CQC report explained · a residential care home
What the CQC found at The Old Vicarage
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were identified and managed, staffing was sufficient, medicines were safely managed, and staff knew how to protect people from abuse. Some infection-control remedial work was still in progress.
- Effective?
- Requires improvement
- This key question was not inspected during this visit. Its rating was carried forward from the last comprehensive inspection.
- Caring?
- Good
- This key question was not inspected during this visit. Its rating was carried forward from the last comprehensive inspection.
- Responsive?
- Good
- This key question was not inspected during this visit. Its rating was carried forward from the last comprehensive inspection.
- Well-led?
- Requires improvement
- Management systems had improved, but inspectors had not yet seen evidence that all improvements were fully embedded, proactive and sustained. Infection-control management needed further work, although an action plan and new audit tools had been introduced.
What inspectors found, September 2022
Rated Good overall; inspectors found safe, kind care, but well-led arrangements and infection-control improvements were not yet fully embedded.
This was a focused inspection on 2 August 2022. One inspector spoke with people, staff and managers, observed care, and checked care plans, medicines, staffing, safety and quality records. Infection prevention and control was also reviewed.
The home was rated Good for Safe. Inspectors found that risks were assessed and managed, staffing was sufficient, medicines were managed safely, and people were protected from abuse. Staff were described as kind, trained and knowledgeable about the people they supported.
The home was rated Requires Improvement for Well-led. Improvements had been made since the previous inspection, including in risk management, records, medicines and community access. However, inspectors said some improvements, especially infection-control arrangements, were not yet fully established and sustained.
The overall rating changed from Requires Improvement to Good. The other three key question ratings were carried forward from the previous comprehensive inspection, because this visit only assessed Safe and Well-led.
Risks were managed
People's risks were assessed, reviewed and reflected in their care plans. Staff understood the steps needed to keep people safe.
“People's care plans showed risks to their safety were effectively assessed, managed and reviewed.” from the report
Safe staffing and medicines
Staffing was judged sufficient for people's care and activities. Recruitment checks, training and medicines competency checks were in place.
“Medicines were safely managed, to ensure people received their medicines when they should.” from the report
Kind and person-centred care
Staff knew people well and supported their dignity, choices and rights. Care was adapted to people's needs and communication styles.
“Staff were kind, caring, trained and supported.” from the report
Improved community access
People, relatives and staff reported improvements in access to the community and enjoyable activities since the previous inspection.
“Many were particularly pleased about the improvements made since our last inspection, to ensure people's regular community access, participation and engagement with others, in activities they enjoyed, both within and outside the home.” from the report
Leadership improvements not fully embedded
needs fixingInspectors found better management systems, but the home had not yet shown that improvements were consistently maintained and proactively checked.
“However, related management and service improvements, either made or needed; were not yet fully demonstrated as embedded, proactively ensured or sustained ongoing for the quality and safety of people's care.” from the report
Infection-control work remained
needs fixingThe local authority's infection-control audit found areas needing improvement. Remedial actions were in progress during this inspection.
“We were somewhat assured that the provider was promoting safety through the layout and hygiene practices of the premises.” from the report
Rating was not displayed online
minorThe previous inspection rating had not been displayed on the provider's website as required. The home corrected this immediately after the inspection.
“However, at this inspection, the most recent inspection rating had not been displayed on the provider's website as required to do so, following our inspection report published in December 2021.” from the report
- 01What infection-control actions from the local authority audit are still outstanding, and when will they be completed?
- 02How do you check that recent improvements in governance and care records remain in place over time?
- 03What quality audits are carried out now, and what happens when an audit identifies a problem?
- 04How will you support my relative's community access and activities outside the home?
- 05How do you check that staff remain competent to administer medicines and manage individual risks?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 22 September 2022 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, December 2021
The Old Vicarage was rated Requires Improvement; inspectors found safety shortfalls and Inadequate leadership.
This was an unannounced focused inspection. Inspectors looked only at Safe and Well-led because of concerns about medicines, staffing, governance and records. They spoke with people, relatives, staff, the manager and local authority commissioners, and checked care, medicines, staffing and management records.
The home was not always safe. Some risks were missing from care plans, fire safety checks were not always followed, and medicines audits and staff medicines competency records were not in place. Infection control arrangements were mostly satisfactory, and people received their medicines when they should.
Leadership was rated Inadequate. The home did not have effective checks to identify and fix problems, records were incomplete, and there was no effective system for gathering feedback or planning improvements. People and relatives said they felt safe and were positive about the kindness and support from staff.
The overall rating fell from Good at the previous inspection in December 2018 to Requires Improvement. The report says the provider must make improvements and that CQC will monitor progress and return to inspect again.
Kind and supportive staff
People and relatives spoke positively about the manager and staff. Inspectors saw staff responding promptly to people's emotional, nutritional and daily living needs.
“All spoke positively about the manager and staff, who they said were approachable kind, caring and supportive.” from the report
Medicines usually given safely
Medicines were stored and recorded accurately, and inspectors saw staff giving them at the right time and in people's preferred way.
“People's medicines were safely stored and accurately recorded. We saw staff giving people's medicines safely, at the time people needed them and in the way they preferred.” from the report
Safeguarding awareness
Staff understood how to recognise and respond to suspected or witnessed abuse. People said they felt safe and knew who to speak to if worried.
“Staff understood how to recognise and respond to any suspected or witnessed abuse within the service.” from the report
Clean environment
The home was visibly clean and cleaning schedules showed that the environment was cleaned regularly. Inspectors were mostly assured about infection prevention arrangements.
“The home was visibly clean and cleaning schedules showed the regular cleaning of the environment.” from the report
Risks were not always managed
seriousSome care plans did not include important risks linked to health conditions or people's use of electrical equipment. Fire drills and safe evacuation arrangements were not always followed.
“Risks were not always effectively, identified or managed for people's safety.” from the report
Weak management checks
seriousThe home did not have effective governance systems or regular audits to check care quality and safety. Problems were not consistently identified and put right.
“The registered persons had failed to operate effective governance and management systems, to consistently ensure the quality and safety of people's care and timely service improvement when needed.” from the report
Limited community access
needs fixingPeople's access to activities and local community services was not always maintained after day care facilities closed. Additional staffing was still being discussed with commissioners.
“Good care outcomes were not always ensured for people, in timely manner.” from the report
- 01What has been done to make sure every person's care plan includes all relevant health, electrical equipment and evacuation risks?
- 02How often are medicines audits and staff medicines competency assessments now completed, and can you show us the records?
- 03What regular quality and safety audits are now in place following the warning notice for good governance?
- 04How are people and relatives now being asked for feedback, given that formal meetings had not taken place since February 2020?
- 05What additional staffing or activities are now available to help people access their local community after the day care closure?
This was an unannounced focused inspection of Safe and Well-led only; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 24 December 2021 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 Vicarage
4 rated inspections over 6 years: the service has held its Good rating throughout.
- September 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Inadequate
- December 2018Goodstayed GoodSafe: GoodWell-led: Good
- September 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 2010.
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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Most charge £1,010 to £1,260 a week. 51 can care for a couple. 12 years' experience on average.
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