Vicarage Lodge

Updated 6 June 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Vicarage Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had two registered managers who were registered with the Care Quality Commission. 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.

Notice of inspection

We gave the service short notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be staff and people at home to speak with us.

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 worked with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

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 or have made since the last inspection. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

Due to the nature of their condition, people were unable to communicate verbally, we therefore spent time with all three people who lived at the home. We accompanied people and staff into the local community and joined them in their chosen activities.

We spoke with the nominated individual, both registered managers, the health and wellbeing manager, the positive behaviour support manager, the learning and development manager, a member of the provider’s commissioning team, the assistant manager and three care staff. We looked at care and support records, risk assessments and medicines records.

After the inspection

We reviewed a range of records. This included more records relating to people’s care and support and records relating to the management of the home. We spoke with four relatives by phone and contacted a number of health and social care professionals for feedback.

Updated 6 June 2020

About the service

Vicarage Lodge is registered to provide accommodation and personal care for up to three people. It has been specifically designed for those with profound and multiple learning disabilities who use wheelchairs. At the time of this inspection there were three people living at the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Staff went the extra mile to support people to undertake a variety of exciting and challenging activities of their choice which interested them. Relatives said staff had helped people develop and widen their experiences in ways that they never thought would be possible. One relative said, “They are forward thinking, they put the individual first. They have an individual time table, whatever their interests are.”

Staff used creative and inclusive ways to help people communicate their wants and wishes. Staff used a diverse range of tools and strategies to help people communicate their choices and preferences. People with very complex conditions were empowered by staff through this approach, to make daily living choices for themselves.

The provider's vision and values were inclusive and person-centred to make sure people were at the heart of the service. This vision was driven by the exceptional leadership of the management team. Relatives spoke extremely highly about the provider and Vicarage Lodge. Comments included, “They are a wonderful company who do great things” and “It should be held up as an exemplary company. They have found a different way to provide care.”

There was a strong emphasis on continuous improvement. One relative told us, “They are always learning to see how they can further people’s wellbeing.” An advanced centralised electronic monitoring system was in place. Every aspect of people’s care and support and the management of the service were monitored in ‘real time.’ This enabled management staff to immediately identify any issues or changes that needed attention and evidence showed that they acted swiftly, applying the ethos of the service to continually strive for improvements to people’s individualised care experiences.

People were fully and regularly supported to take positive risks to enable them to live fulfilling lives. Core staff teams worked extremely effectively together and were built around meeting the needs of people.

There was a strong emphasis on the importance of eating and drinking well. The provider had set up ‘training kitchen’ workshops. Staff and people attended sessions to learn about the effects of cooking and pureeing of food.

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.

People received care and support from staff who knew them well. Relatives were positive about the care provided. One relative told us, “They look after [name of person] as well as we could.”

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 9 September 2017).

Why we inspected

This was a scheduled inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about Vicarage Lodge until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.