CQC report explained · a residential care home
What the CQC found at The Old Rectory
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People had individual risk assessments and staff understood safeguarding and positive behaviour support. There were enough staff, recruitment checks were completed, medicines were audited and the environment was regularly checked.
- Effective?
- Good
- People's needs were assessed and reviewed, and staff had relevant training and experience. Staff worked with health professionals, supported healthy lifestyles and followed the Mental Capacity Act principles.
- Caring?
- Good
- People were happy and relaxed around staff, who treated them with dignity and respect. Staff supported people to communicate, make choices and build independence.
- Responsive?
- Good
- Care plans were detailed and personalised. People had varied activities, regular outings and opportunities to maintain relationships, although more work and volunteering opportunities were being sought for some people.
- Well-led?
- Good
- Leaders were described as approachable, organised and open to feedback. Quality checks, staff meetings and reviews of incidents were used to monitor and improve the home.
What inspectors found, January 2020
Rated Good; inspectors found safe, caring and personalised support, with some work opportunities still being developed.
The inspection was unannounced and took place on 7 January 2020. One inspector met 11 people, spoke with relatives, staff and health and social care professionals, and checked care, medicine and staff records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were treated with dignity, supported to make choices and helped to live active, personalised lives.
Staff were described as trained, experienced and caring. The home had enough staff, medicines were managed safely, and the building was clean and maintained. Leaders used checks, feedback and incident reviews to improve the service.
This was the same overall rating as at the previous inspection, published in June 2017. Good means inspectors found the service met the required standards and delivered consistently good outcomes, but it does not mean every aspect was perfect.
Caring staff
People were relaxed and happy around staff. Relatives and professionals spoke positively about the support and relationships in the home.
“The Old Rectory provided people with a homely, happy and friendly environment.” from the report
Personalised communication
Staff understood how people communicated, including non-verbal communication, Makaton and picture-based systems. Care plans explained each person's communication needs.
“People's communication needs were captured in detailed communication care plans including any visual, hearing needs and how to recognise and understand people's individual non-verbal cues.” from the report
Choice and independence
People were supported to make decisions and take part in everyday tasks such as shopping, cooking and household activities. Their care was planned around their preferences.
“Staff supported people to increase their independence and develop new skills.” from the report
Safe and skilled support
Staff had training relevant to people's needs, including autism, epilepsy and positive behaviour support. Medicines, risks, staffing and the environment were managed safely.
“There were enough staff to meet people's needs.” from the report
Active quality improvement
Managers used audits, feedback and incident reviews to make changes. Improvements included environmental work and creating a cinema-style room.
“The service had a range of effective quality monitoring arrangements in place.” from the report
Size of the home
minorThe home was registered for 15 people, which inspectors said was larger than current best practice guidance for learning disability services. They found that people lived in four smaller units, which reduced the possible negative impact.
“Although this is larger than current best practice guidance for learning disability services, any potential negative impact on people was mitigated because people lived in smaller groups together, within four separate units.” from the report
Work and volunteering opportunities
minorSome younger people had stopped previous work or volunteering placements because they became bored. The home was looking for other suitable opportunities.
“The registered manager said they were looking for other work or volunteering opportunities for them.” from the report
End of life planning
minorInspectors discussed the need to record more detailed information about people's end of life wishes and those of their families when possible.
“We discussed end of life care plans with the registered manager and the importance of capturing more detailed information about people's end of life care wishes and those of family members, whenever the opportunity arose.” from the report
- 01What work, volunteering or skills opportunities are currently available for my relative?
- 02How would my relative's life be organised within the four separate units?
- 03How will you record and review my relative's end of life wishes and involve our family?
- 04How would staff recognise and respond to my relative's communication cues, distress or changing behaviour?
- 05How are medicines, including any as-required medicines for anxiety, reviewed and monitored?
This was an unannounced comprehensive inspection that looked at the premises and care provided and reviewed all five key questions; all ratings remained Good from the previous inspection. This explanation was written from the published report of 24 January 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2017
Rated Good; inspectors found safe, kind and personalised care, but some best-interest decisions still needed better recording.
This was a comprehensive inspection on 23 and 24 May 2017. Inspectors met all 15 people, observed staff, spoke with relatives, staff and visiting professionals, and reviewed care, staff and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, effective healthcare support, kind relationships and personalised activities and care.
The Effective rating improved from Requires Improvement at the previous inspection in December 2015. The home had improved its staff induction and its records about people who could not make some decisions for themselves. Inspectors still identified some further recording improvements.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs, including one-to-one support where required. Medicines records were correctly completed and checked.
“People had enough staff to assist them with their care needs, take part in activities and go out.” from the report
Improved staff preparation
New staff worked alongside experienced colleagues before working alone. Staff also received regular training, supervision and opportunities for further qualifications.
“New staff received a comprehensive induction, so they got to know people and how to meet their needs.” from the report
Kind and respectful care
Staff knew people well and supported their privacy, dignity, communication and everyday choices. The atmosphere was described as calm and happy.
“People had built strong relationships with each other and with staff who were caring and compassionate.” from the report
Personalised activities and independence
People were supported to enjoy hobbies, go out in the community and build daily living skills. Care plans reflected their preferences, health and interests.
“People enjoyed a wide variety of hobbies and interests and were part of their local community.” from the report
Strong management checks
The management team used meetings, audits, care-plan reviews and a service improvement plan to monitor the home and make changes.
“A number of methods were used to assess the quality and safety of the service and staff made continuous improvements in response to their findings.” from the report
Best-interest records
needs fixingAlthough the home had improved its consent arrangements, inspectors said that day-to-day best-interest decisions and support for people to make their own decisions were not always recorded well enough.
“Further improvements were needed in documenting day to day best interest decisions, and in recording how staff support people to make as many decisions for themselves as possible.” from the report
Phone access in one unit
needs fixingStaff in the newest unit did not have a landline, which they identified as a risk because they worked alone. A mobile phone was being used while the provider dealt with technical problems.
“In unit four, the newest unit, staff identified to us, not having a phone line as a risk.” from the report
- 01How are day-to-day best-interest decisions recorded now, and how do you show that the person was supported to decide for themselves?
- 02Has the landline in unit four been installed, and what arrangements are in place if staff working alone need urgent help?
- 03How will you make sure new staff complete their induction and are ready before working one-to-one with people?
- 04How do you review behaviour support plans and check whether people still need as-required medicines?
- 05How are people's activity, education, work and independence goals reviewed and updated?
This was a comprehensive inspection covering all five question areas; Safe, Caring, Responsive and Well-led remained Good, while Effective improved to Good from Requires Improvement at the previous inspection. This explanation was written from the published report of 23 June 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The Old Rectory
3 rated inspections over 4 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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17 live-in carers within about an hour of Devon
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
“She is such a warm and gentle person while being professional and competent at the same time.”
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.