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

People were supported safely and in line with the information in their care plans. The risks to their safety were assessed and mitigated and where necessary safeguarding processes were followed to ensure people were safe. People lived in a safe and clean environment their medicines were safely managed.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People felt safe at the service and the relatives we spoke with told us their family members were safe at the service. One relative said, “I do turn up unannounced and everything always seems well run. You just know.” Another relative said their family member was well cared for, they said, “Nowhere else worked for [Name]."

Staff and leaders at the service showed good knowledge of how to protect people from potential abuse. One member of staff said, “Your training here in general is really good, you learn all about what safeguarding is and how to report things. We can go to our manager but there are processes in place if we didn’t want to go to the manager. I have confidence in the confidentiality of the managers.” One of the managers told us they had recently undertaken an extra safeguarding training online module with the NHS which had been available to management. They found the course useful, they went on to say, “All colleagues complete mandatory (safeguarding) training.”

During our visit we saw staff supporting people safely, in line with the information in their care plans and wishes. There were posters and information at the service on how to report any safeguarding concerns.

There were robust processes in place to manage safeguarding incidents. We saw an example of an incident which had been reported to the management team. There was a clear investigation and actions taken by the management team to ensure people were protected from any potential abuse. When incidents occurred staff were supported to learn from these events with debriefing meetings. They discussed a range of details including how they could work to reduce people’s anxieties that led to incidents.

Relatives we spoke with gave a number of examples to show how they had been involved in managing risks to their family member. This included managing risks to people’s health such as monitoring their diet. Showing understanding of people’s anxieties and putting in measures to reduce these anxieties. One relative said, “[Name] is upstairs in the main house. They have a large room, it’s very roomy and en suite with a bath. [Name] has a fixation on water so it’s been fully waterproofed and damp proofed. They keep on top of it.”

Staff we spoke with were knowledgeable about the different risks to people’s safety. They told us they had access to people’s care records that contained their care plans, risk assessments and daily records to help them keep up to date with people’s needs and how to safely support them. One member of staff said, “Everything we do is online. Each individual has their own care plans, risk assessment etc. Everything you would need. 'Clickets' (these are alerts on the system) come through when there are changes (to people’s care needs) –very handy. When I first started only a few things were online – nice process of changes being drip fed through.” The registered manager told us there were debrief meetings for staff following incidents. They also had governance meetings where they discussed any issues of concern. They went on to say, “There may be an urgent core team meeting, risk assessment review etc or specific supervisions for staff.” The positive behavioural support team manager told us they monitored people’s behaviour and worked to reduce anxieties through individualised strategies which were proven to be successful for people.

During our visit to the service we found the measures identified in people’s care plans to reduce risks to them were in place. This included sensor alarms, specialist furniture and mobility aids. Some people were at risk of entering their bathrooms and turning taps on and leaving them. These people had water isolation switches in place and in use. We saw environmental risks had also been assessed with measures in place to reduce these risks. This included, window restrictors, radiator covers and fire safety equipment. People had personal emergency evacuation profiles (PEEP’s) in place so if they needed evacuating during an emergency both staff and emergency service personnel would know how to evacuate them safely.

The processes in place gave staff the tools to support them manage risks to people’s safety. This included individualised risk assessments for all aspects of people’s care. For example, we reviewed one person’s care plan which gave clear information on the person’s level of capability when accessing the community. There was detailed information on how to safely support the person when travelling, where they should sit in a vehicle, how many staff should support the person and what items the staff should take with them known to reduce the person's anxieties.

People and their relatives were happy with the environment. People’s living arrangements had been assessed to meet their needs. One relative whose family member had recently moved to the service told us the living accommodation had been completely redecorated for their family member.

Staff we spoke with were happy with the way the environment was managed for the people at the service.

The environment was well maintained. We saw people’s rooms and communal areas were clean and safely maintained by staff.

There were clear processes in place to support staff manage the upkeep of the building. Managers completed regular walk arounds and highlighted concerns on their manager walk round sheets to ensure issues were addressed. Both staff and managers had ‘sort it’ request forms which alerted the provider’s central maintenance staff to allow them to address any outstanding issues. The provider used central maintenance teams to support on site staff to both maintain the environment and ensure regular servicing of essential equipment and systems in the service. This ensured the provider had good oversight of the fabric of the building and equipment to provide a safe service for people to live in.

Relatives we spoke with were happy with the staffing at the service. One relative said, “The staff are very well trained, they’re amazing.” Another relative said, “There’s enough staff and they are very, very well trained, always updated and refreshed.”

Staff we spoke with were happy with the staffing levels at the service. One staff member said, “ We have a higher number of staff in a morning to cover personal care. We have enough staff and the shift leads always support and can dip in and out - there was usually 5 on nights and the guys sleep well so this is enough.” A senior manager told us they had recognised there had been a concern about the distribution of staff a few months previously, as a result they had staff meetings to discuss how to address this. This had resulted in the shift lead role being separated from the medicines role to make the roles less stressful and reduce the risk of medicines errors. They had found this and an increase in staff in a morning had addressed the concerns.

On the day of our inspection there were enough staff to support the people at the service. There was a calm and relaxed atmosphere with staff responding to people’s needs quickly, with a pleasant demeanor.

Staff were supported with a structured induction to enable them to provide safe care for people. The training programme included training on all aspects of care and included autism awareness, NAPPI (non-abusive psychological and physical intervention) training, safeguarding adults and an introduction to epilepsy. Staff undertook regular refresher training to keep their knowledge updated. When people had specific health care needs, staff were provided with training to support them safely manage those needs. Staff undertook shadow shifts with staff on site and had mentors allocated to support them during their induction period. There was a central resource management team who worked with managers and staff on site to ensure staffing at the service incorporated people undertaking, appointments, social activities and home visits. There were weekly planning meetings where a wide range of staff issues were discussed to ensure the staffing levels were safe and effective. The processes for recruitment of staff was safely managed. The provider had clear records to show the interview process, reference requests and use of the Disclosure and Barring System (DBS). This system allows providers to exclude the possibly of potential staff having any criminal records. These checks ensure they employ fit and proper staff to support people.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Relatives were happy with the way people’s medicines were managed. They told us they were consulted about any changes and their wishes were listened to. One relative said, “They do all [Name’s] medicines. They had an ear infection but it’s cleared up now. They’ll phone me and I get regular emails."

Staff told us they had received appropriate training and competency checks to support them administering medicines. Staff were knowledgeable about how to support someone if they refused their medicines and what processes they should follow to escalate any concerns they had.

The processes in place to manage people’s medicines were managed in a safe and efficient way. Staff undertook regular checks of both the medicines and environment where medicines were stored. Daily temperature checks were undertaken to ensure medicines were kept at correct temperatures, medicines were dated when opened to ensure they were used in line with manufacturer’s expiry dates. Staff practice when administering medicines was save.