Archived: The Old Rectory

Updated 12 April 2023

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

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

This inspection was carried out by 1 Inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Old Rectory 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 Rectory 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who lived at The Old Rectory and 2 relatives. We spoke with 8 staff including the kitchen staff, care staff, deputy manager and the registered manager. We reviewed 3 records in relation to people's care, including the medication records. We also reviewed a range of records held by the service including, staff training and rota's, recruitment records, audits and checks. After the site visit, we spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 12 April 2023

About the service

The Old Rectory is a residential care home providing personal care to up to 28 people in one adapted building across three floors. The service provides support to older people who may have a physical disability and/or live with dementia. At the time of our inspection there were 17 people using the service.

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

Potential risks to people's health and wellbeing had been identified and were managed safely, however records of when mitigation was put in place after an incident required further improvement. There were sufficient numbers of staff on duty to keep people safe and meet their needs, however more staff with medicines training were required. People's medicines were managed and stored in a safe way; improvements were required in the administration checks of controlled drugs. Safe practice was carried out to reduce the risk of infection.

Staff had the training and support to be able to keep people safe in line with best practice, however staff felt there were other aspects of training which would be beneficial to help support people with their dementia care needs.

People and relatives told us the service had improved since our last inspection. Staff told us there had been improvements which were working better, however staff felt that more engagement and opportunities to empower them with the knowledge and skills to care for people was needed.

The audits and checks required broadening to ensure the service was constantly striving to drive improvement.

People told us they felt safe and were supported by staff. Relatives felt their family member was safe and cared for in the right way. Staff recognised different types of abuse and how to report it. The registered manager understood their safeguarding responsibilities and how to protect people from abuse. People, and where appropriate, their relatives, had been involved with decisions in how to reduce risk associated with people’s care.

People's care needs had been assessed and reviews took place with the person and, where appropriate, their relative. People were supported to have a healthy balanced diet and were given food they enjoyed. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people following best practice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did support this practice.

People told us staff were kind and treated them well. Relatives felt the staff cared for their family member in a caring and supportive way. Staff treated people as individuals and respected the choices they made. Staff treated people with care and respect and maintained their dignity.

People's care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People were supported to maintain contact with people who were important to them. People engaged in activities that were individualised to them. People had access to information about how to raise a complaint. People's end of life care needs was met in line with their preferences in a respectful and dignified way.

People, relatives and staff felt the registered manager was visible within the home and listened to people's and staff's views about the way the service was run. The nominated individual (NI) visited the home and carried out checks on the service provision.

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 inadequate (published 29 September 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

This service has been in Special Measures since 23 August 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 Rectory on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to Regulation 17 good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.