Vicarage Road (B)

Updated 30 January 2024

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.

Inspection team

The inspection was carried out by 1 inspector and a senior specialist who supported the inspection off site.

Service and service type

Vicarage Road B 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 B 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 not a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 24 October 2023 and ended on 08 November 2023. We visited the location’s service on 24, 25 and 30 October 2023.

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 1 person and interacted with and met all the people living at the home. We spoke with 2 relatives and 2 representatives of people living at the home. We spoke with the area manager, newly appointed manager, deputy manager and two registered managers from the providers other homes who were currently supporting Vicarage Road B. We spoke with 5 care staff. We conducted observations and also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed 3 people’s care plans and associated documentation. We viewed 2 medication records. We viewed 3 staff recruitment files to see how staff were recruited. We reviewed information relating to staff training and documents relating to how the service was monitored.

Updated 30 January 2024

About the service

Vicarage Road B is a residential care home providing personal care to up to 6 people. The service provides support to people with learning disabilities, autism and physical disabilities. At the time of our inspection there were 6 people using the service.

The care home accommodates 6 people in one adapted building. The home is on one level enabling people to mobilise around the building at ease.

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

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.

Right Support:

People had not always been supported safely with their medicines. Improvements were needed in the guidance around ‘as required’ medicines and in considerations when thickeners were added to medication. Staff had enabled people to access specialist health and social care support in the community. 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 supported this practice.

Right Care:

People had not always been supported to take part in activities and pursue interests based on their preferences. People had not been supported to develop goals and aspirations based on their interests. The provider had enough staff to meet people’s needs and staff received training around people’s needs. However, checks had not consistently been carried out on staff competencies following training. Staff understood how to protect people from poor care and abuse. The provider worked with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right Culture:

People had not always been involved in daily decisions about their care nor had people always been involved in developing or reviewing their care plans. The provider did not have effective systems to monitor the quality and safety of the service. This included ineffective systems to monitor safety concerns, people’s health needs and to make necessary improvements in the service. The management team began to make improvements within the service during the inspection and sent information of further planned improvements following the inspection.

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

Rating at last inspection

The last rating for this service was good (published 27 July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focussed inspection to review the service. During the inspection we identified concerns relating to the care and support people were receiving so we widened the scope of the inspection to a comprehensive inspection reviewing all 5 key questions.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of the full report.

Enforcement

We have identified breaches in relation to person centred care, safe care and treatment, staffing and in the systems to monitor safe and good quality care at this inspection.

Please see the action we have told the provider to take at the end of this report. 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

We will request an action plan from the provider and will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.