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 good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received care and support that was based on comprehensive assessments of their individual needs, preferences, strengths and aspirations. Assessments considered people's physical health, mental health, communication needs, sensory requirements and any support required to meet their learning disability needs.

People, their relatives and other professionals were involved in the assessment process to ensure information was accurate and reflected people's current needs. Assessments identified reasonable adjustments required to support people to access services and participate in activities meaningful to them. For example, some communal areas of the home were dedicated spaces for individuals to undertake their activities meeting their sensory needs and routines.

People received care and support in line with current best practice guidance and standards relating to supporting people with learning disabilities.

Staff understood the importance of providing person-centred support that promoted choice, dignity and independence. Care planning reflected recognised approaches for supporting people whose behaviour may communicate distress and included proactive strategies aimed at reducing anxiety and supporting positive outcomes.

The service worked collaboratively with healthcare professionals, including learning disability specialist teams, community nursing services, occupational therapists, speech and language therapists and behavioural support professionals when required. Recommendations made by professionals were incorporated into people's care and support plans and reviewed regularly to ensure they remained effective.

People were supported to develop and maintain daily living skills wherever possible. The ethos of the service focused on enabling people to achieve greater independence and maximise their potential. However, at times, staff did not always reflect the level of care provided within daily records. Despite this through our observations during the assessment we observed evidence-based care and treatment being offered effectively and safely.

People experienced coordinated care because staff worked effectively with each other and with external healthcare professionals.

Staff told us communication within the service had improved and that handovers provided relevant information about people's wellbeing, appointments, changes in support needs and any identified risks. Records demonstrated important information was shared appropriately between teams to ensure continuity of care. One staff member said, “There has been so many positive changes and communication is one. We receive information and handovers all the time now.”

The service maintained positive relationships with external agencies and healthcare professionals. Where people required specialist support, referrals were made promptly and recommendations were implemented.

The stable and consistent management team had strengthened communication across the service and ensured effective oversight of people's care. Staff told us they felt supported and were clear about their roles and responsibilities.

People were supported to maintain and improve their health and wellbeing. Staff understood people's health needs and acted promptly when concerns were identified.

Each person had detailed health action plans which supported staff to monitor and respond to healthcare needs. Records showed people attended routine healthcare appointments, including GP reviews, dental appointments, opticians and specialist clinics.

People with learning disabilities were supported to access annual health checks and other preventative health services designed to reduce health inequalities. Staff ensured healthcare information was shared in a way people could understand and supported people to make informed decisions about their care wherever possible.

People were encouraged to participate in activities that promoted physical and emotional wellbeing. For example, people were supported to access community activities, exercise opportunities, social events and hobbies that were important to them.

People were supported to achieve positive outcomes and there was evidence of increased independence, greater involvement in community activities and improved social opportunities for many people using the service. Reviews of care and support were undertaken, and people, relatives and professionals were involved in discussions about progress towards individual goals.

Staff understood the importance of promoting independence and supporting people to develop daily living skills. Examples included people increasing their participation in household tasks, accessing community facilities more independently and developing relationships and interests that were important to them.

However, systems for monitoring and evidencing people's progress were not always effective due to inconsistencies in daily care recording. Whilst care plans identified expected outcomes and staff spoke knowledgeably about the progress people had made, records did not always provide sufficient detail to demonstrate how care and support had been delivered or how outcomes were being achieved.

For example, one person required monitoring of their nutritional intake due to identified health needs. Records showed staff were expected to document food and fluid intake, including the choices offered to the person. However, we found entries that simply recorded "the usual" rather than providing specific details of what had been offered or consumed. This limited the provider's ability to effectively monitor nutritional intake, evaluate risks and evidence whether the person's nutritional needs were being consistently met.

People were supported to make decisions about their care and treatment, and their rights were protected in line with the Mental Capacity Act 2005.

Staff understood the importance of seeking consent before providing support and demonstrated a good understanding of people's decision-making abilities. Care records reflected how people communicated choices and preferences, including for those who communicated non-verbally.

Where people lacked capacity to make specific decisions, appropriate mental capacity assessments had been completed and best-interest decision-making processes had been followed. Records demonstrated decisions were made in consultation with relevant professionals and those important to the person.

Staff received training in the Mental Capacity Act and applied this in practice. People's rights were respected, and efforts were consistently made to maximise their involvement in decisions that affected their lives.

People were encouraged to exercise choice and control over their daily routines, activities, meals, healthcare appointments and future plans. This promoted independence and ensured care was delivered in accordance with their wishes, preferences and best interests.