Archived: The Old Vicarage

Updated 23 January 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 checked whether 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 inspection took place on the 28 & 29 November 2017 and was unannounced. It was carried out by two adult social care inspectors, a specialist nurse advisor and an expert by experience on the first day. On the second day there was two adult social care inspectors. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed information we kept about the service and previous inspection reports. This included notifications of incidents. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern. We reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plan to make.

During the inspection we used a range of methods to help us make our judgements. This included talking to people using the service and their relatives, interviewing staff, pathway tracking, SOFI, reading people’s care plans, and other records kept about them), carrying out observations of care and reviewed other records including audits about how the service was managed.

We reviewed seven care plans, recording of medicines and seven staff personnel files. We spoke with ten people and two relatives and two professionals about their views of the service provided. We also spoke with the manager and director, three staff, one team leader, a senior carer, the chef and one house keeping staff.

Updated 23 January 2018

This inspection took place on the 28 & 29 November 2017 and was unannounced.

At our last inspection we found breaches of legal requirements. This was because the service was unsafe, there were unsafe staffing levels to meet people’s needs, records were incomplete and unavailable. There were poor quality assurance systems in place. Notifications were not always being made when required and the provider was not accurately registered with us.

Following our last inspection we imposed a condition on the provider’s registration. This was because people were at risk of receiving unsafe and inadequate care. Each month the provider had provided a report of the quality assurance systems in place including any action taken or planned.

At this inspection we found improvements had been made to ensure the service was safe, had sufficient staff, records were accessible and quality assurance systems were in place although some shortfalls found during this inspection had not been identified. Improvements were still required to submission of all notifications and the provider was not accurately registered with us.

The Old Vicarage is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Old Vicarage accommodates up to 19 people in one building and is registered to provide accommodation for persons who require nursing or personal care. At the time of the inspection there were 17 people living at the home.

At the time of the inspection there was no registered manager in post. We had received an application and this was being processed. We will monitor this progress. 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.

People were not always protected from the risk of cross contamination and infection control. Due to poor practices being followed relating to handling laundry, the use of personal protective equipment, lack of liquid hand soap and disposable hand towels.

The provider was not accurately registered with us to reflect the organisation responsible for operating the service. An application had been submitted and we are monitoring the outcome.

The home’s quality assurance system was not always identifying shortfalls found during this inspection. This related to a missing incidents and accident forms and notification to CQC. People having no recorded air mattress setting in place, poor practice relating to infection control, the infection control risk assessment not being up to date or being followed by staff. The home’s quality assurance policy also required confirmation of all systems in place at the home and when they are undertaken.

People were supported by staff who had received training, supervision and an annual appraisal. Staff were able to demonstrate their knowledge and they knew people well.

People had care plans that were personalised and risk assessments identified risks and what actions had been taken to minimise the risks. Personal evacuation plans were in place and confirmed people’s individual support needs.

Medicines were administered when required and safely. People were supported by staff who had checks undertaken prior to being employed at the service.

People felt supported by staff that were kind and caring. Staff demonstrated privacy by shutting people’s door and knocking before entering.

People could have visitors and friend’s at various times during the day. The home had activities that people could access if they wished and local schools would visit from time to time.

People felt able to complain and various compliments had been received by thankful relatives.

The management the home was accessible and approachable and staff felt well supported and the home made referrals when people’s needs changed.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

We found two breaches of Regulations in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.