their arms and legs safely positioned when being transferred in wheelchairs, staff ensured there was enough space when seating people at tables and staff provided assistance at a pace that matched people’s needs.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Risks in the environment were now safely managed. For example, we observed all wheelchairs in use were in working order, repairs had been made to the ceiling, areas of flooring had been replaced to reduce trip hazards and wardrobes were securely fastened to walls.

Regular checks were in place to help ensure other aspects of environmental safety, for example checks were made on fire and water safety. This helped to ensure The Old Vicarage remained a safe environment for them to live in.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

We observed staff now had the necessary skills and competence to provide safe care and to help people safely transfer. Staff told us there were now 2 regular domestic cleaners on shift to ensure all cleaning tasks were completed. Staffing rotas showed this had been mostly maintained. Where domestic cleaning staff not been available the registered manager told us this had been covered by other members of the staff team.

Staff had completed training in areas relevant to people’s health and care needs. The registered manager had oversight of this training to ensure to was kept up to date.

People had mixed views on whether they received timely care. One person told us, “You often have to wait,” while another person said, “Staff come quickly, I feel safe, and staff are good.” On the day of our inspection, we observed staff responded in a timely manner to help prevent falls and completed regular well-being checks on people cared for in their own rooms. The registered manager reviewed people’s needs regularly and used this to inform how many staff were needed.

The registered manager completed checks on the suitability of new staff when they applied to work at the service. This included Disclosure and Barring Service (DBS) checks. These provide information including details about convictions and cautions held on the Police National Computer. Other checks included obtaining references and checking employment history for gaps. We found further checks were needed on one staff member’s employment history and recent references had not been verified. The registered manager told us they would complete the necessary checks and make the required changes to their process to ensure these checks were fully completed going forwards.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Risks from infection were now reduced. Improvements had been made to the environment including replacement flooring, chairs, toilets seats, handwash sinks, waste bins and the laundry systems. Areas with a high risk of infection, such as sluice rooms were now kept locked.

Audits were in place to check risks from infection were reduced in items of equipment such as pressure cushions and mattresses.

The provider now had staff who were lead roles for infection prevention and control management. This helped to raise the importance of infection prevention and control and to provide updates and reminders of good practice.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People were happy with how staff helped them with their medicines. One person told us, “Staff help me with everything I need, and all my medication.”

Medicines were stored securely and administered and disposed of in line with good practice guidance. Staff explained what medicines people were given, and made sure people could take their medicines in their preferred way and in ways that promoted their independence and involvement. Medicines administration records were in place for people’s prescribed medicines and skin creams, and these had been updated after each administration of medicine.

We observed staff liaised with other healthcare professionals to change people’s medicines in response to their changing needs. This helped to ensure people received the right medicine when they needed it.