CQC report explained · a residential care home
What the CQC found at The Old Vicarage Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Staff managed medicines, risks, staffing and infection control safely, although references were not always obtained from previous employers in the health and social care sector.
- Effective?
- Good
- People's care, food, fluids and healthcare support achieved good outcomes. Staff were trained and supported, but records did not always show how best-interests decisions were reached or who was consulted.
- Caring?
- Good
- People were treated with kindness, compassion, dignity and respect. Staff involved people in decisions as far as possible and promoted their privacy and independence.
- Responsive?
- Good
- Care was personalised and activities supported people's wellbeing and relationships. Care records had improved, although some information was conflicting or missing in different parts of the care-planning system.
- Well-led?
- Good
- Leadership, organisation, teamwork and quality monitoring had improved significantly. The registered manager had created a more open culture and clearer systems for managing risks and care quality.
What inspectors found, April 2023
Rated Good; inspectors found safe, kind and well-organised care, with a few records and recruitment checks still needing attention.
This was an unannounced follow-up inspection on 9 and 21 February 2023. Two inspectors spoke with people living in the home, relatives, staff and an external professional. They observed care, checked the premises, reviewed care records and medicines records, and looked at staffing, training and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found improvements in medicines, staffing, infection control, risk management, care planning and leadership. People were treated kindly, their needs were assessed, and the home worked with health professionals.
The previous rating was Inadequate and the home had been in Special Measures since 25 August 2022. Inspectors found that improvements had been made and that the home was no longer in breach of regulations or in Special Measures. They made recommendations about checking references and recording best-interests decisions.
Safer systems
Inspectors found that risks, medicines, staffing and infection control were managed safely. Staff knew people's individual risk plans and had emergency arrangements to follow.
“Staff managed risks to people's safety. They assessed and regularly reviewed risks to people, to manage any identified risks and keep people safe from avoidable harm.” from the report
Kind and respectful care
People were treated with compassion and respect. Staff supported privacy, dignity, choice and independence.
“People were treated with respect, compassion and kindness by staff.” from the report
Personalised support
Care plans contained good person-centred information and staff knew people's needs and preferences. Activities and communication support were planned around individuals.
“Care plans and associated records were generally accurate and up to date, with a good level of person-centred information.” from the report
Food and healthcare
The home assessed nutritional needs, followed professional guidance and provided meals suited to people's needs and preferences. Staff worked with GPs and other professionals.
“Staff supported people to ensure they received a balanced diet and sufficient fluids to maintain their health.” from the report
Relevant employment references
minorRecruitment checks were generally robust, but references were not always obtained from previous employers in the health and social care sector. CQC made a recommendation for this process to be reviewed.
“However, references were not always sought from previous employers in the Health and Social Care sector.” from the report
Best-interests records
needs fixingStaff followed the Mental Capacity Act principles, but records did not always explain how decisions were made or who was consulted. CQC recommended reviewing how this is recorded.
“However, it was not always evident from records how decisions were reached and who was consulted.” from the report
Conflicting care-plan information
needs fixingSome information was missing or inconsistent in different parts of the care-planning system. The registered manager planned to introduce an audit to find and correct these issues.
“There were, however, some aspects of information recorded on the care planning system which were conflicting or omitted in different places on the system.” from the report
- 01How do you now make sure references are obtained from previous employers in the health and social care sector?
- 02How do you record who was consulted and how decisions were reached when someone lacks capacity?
- 03What care-plan audit system is now in place to find conflicting or missing information?
- 04How are you checking that the improvements found at this inspection continue over time?
- 05How do you involve people and relatives in reviews of care, menus and activities?
This was an unannounced follow-up inspection covering all five key questions and checking action taken after the previous Inadequate rating and breaches. This explanation was written from the published report of 1 April 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, August 2022
The Old Vicarage Care Home is rated Inadequate and placed in special measures; inspectors found unsafe care, staffing problems and weak management.
This was an unannounced focused inspection after concerns were raised about safety. Inspectors visited on 17 May and 6 June 2022. They spoke with people and staff, observed care, reviewed care and medicines records, and checked the building and management information.
The home was not providing safe care. There were too few suitably trained staff, medicines were not always given or stored safely, recruitment checks were incomplete, and risks from falls, malnutrition, choking and pressure damage were not properly managed. Fire equipment testing and infection control arrangements were also not assured.
Management was rated Inadequate because there had been no stable management team, audits were not completed, staff felt unsupported, and required notifications had not been sent to CQC. The overall rating fell from Requires Improvement at the previous inspection. The home was placed in special measures and CQC said it would continue monitoring and usually re-inspect within six months.
Immediate safety actions
The provider took some action during or after the inspection. This included making extra management staff available during the day.
“Additional management staff were made available during the day, allowing care staff to support people in the home.” from the report
Safeguarding training
The provider told inspectors that all staff had completed safeguarding training after the inspection.
“Since the inspection, the provider informed us all staff have completed safeguarding training.” from the report
Visitors using PPE
Although visitor safety checks were not being completed, the visitors seen by inspectors were following the required PPE arrangements.
“visitors we saw followed correct PPE procedures and were wearing masks and visiting people in their rooms where possible.” from the report
Not enough trained staff
seriousStaffing levels did not meet people's needs. Some people were left without supervision or access to food and drink, and the evacuation plan could not be carried out by two staff.
“There were not enough staff to meet the needs of people living in the home.” from the report
Unsafe medicines practice
seriousPeople did not always receive pain relief when needed. Cream records did not show that medicines were being applied as prescribed, and one eye cream was used after its best-before date.
“People did not always receive medicines to manage pain when they needed them.” from the report
Safeguarding and restrictions
seriousSome incidents, including unexplained bruising and suspected abuse, had not been properly reported or investigated. Four people were in rooms behind a locked door without the required assessment, consent or authorisation.
“Effective procedures were not in place to protect people from abuse.” from the report
Risks not managed
seriousRecords did not show that repositioning had taken place, and dietary requirements intended to reduce choking risk were not reflected in care records.
“An effective system to assess, record and manage risks was not in place.” from the report
Infection control
seriousInspectors were not assured that the home was managing visitors, PPE, testing, admissions, social distancing or outbreaks safely. The infection control policy was not up to date.
“Procedures designed to keep people safe from infection and cross contamination were not followed or implemented.” from the report
Weak management oversight
seriousThere had been no stable management team for some time. Audits and monitoring were not completed, so problems were not identified and required notifications were not sent to CQC.
“Systems were not in place to measure the quality of the service provided and assurances could not be acquired that the service was meeting people's needs.” from the report
- 01How many suitably trained staff are now on each shift, especially overnight, and can they carry out the emergency evacuation plan?
- 02Have DBS checks, verified references and all other recruitment checks been completed for every staff member?
- 03How are medicines, including pain relief and prescribed creams, now checked and recorded?
- 04What has changed in infection control, including visitor checks, PPE, testing and outbreak management?
- 05Who is now managing the home, and how are audits checking accidents, falls, pressure areas, weight loss, medicines and care records?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive carried over from the previous inspection. This explanation was written from the published report of 25 August 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 Care Home
10 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- April 2023Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2022InadequateSafe: InadequateWell-led: Inadequate
- March 2022Inspected but not ratedSafe: Inspected but not rated
- September 2020Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- June 2020Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- July 2019Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- January 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2016Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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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85 live-in carers within about an hour of Lancashire
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 £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.