Archived: The Old Vicarage

Updated 25 July 2021

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 whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 27 May 2020 and was announced. It was announced because it occurred during the COVID-19 pandemic and checks were made at the service before inspection to ensure it was safe to proceed.

Updated 25 July 2021

The Old Vicarage is an old stone house adapted for use as a care home. The home is situated over two floors and there is a lift and stair lift available for access to the first floor. The home is registered for fifteen people who require accommodation and personal care. It is set in its own grounds in the village of Hornby in the Lune Valley between Lancaster and Kirkby Lonsdale. The home is close to local shops, churches and public houses. At the time of our inspection visit, there were thirteen people residing at the home.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was last inspected on 04 October 2014 and was rated overall as good. We had rated the service as ‘Requires Improvement’ under the safe and responsive domain. This was because improvements were required to ensure staff were suitably deployed and activities were considered for people who lived at the home.

At this inspection, carried out in August 2017, we found all improvements had been made and the service was meeting the fundamental standards. The registered manager had reviewed staffing levels to ensure there were suitable numbers of staff on shift to meet the needs of the people who lived at the home. People told us staffing levels met their needs. Staff were not rushed and had time to sit with people.

In addition, staff had been deployed to ensure people had the opportunity to take part in activities on a daily basis. People and relatives told us activities took place. We saw evidence of activities occurring during our inspection visit.

We reviewed systems in place for managing medicines. We found good practice guidelines were implemented when administering regularly prescribed medicines. However, documentation relating to ‘as and when’ medicines was sometimes unclear. We have made a recommendation about this.

People and relatives told us staff had the required skills and knowledge to provide effective care. The registered manager maintained a training matrix so that training could be planned effectively. Although training was provided we noted staff did not always receive refresher training to ensure their skills were up to date. We have made a recommendation about this.

We looked at fire evacuation procedures at the home. Whilst procedures were in place these were not always fully documented to show all risks had been considered. We have made a recommendation about this.

People told us they felt safe at the home. Procedures were in place to protect people from harm. Staff told us they had received training in this area and were able to describe abuse and their responsibilities for reporting this.

The registered manager assessed individual risk and developed risk assessments to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes were recorded. Risk was suitably managed.

We reviewed staff records. Suitable recruitment checks were in place to ensure staff recruited possessed the correct characteristics and experiences for working with vulnerable people.

We looked around the building. We found it was hygienic and suitably maintained. We reviewed documentation relating to health and safety at the home and found suitable maintenance checks had been carried out.

People and relatives spoke positively about the quality of service provided. They praised the caring nature of staff, constantly referring to them as ‘kind’ and ‘caring.’ We found there was a warm and welcoming atmosphere at the home. People repeatedly described the home as homely and described it as a home from home.

We received positive feedback about the quality of food at the home. There was a variety of food on offer and staff were accommodating to people’s individual needs and preferences. Meal times were relaxed. Nutritional and hydration needs were met.

Care records were person centred and reflected the needs of people who lived at the home. We saw evidence these were reviewed on a regular basis or when people’s needs changed.

The registered manager had an understanding of the principles of the Mental Capacity Act and the Deprivation of Liberty safeguards. We saw evidence of capacity being considered within care records.

Resident meetings took place on a regular basis. We saw evidence of people being encouraged to give feedback about the service and areas in which improvements could be made.

People were supported by a stable staff team. This promoted effective and responsive care as people were supported by staff who knew them well. We observed dignity being respected at all times during our inspection visit.

People and relatives had no complaints about the service provided. They told us they were encouraged to raise any concerns and complaints.

People were encouraged to retain their independence. Care plans emphasised the importance of promoting independence and empowering people. People told us this occurred in practice.

The service worked in partnership with other care professionals to meet needs. Health professionals we spoke with said they had no concerns about the service provided and the skills of the staff.

Leadership within the organisation was good. Staff were positive about ways in which the service was managed and the support received from the registered manager.

The registered manager used a variety of methods to assess and monitor the quality of care at the home. These included regular audits of medication, care plans and the environment.

The registered manager was aware of their responsibilities in reporting to the Care Quality Commission.