Archived: The Old Vicarage

Updated 20 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. This was a comprehensive inspection.

The inspection took place on 26 and 29 January 2018 and was unannounced. The inspection was undertaken by one inspector.

Prior to the inspection we requested a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was returned and completed in full. We looked at other information we held about the service. This included previous inspection reports and notifications. Notifications are how the service tells us about important issues and events which have happened at the service.

We spoke with three people using the service and observed the provision of care support in communal areas. In addition, we spoke with two care workers, the maintenance person, the training manager, the activity coordinator, the cook, the deputy manager, the registered manager and the nominated individual. We also spoke with five relatives and one health care professional at the inspection. After the inspection we received feedback from three social care professionals about their experience of the service.

We observed the lunchtime meal service, three group activity sessions, and the administration of medicines. Four care plans and care records were looked at to check the information recorded about people matched the care and support observed. We also looked at three staff files, the Medicines Administration Records (MAR), accident and incident recording, complaints and compliments, and the audits and policies relating to the quality assurance and management of the service.

Updated 20 March 2018

The Old Vicarage is a residential care home, providing accommodation and personal care for up to 21 people. At the time of our inspection, there were 21 people living at the service. The people’s rooms are situated across two floors. There is a large lounge area, with an adjacent quiet lounge-conservatory. Both rooms overlook the garden and people enjoyed watching the ducks that people and the staff have helped to hand rear. The dining room is opposite the lounge and the management offices are situated along the main corridor.

The inspection took place 26 and 29 January 2018 and was unannounced. At our previous inspection in December 2015 the service was rated as Good in all areas. At this inspection we found that standards had been maintained and that efforts were being made in working towards achieving Outstanding.

People and their relatives spoke highly of the staff and management team. One relative said, “They treat everyone as they would their own, it is like one big family here.” This was echoed by the staff and registered manager, who also described the ethos of the service as being “family orientated”.

Relatives and health and social care professionals praised the staff team for their knowledge and skills, as well as how the team “go above and beyond” to support people. One relative said, “it gives a real peace of mind knowing mum is safe, happy and looked after here.”

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Where people had their liberty restricted, the service had completed the related assessments and decisions had been properly taken. Staff had been trained and understood the general requirements of the Mental Capacity Act (2005).

The service sought to offer holistic alternatives to medicines where possible. For example, exploring alternative methods to mild pain relief. There were also regular medicine reviews to prevent people from being over medicated. Medicines continued to be stored, administered and recorded safely. The service had built a good working relationship with the local health centre, as well as with visiting health professionals.

There were safe recruitment processes in place. Staff had the skills and knowledge to support people. Staff received up to date training and could request additional training where required, and every staff member had completed, or was in the process of completing dementia awareness training.

The activities programme was tailored to suit individual and group interests. We found that staff understood people’s interests and hobbies. Staff incorporated people’s interests into the social programme and supported people to maintain routines. For example, some people had enjoyed reading specific newspapers and magazines, and these were brought into the home; and one person was supported to the local shop to purchase their lottery tickets.

The activities coordinator understood and utilised the interests of individuals and groups of people to build community links and offer activities in and out of the service. Staff used a positive risk taking approach to support people to access their local community.

Care plans were very person centred and evidenced an understanding of what was important to the individual. These included information around the day to day decisions, such as how a person liked their hot drinks, but also the more complex decisions, such as information around their preferred end of life treatment and support. There was a person-centred culture within the service, with staff valuing each person as an individual.

Staff undertook training in end of life care and relatives spoke highly of the service their loved ones had received while living at the service. Staff understood the importance of dignity and empathy while providing end of life care.

Creative support methods were used to enable people to be involved in making decisions around their care. Staff and management used their understanding of the person when it came to trying new ideas and exceeded the expectations of social care professionals when doing so.