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, March 2019
The Old Vicarage: Rated Good; inspectors found kind, safe care, with some infection control and assessment records needing improvement.
This was an unannounced inspection over 27 and 28 February 2019. One inspector and an expert by experience spoke with people living there, relatives, staff and a visiting health professional. They reviewed care files, medicine records, staff records, complaints and safety checks, and looked around most areas of the home.
The inspectors found people were safe, medicines were given as prescribed, and there were enough staff. People and relatives described staff as kind, patient and respectful. Care plans were personalised and updated when needs changed. People were supported with food, activities, healthcare and end of life care.
There were some areas to improve. Infection control arrangements for hand hygiene notices and commodes needed review. Some initial assessments did not contain all the required detail, and staff were not clear about the legal rules for caring for people who could not give consent.
The home was rated Good in all five areas and overall. This was the same overall rating as at the previous inspection, published in September 2016.
Kind and respectful staff
People and relatives spoke positively about staff. Inspectors saw staff being patient, friendly and respectful, including when providing personal care.
“The staff are really good, they all take time to listen to you and find out about you and how you like things done.” from the report
Safe staffing
The provider completed employment checks before staff started. Inspectors found enough staff were deployed to meet people's needs.
“There is always enough staff to look after my mum” from the report
Personalised care
Care plans recorded people's preferences, relationships, interests, communication methods and support needs. They were updated when needs changed.
“Care records were personalised around the person they were written for.” from the report
Good food and nutrition support
People could choose from a variety of meals. Staff knew about dietary preferences and allergies, and people at risk had their weight and food intake monitored.
“The food is really good here, you can't complain about the food here; it really is very good.” from the report
Responsive management
People could raise complaints and the manager investigated them, gave meaningful replies and took action to reduce the chance of problems happening again.
“We saw that the registered manager took complaints seriously, ensured the complainant got a meaningful reply and then was action taken to ensure the same issues could be avoided in future.” from the report
Hand hygiene information
needs fixingHand hygiene notices were missing from some bathrooms and hand-washing areas. The report said these would help maintain good hygiene standards.
“Hand hygiene notices were not found in all bathrooms and hand washing facilities.” from the report
Commode cleaning
needs fixingSome bedrooms without en-suite facilities had commodes. The way these were emptied and cleaned needed to be reassessed.
“The way commodes were emptied and cleaned needed to be reassessed.” from the report
Initial assessments
needs fixingA few initial assessments did not cover every aspect of a person's needs, although the missing information was found in care plans. The manager said this would be improved.
“We looked at completed assessments and noted a few did not cover all aspects of the person's needs.” from the report
Understanding consent law
needs fixingStaff were not clear about the legal rules for providing care to people who could not give permission. The manager said written evidence of mental capacity would be recorded for new admissions.
“Staff were unclear about the laws which enabled them to provide care to people who were unable to give their permission.” from the report
Dating opened skin creams
minorLotions and creams were not dated when opened. The manager said staff would be reminded to date topical medicines.
“Lotions and creams used for applying to people's skin were not dated when they were opened.” from the report
- 01What changes have been made to the way commodes are emptied and cleaned?
- 02Are hand hygiene notices now displayed in every bathroom and hand-washing area?
- 03How do you record a new resident's mental capacity and make sure staff understand the legal rules about consent?
- 04How do you make sure initial assessments contain full information about each person's needs?
- 05Are opened lotions and creams now dated, and how is this checked?
This was an unannounced inspection of the residential care home, covering all five CQC questions and both accommodation and personal care. This explanation was written from the published report of 28 March 2019 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, September 2016
Rated Good; inspectors found kind, personalised care and safe systems, with one medicines stock-counting shortfall corrected during the visit.
The inspection was unannounced and took place on 10 August 2016. The inspector spoke with nine people using the service, six care staff, a visiting health professional, managers, the provider and four regular visitors. They also observed care and lunch, and checked care plans, staff files, medicines records and rotas.
People said they felt safe and were very happy with the care. Inspectors found enough staff, safe medicines systems, personalised care plans, staff training and good access to health professionals. Care was described and observed as kind, respectful and responsive to people's choices.
The home was rated Good overall and Good in all five areas: safe, effective, caring, responsive and well-led. The previous inspection in January 2014 had found no concerns.
Enough staff
Inspectors found enough staff to keep people safe. Staff knew people's needs, preferences and routines well.
“People were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes.” from the report
Kind and respectful care
People described staff as kind, caring and willing to go further to help. Inspectors also observed warmth, patience and respect.
“People were cared for by kind and caring staff who went out of their way to help people and promote their well-being.” from the report
Personalised support
Care plans included people's wishes, life histories and preferred ways of receiving support. People were able to make choices about their daily lives.
“People's care and support was responsive to their needs and personalised to their wishes and preferences.” from the report
Positive mealtimes
Inspectors saw an unhurried lunch with choice, snacks and drinks available throughout the day. People's dietary needs were assessed and specialist advice was sought when needed.
“The mealtime experience was seen to be a positive for all people using the dining areas in the home.” from the report
Good leadership
People, relatives and staff found the management approachable. Regular meetings, audits and feedback were used to monitor and improve the home.
“People and staff were supported by a registered manager who was approachable and listened to any suggestions they had for continued development of the service.” from the report
Medicine stock counts
needs fixingSome stock levels for medicines kept for possible urgent use had not been counted. The manager acted immediately and changed the process so all stock was checked weekly.
“Some stock levels for medicines to be used "just in case", had not been counted.” from the report
End of life planning still developing
minorThe home was working towards the Gold Standards Framework and developing advanced care plans and DNAR forms. Families should check how this work has been completed since the inspection.
“We are in the early stages of working towards the accreditation” from the report
- 01How often are medicines kept for 'just in case' use counted now, and how is this checked?
- 02How are advanced care plans and DNAR discussions recorded and kept up to date?
- 03What activities would be available for my relative, especially if they preferred one-to-one time or sometimes became bored?
- 04How would you involve our family if my relative's needs changed or they needed more support?
- 05How do you make sure new staff complete their induction and are safe to provide care?
This was an unannounced inspection of the overall service, covering all five CQC questions and including observations, discussions and checks of care, staffing, medicines and other records. This explanation was written from the published report of 1 September 2016 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
2 rated inspections over 3 years: the service has held its Good rating throughout.
- March 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Registered with the Care Quality Commission on 21 March 2014.
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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76 live-in carers within about two hours of Somerset
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 £1,370 a week. 62 can care for a couple. 12 years' experience on average.
“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.”
“She was not phased by anything, she was adaptable, kind & gave us complete confidence to go away & not worry about a thing!”
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.