The Old Vicarage

Updated 4 March 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 2 inspectors and a specialist nurse advisor.

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 with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

The 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. A new manager had been in post for just over 2 months and told us they were planning to submit an application to register.

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 and professionals who work with the service. 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 3 people who used the service and a relative of a person who used the service. We spoke with 6 members of staff including the manager, area manager, nurses, care assistants, and kitchen staff. We completed observations of communal areas. We reviewed a range of records including 4 people's care records, medication administration records and some records relating to the management of the service were reviewed.

Updated 4 March 2023

About the service

The Old Vicarage is a residential care home providing personal and nursing care to up to 30 people. The service provides support to people with physical disabilities, mental health support needs and older people, including those living with dementia. At the time of our inspection there were 15 people using the service. The home accommodates people over 3 floors, however, only 2 were being used at the time of inspection.

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

Significant improvements had been made in the service since our last inspection which reflected positively on people's experience. The management acknowledged further improvements were required to ensure these improvements were embedded and sustained.

A new manager had been in post since November 2022. We received consistent positive feedback on the management of the service and that improvements were ongoing. The provider demonstrated a commitment to continuous learning and was working towards an improvement plan, sharing progress with relevant stakeholders. Effective monitoring systems and quality checks were now being completed. Where action was required to improve people’s safety and experience at the service, this was carried out. People and staff had opportunities to be engaged in the running of the service and felt listened to.

Medicines were safely stored, administered and managed. People received their medicines as prescribed and staff followed best practice guidance for safe administration. Risks to people were assessed and there was enough guidance for staff to support people safely. There were enough staff to meet people’s needs, and spend time engaging with them. People felt safe using the service because the manager and staff understood how to recognise, report and investigate potential abuse. Lessons were learned when things went wrong, and effective action was taken to keep people safe.

People’s holistic needs were comprehensively assessed and regularly reviewed using evidence-based tools. Staff worked well together and referred to relevant health care professionals appropriately, so people achieved good outcomes in relation to their health and well-being. Staff were suitably trained to carry out their role. The premises and equipment were safe and met people’s needs.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 12 October 2022) and there were breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 12 May 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

We carried out an unannounced focused inspection of this service on 30 March 2022 and there were breaches of regulation. CQC issued the provider with warning notices in relation to regulation 12 (safe care and treatment) and regulation 17 (good governance). We followed up with an unannounced focused inspection on 16 August 2022 to check whether the warning notices had been met and found the provider remained in breach of legal requirements. We met with the provider after the last inspection and they completed an action plan to show what they would do and by when to improve safe care and treatment, staffing and governance.

We undertook this focused inspection to check whether the warning notices we previously served in relation to regulation 12 and regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We also checked whether the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective 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. The overall rating for the service has changed from inadequate to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Old Vicarage 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.