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.
What inspectors found, August 2023
Inspected but not rated; inspectors found important improvements, but said these still needed to become fully embedded and timely.
This was an unannounced targeted inspection on 27 June and 4 July 2023. Two inspectors checked whether the home had acted on warning notices about safeguarding and management systems. They spoke with people and staff and reviewed care plans, medicines records and management documents.
The inspectors found that systems for safeguarding, managing risks and overseeing the home had improved. The home was no longer in breach of Regulations 13 and 17, which were breached at the previous inspection.
The overall rating was not changed and remains requires improvement from the previous inspection. This visit was targeted, so it did not assess every part of the five CQC questions. Safe and well-led were marked inspected but not rated.
Safeguarding systems
The inspectors found effective systems for reporting, investigating and learning from safeguarding incidents.
“Effective safeguarding management systems were now in place.” from the report
Action on previous warnings
The provider had complied with the earlier warning notices relating to safeguarding and good governance.
“At this inspection, we found improvements had been made and the provider had complied with the requirements of the warning notice which related to Regulations 13 and 17.” from the report
Health deterioration records
needs fixingTwo people's care plans missed important signs of health deterioration. Staff understanding was variable for one person, creating an increased safety risk.
“We found recording omissions in 2 people's care plans, regarding signs of health deterioration that were important for staff to be aware of.” from the report
Hot water safety
seriousA hot water geyser was in an accessible drinks-making area and had not been risk assessed.
“However, we found potential risk to people's safety, from a hot water geyser located in an accessible drinks-making area, which had not been risk assessed.” from the report
Statutory notifications
needs fixingThe provider had not always told CQC about important events without delay.
“the provider had not always sent us statutory notifications about important events when they happened at the service, without delay.” from the report
Glove storage
minorUnused disposable gloves were not always stored safely, despite written management instructions and storage being provided.
“Staff were not always storing unused disposable gloves safely, despite evidence of recent management written instruction and safe storage provision.” from the report
- 01How are you now recording and sharing signs of health deterioration in people's care plans?
- 02What risk assessment and safety controls are now in place for the hot water geyser?
- 03How do you check that unused disposable gloves are stored safely every day?
- 04How do you make sure statutory notifications are sent to CQC without delay?
- 05What evidence can you show that the improvements from the previous inspection have been sustained?
This was a targeted inspection of specific safeguarding and well-led concerns linked to previous warning notices; it did not assess the whole of any key question, and the other ratings were not reviewed. This explanation was written from the published report of 23 August 2023 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 2022
The Old Vicarage was rated Requires Improvement, with risks around safeguarding, oversight and dignity despite kind staff and some improvements.
Inspectors carried out an unannounced comprehensive inspection over 31 October and 1 November 2022. They spoke with people living in the home, staff and relatives, and reviewed records, care and safety arrangements.
The home was not always protecting people from avoidable harm. Safeguarding actions were not always put in place, some risks were not properly managed, and lessons were not consistently learnt after incidents. Inspectors also found gaps in fire safety, medicines guidance, assessments and staff supervision.
Staff were observed treating people with care and kindness. People were offered choices, supported to take part in activities and helped to access healthcare. However, all five areas were rated Requires Improvement, meaning care was inconsistent and there was limited assurance that people were always safe and well supported.
Kind staff
Inspectors saw staff treating people well. Relatives also said staff were suitably trained.
“We observed staff treating people well with care and kindness” from the report
Staffing and recruitment
The home had enough staff to meet people's needs, and recruitment checks were carried out. People were supported by familiar staff.
“There were enough staff to keep people safe and meet their individual needs.” from the report
Activities and relationships
People could take part in group or one-to-one activities and maintain contact with important people.
“People had the opportunity to participate in activities in a group or on a one to one basis with staff.” from the report
Healthcare support
People had regular input from healthcare professionals, including weekly reviews with a GP surgery.
“The service worked in partnership with a GP surgery who conducted weekly reviews of people's ongoing health and wellbeing needs.” from the report
Infection control
Inspectors were assured that infection risks, visits and protective equipment were being managed safely.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Safeguarding and repeated incidents
seriousActions recorded after safeguarding incidents were not always in place, and incidents could happen again. Some incidents were not properly investigated.
“Systems continued to not be robust enough to demonstrate safeguarding was effectively managed. This placed people at risk of harm.” from the report
Risks and fire safety
seriousKnown risks were not always reduced. A fall had not led to an investigation or updated risk assessment, and fire safety actions were still outstanding.
“Risks identified in the service's fire safety risk assessment review from March 2022 had not been addressed.” from the report
Mental Capacity Act
seriousA locked door restricted a person's access to their bedroom without the required assessment or best-interest decision. The lock was removed when inspectors raised it.
“This was not supported by a mental capacity assessment or a best interest decision.” from the report
Dignity and laundry
needs fixingRelatives reported missing clothes and people wearing other people's clothing. Inspectors also found confidential personal information displayed in a hallway.
“People's dignity was not always promoted. Relatives told us about issues they had encountered with the laundry.” from the report
Weak quality checks
seriousThe home's systems did not fix problems found in audits quickly enough. Shortfalls in medicine, mealtime and repositioning records continued or were not identified.
“The quality assurance and governance arrangements in place were ineffective.” from the report
Staff supervision
needs fixingSeveral staff had not received the regular supervision promised in the home's policy. This limited opportunities to review their work and development.
“Managers did not ensure that staff had regular supervisions.” from the report
- 01What actions have you completed to prevent safeguarding incidents from recurring, and how do you check that those actions are actually in place?
- 02What has been done about the fire safety risks and the fire evacuation plan, including the garden gate locks?
- 03How do you now assess people's needs and risks before they move into the home?
- 04How are laundry problems, missing clothes and clothing mix-ups being prevented and resolved?
- 05How often are staff receiving supervision, and how do your audits show that medicines, mealtimes and repositioning records are accurate?
This was an unannounced comprehensive inspection covering all five key questions, including infection prevention and control; the inspection followed up concerns from the previous inspection. This explanation was written from the published report of 20 December 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.
Every inspection of The Old Vicarage
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- August 2023Inspected but not ratedcurrent ratingSafe: Inspected but not ratedWell-led: Inspected but not rated
- December 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2020Requires improvementstayed Requires improvementWell-led: Inadequate
- January 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015
Registered with the Care Quality Commission on 14 May 2015.
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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