The Old Vicarage

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 100 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect. Staff built warm and caring relationships with people. We observed staff support a person who needed some help with their hearing aid. Staff showed empathy and understanding, and calmly reassured them as they resolved the issue for them. Another time we observed staff check on a person cared for in their bedroom. They checked the television programme was one they wanted to watch and found the television guide for the correct day so the person could look at the options available. We observed one person was upset over dinner and staff helped provide reassurance. We routinely heard staff ask people how they were, whether they had enjoyed their meals, and use people’s preferred names. People told us, “The staff are so nice.” A relative said, “All the staff have bent over backwards to help [my family member], nothing has ever been any trouble to them.” Leaders told us how new people were given a welcome card and toiletries when they moved in. Leaders celebrated people’s birthdays and made sure everyone was sent a Christmas card. Celebratory events such as Valentine’s Day and International Women’s Day saw gifts of flowers given to the women. Caring events for the men, such as a ‘Men’s Pampering Session’, were arranged. People’s privacy was respected, for example a person’s care plan detailed they managed their own private correspondence. Another person told us, “I am asked if I want my bedroom door open, I do like to have it left open.” We observed staff spoke discretely with people and were mindful of their privacy. Staff told us they understood people may want privacy if they had visits from other healthcare professionals and would respect this, while being available to help and contribute if needed. Other healthcare professionals told us staff demonstrated kindness and compassion.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Cultural and religious needs, and the local rural community were celebrated. A regular church service was held in the home, and some people were supported to attend church. One person told us, “[Staff member] is good, they have some good ideas, and they took me to church. It was wonderful, and then we went to the bookshop and saw the water at the river.” People celebrated cultural events with themed foods and entertainment. The Old Vicarage is situated in a rural location and when it was lambing time, lambs were bought into the home for people to enjoy holding. People were also visited by the local Morris dancers who performed in the garden. People were supported to share their unique life experiences and interests with one another. One person told us they had suggested a new project for people to work on together and this was now being facilitated by the activities coordinator. They said, “I’ve been writing my life history from memory and the next project I’ve suggested is similar, it’s where we tell people about our own personal seven wonders of the world. I’ve already picked what mine will be.” They added, “I love the quizzes, I like to keep my brain active, and I think about it in the night, I’m there working out all the answers.” A relative told us how staff had suggested using a specific dementia therapy with their family member and this was helping their family member feel more settled. Leaders told us that different activities were provided to different people and tailored to their needs and interests. A relative told us, “We feel that the staff do make an effort to get to know people, understand their particular foibles and try and adapt their level of care to the individual.”

The provider was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. People told us how the idea to create a film and hold a red-carpet film premiere in the local Town Hall had developed from their regular creative writing activities. One person told us, “It took us a few months in all, we had interviews with the media, and it made us feel something different. The actual night was beautiful, a full house, champagne and red carpet.” Another person told us, “The value of it was that it took my mind off what I didn’t want to think about, and I enjoyed doing it.” We observed people enjoyed taking part in a book reading club during our inspection and saw the stories written by people participating in the creative writing group had been developed into comic strip books. People told us they enjoyed getting to know one another through these activities. One person said, “It has helped people feel more confident and it helps us find out about each other. We try and welcome new people in and involve them in conversation.” A programme of group and individual activities was co-ordinated by an activities coordinator and these were based on people’s suggestions. One person told us, “We have a special meal once a month and it is based on a favourite meal that one of us plans; this was one of my suggestions.” People were supported to maintain their relationships. Postcards were available for people to choose and send to their family and friends. Relatives told us about their experiences. One relative told us, “The group activities seem to be designed to stimulate and engage people rather than merely just occupy them.” The registered manager told us they would try different activities with different people to try and find something suitable. Leaders used people’s known interests and life experiences to help introduce them to people with similar interests.

The provider was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. Staff knew people well and could identify changes that could indicate a deterioration in their health. One staff member told us they observed a person was not themselves and this allowed them to reach and help them before they lost strength in their legs. The staff member was able to lower them to the floor and request emergency healthcare. A relative described when their family member had required immediate attentions, they told us, “The senior on duty attended to this, and we were happy to see the thorough checks they made for injury and discomfort as they assisted [our family member]. This did not feel like theatre for our benefit, it felt like a robust process being followed by someone who knew what they were doing and was also concerned for another individual.”

During our inspection we observed staff respond to people’s immediate needs. For example, we saw staff helping a person with their hearing aid, replacing batteries in their TV remote control and providing reassurance for a person who had become upset. Other health professionals who worked closely with The Old Vicarage told us, “The care staff are aware of signs of deterioration and act accordingly and signpost residents to external services when required. They participate in weekly GP and Advanced Nurse Practitioner ward rounds to promote healthier outcomes for their residents.”

The provider always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care. Staff spoke highly of their leaders. One told us, “I feel appreciated, the manager wants us to be open as it helps them to guide us properly, it does feel like a family.” They went on to say, “The manager says to call them [if I need anything]. It rubs off on everyone, so I check if other staff need anything, it is a good, caring workforce, and we look after each other and this trickles down to [the people we care for].” Staff spoke about how the leaders had provided them with support at work and personally when needed. They told us they appreciated this, and it made them feel valued.

Leaders and staff showed us procedure guides that set out their roles and what action to take in relation to an identified event, for example, a fall. Leaders told us this helped staff with their confidence in handling events, especially when liaising with other healthcare professionals to request advice and help. Effective systems ensured staff had the information they needed to help them provide person-centred care, these included handover meetings and written handover notes of any changes to people’s needs. Leaders told us they were currently looking how to further support and develop the senior carer role as they recognised the responsibilities they managed when leading a shift. Leaders took other actions to enable staff to give their best at work and feel valued. They met with them individually, and in small groups to help people feel confident about voicing anything they needed. They had developed discreet ‘welfare lockers’ where staff could access free products such as personal care products and a staff room where staff could take their breaks. Appreciation acknowledgements, gifts and thank-you messages celebrating staff and what they had achieved were shared.