The Old Vicarage

Updated 22 September 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This was a focused inspection, carried out in part to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also checked whether the provider was meeting the legal requirements and regulation associated with the Act for Safe Care and Treatment.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of one inspector.

Service and service type

The Old Vicarage is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Old Vicarage is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of this inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We gave a short period of notice of the inspection because it is a small service. We needed to be sure the provider or registered manager would be present to support the inspection. People are often out and we also wanted to make sure both they would be at the care home for us to speak with.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used this information to plan our inspection.

During the inspection

We spoke with two people who used the service, four care staff, the registered manager and an external representative of the registered partnership. We observed how staff interacted with people and we reviewed a range of records. This included three people’s care plans, quality assurance and safety audits, operational policies and staffing records and records relating to fire, environmental and equipment safety.

We also used the information the provider sent us when we asked them to, in the provider information return (PIR). This was received following the inspection visit. The PIR is information providers are required to send us annually with key information about their service, what they do well, and any improvements they plan to make.

Updated 22 September 2022

About the service

The Old Vicarage is a residential care home providing personal care for up to 10 adults with a learning disability or autistic spectrum disorder. At the time of our inspection there were eight people using the service. Accessible, single room accommodation is provided within a large adapted domestic style ‘house’, including a range of communal facilities and level access to a well kept garden.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

The provider's governance arrangements, were now effectively operated, to consistently ensure timely decision making and risk mitigation for the quality and safety of people’s care. Related records were accurately maintained. A range of service improvements had been sufficient to rectify breaches we found at our last inspection in October 2021, with regard to safe care and treatment and governance. The provider now needs to demonstrate service improvements are fully embedded, proactively ensured and sustained.

Effective remedial measures were now implemented to fully ensure safe staffing, medicines and measures for the prevention and control of infection and cleanliness at the service. People were protected from the risk of harm or abuse when they received care from staff.

Right Support: People were now fully supported to have maximum choice and control of their lives. The provider was able to consistently demonstrate that decisions made for people's care and daily living arrangements, were lawful, least restrictive and in people's best interests.

Right Care: Care was person-centred and promoted people’s dignity, privacy and human rights.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensured people using the service led confident, inclusive and empowered lives.

Systems to regularly seek the views of people, relatives and staff and ensure effective partnership working with relevant authorities for people’s care were improved and sufficient. Feedback from this was now used to inform, improve or enhance people’s care experience when needed.

Staff were kind, caring, trained and supported. They knew people well, understood their role and responsibilities for people’s care and had good relationships with them and their families.

Staff were responsive, to ensure people's access to relevant external health professionals when needed and consistently sought to provide care in a personalised way. All parties we engaged with for the purposes of the inspection were happy with the management, leadership and culture of the service, along with the arrangements for people’s care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 24/12/2021) and there were breaches of regulation. The provider completed an action plan following the last inspection, to show what they would do and by when to improve safe care and treatment. At this inspection improvements had been made and the provider was no longer in breach of regulations. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection to ensure good governance; to check the provider had followed their action plan to rectify the breach regarding safe care and treatment, which we found at our last inspection in October 2021, and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led, which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Old Vicarage [care home] on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.