4 September 2023
During an inspection looking at part of the service
The Old Vicarage Nursing home is a residential nursing home providing care for up to 45 people. The service provides support to older people, people with physical disabilities and people living with dementia. Accommodation is provided across three parts of the building. At the time of our inspection there were 43 people using the service.
People’s experience of using this service and what we found
The provider was unable to demonstrate they were responding effectively to risks and systems in place did not always identify lessons were learnt when things went wrong. Medicines were not always stored and recorded in a safe way. Not all staff received the required training to deliver care safely. Systems and processes in place to safeguard people from the risk of abuse were not always effective.
The service was working within the principles of the MCA, although staff we spoke to were not always able to describe how they would act in people’s best interests when delivering care.
Concerns were found over infection prevention control. However the provider was aware of these concerns and there was an plan in place.
The systems in place to assess and manage the quality and safety of the service were not always effective. The governance systems for investigations and complaints handling were not always effective. The registered manager was approachable. Staff had regular supervisions and felt supported in their roles. The provider understood and met the duty of candour. Staff worked with external professionals which included the GP and social workers.
Rating at last inspection
The last rating for this service was requires improvement (published 11 January 2023).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found the provider remained in breach of regulations.
Why we inspected
The inspection was prompted in part due to concerns received about people’s nursing care needs, medicines management, staff training and infection control. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has remained requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to the safe care people receive, the management of complaints and the overall governance of the service.
We have issued the provider with a warning notice. We will check the provider is taking action to comply with the legal requirements set out in the warning notice.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service, which will help inform when we next inspect.