Archived: Vicarage Road

Updated 30 June 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. 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

The inspection was carried out by an inspector, a medicines 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

Vicarage Road 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. Vicarage Road is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means that only the registered provider, and not the manager, are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before 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 the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We visited the service on 4 and 11 May 2022. We spoke with three people who used the service and three relatives about their experience of the care provided. The people living in the service were able to communicate with us verbally. We also observed the support provided.

We spoke with five members of staff including the manager, deputy manager, a senior support assistant, a support assistant and an agency staff member. We communicated via emails with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included four people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We spoke with two professionals who have regular contact with the service.

Updated 30 June 2022

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.

About the service

Vicarage Road is a residential care home providing personal/ and nursing care to four people at the time of the inspection. The service is registered to support up to eight people. At the time of the inspection the provider had applied to reduce this number to up to six people. Vicarage Road is a three-storey terraced house with a small courtyard garden. Accommodation is provided over the three floors, with a small communal lounge and kitchen located on the first floor. At the time of the inspection three people were accommodated in self-contained flats which provided a bathroom and lounge area.

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

Based on our review of safe, responsive, and well-led the service was not able to demonstrate they were meeting some of the underpinning principles of Right support, right care right culture.

Right Support

The model of care did not maximise people's choice, control and independence. The physical environment did not meet people’s needs and placed people at an increased risk of harm. People were not given proper control over how they spent their day as this was compromised due to poor staffing levels and a lack of planning. There was a lack of focus on outcomes for people such as promoting independence.

Right Care

People were not receiving person-centred and safe care. The ability to provide person-centred care was compromised due to low staffing levels, poor care planning and poor engagement with relevant people, such as health and social care professionals. The systems in place to promote person-centred support were not being utilised effectively. There was no meaningful goal planning or activity planning. As a result, people were receiving a poor-quality service. People’s rights were not promoted as processes around consent and safeguarding were not effectively implemented

Right culture

Governance systems were ineffective and did not promote a person-centred high-quality culture. Staff morale was impacted negatively by the staffing levels and this in turn impacted on the delivery of the support provided. The provider had not taken timely action to ensure improvements had been made. Engagement with people, their relatives, and other external professionals was not taking place to help identify and ensure improvements were made.

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 03 March 2022). The previous inspection was carried out on 26 August 2021. Following this inspection conditions were imposed on the provider’s registration at this location. At this inspection we found the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, the environment and the management of the service. A decision was made for us to inspect and examine those risks. The information received raised concerns on how the service was applying the principles of right support, right care, right culture. We assessed the application of these principles during this inspection.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, safeguarding, consent, person-centred care, staffing, and good governance.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.