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
- People were protected from avoidable harm. Inspectors found that safeguarding referrals, risk assessments, recruitment checks, staffing, infection control and medicines management had improved and were being handled safely.
- Effective?
- Good
- People's health needs, appointments and outcomes were recorded in up-to-date Health Action Plans. Staff had relevant training and people were supported with healthcare, food, communication and decision-making.
- Caring?
- Good
- Inspectors saw caring interactions and found that people's privacy, dignity, choices and relationships were respected. People were involved in decisions about their care and activities.
- Responsive?
- Good
- Care was individualised around people's needs, preferences and interests. People and their representatives had opportunities to give feedback, and inspectors found improvements in how concerns were addressed.
- Well-led?
- Good
- Managers had improved oversight of the home. Monthly audits tracked actions, staff felt supported, and people, relatives, staff and professionals were asked for their views.
What inspectors found, March 2019
The Old Vicarage is rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection by one inspector on 11 March 2019. The inspector spoke with people living at the home, relatives, staff and managers. They observed care, checked medicines, reviewed two people's care records and two staff recruitment files, and examined quality checks.
The home supported eight people at the time of the inspection. Inspectors found that people were safe, treated with dignity and supported to make choices about daily life, food, activities and relationships. Staff understood people's needs, including how to support people during anxiety or distress.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The previous inspection had rated the home Requires Improvement. Inspectors said improvements had been made in safeguarding referrals, care records, staffing, health plans, feedback and management checks.
Personalised support
Staff knew people well and supported them to make choices about activities, holidays, food and how they spent their time.
“The support each person received was individualised to meet their needs and preferences.” from the report
Safe support during distress
Staff understood people's positive behaviour support plans and how to help when someone became anxious or upset. Physical intervention was described as a last resort.
“We saw that positive behaviour support plans were in place and had been followed.” from the report
Community access
There were enough staff to support people to go out according to their preferences, while also respecting when someone chose to stay at home.
“People were supported to access community activities that they enjoyed.” from the report
Kind and respectful care
Inspectors saw caring relationships between staff and people. People's privacy, dignity and family relationships were respected.
“We saw caring interactions between staff and people.” from the report
Improved management
The home had acted on problems identified at the previous inspection. Managers used audits, meetings and feedback to track improvements.
“At this inspection improvements had been made.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure each person's care plans and risk assessments stay up to date?
- 02How would you support my relative during periods of anxiety or distress, and when would any physical intervention be considered?
- 03How do you make sure there are enough staff for my relative's preferred community activities?
- 04How are families told about incidents, safeguarding concerns and actions taken afterwards?
- 05How can my relative and our family give feedback or raise a concern, and how will we be told what was done?
This was an unannounced planned inspection that looked at the home, the care provided and all five CQC questions; the report says improvements had been made since the previous inspection. This explanation was written from the published report of 29 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, March 2018
Rated Requires Improvement; care had become safer and kinder, but important risks and management weaknesses remained, and the home had only just left Special Measures.
Inspectors visited on 27 and 28 November and 4 December 2017. The first day was unannounced. They spoke with people, relatives, staff and professionals, observed care, and checked care records, staff files and quality checks.
The home had improved since an April 2017 inspection, when it was rated Inadequate and placed in Special Measures. It was no longer Inadequate and had left Special Measures. However, people were not consistently protected from avoidable harm, health risks or delays in acting on concerns.
Staff were kind and respectful. They understood people's communication needs and provided personalised support. But care records, health monitoring, staffing records, complaints handling and quality checks were not reliable enough. The home was rated Requires Improvement overall, with Caring rated Good and the other four areas rated Requires Improvement.
Kind and respectful staff
Staff treated people calmly and respectfully. They took time to explain what was happening and supported people who were anxious or unsettled.
“Throughout our inspection visit, staff supported people in a caring, friendly and respectful way.” from the report
Communication support
Staff understood people's verbal and non-verbal communication. They followed individual guidance, including picture-based communication and allowing people time to respond.
“People were supported to communicate effectively by staff who understood their verbal and non-verbal communication.” from the report
Less restrictive support
Staff used guidance and training to reduce distress and avoid physical restraint where possible. Reviews of incidents led to extra support and involvement from health professionals.
“The techniques and skills used by staff were consistent and in accordance with clear guidance in the person's care plan.” from the report
Personalised daily care
Staff knew people's preferences and followed detailed guidance about activities, bathing, drinks and communication. People were supported to make choices about their routines and surroundings.
“People received personalised care that was responsive to their needs.” from the report
Medicines and premises
Medicines were stored, recorded, given and disposed of correctly. Safety checks for the buildings and equipment were up to date, and the premises were clean.
“Medicines were stored, documented, administered and disposed of in accordance with current guidance and legislation.” from the report
Late safeguarding reports
seriousSeveral possible safeguarding concerns were not reported to the local authority promptly, and CQC was not told until prompted. This could delay action to protect people, especially those who could not clearly communicate concerns.
“There was a risk that concerns about potential abuse were not identified quickly to enable action to be taken to ensure people's safety.” from the report
Incomplete health information
seriousSome care plans did not contain enough information about health risks, and daily monitoring was incomplete. Staff knew some actions were needed, but records did not show that follow-up always happened promptly.
“The provider could not be assured people were supported to maintain their health.” from the report
Staffing and recruitment records
seriousThere were times when staffing did not meet people's assessed needs, which could affect outings. Some recruitment records lacked identity information or employment history, so the provider could not be sure safe recruitment checks were complete.
“Evidence from our inspection showed there were times when there were not sufficient staff to meet people's assessed needs.” from the report
Complaints were not tracked consistently
needs fixingPeople and relatives received information about complaints, but the home could not show a clear and consistent process for recording and dealing with concerns. Some issues raised by professionals were not followed up promptly.
“There was no clear process in place for the provider to ensure concerns or complaints raised by people or relatives were managed consistently.” from the report
People not always involved in reviews
needs fixingPeople were not consistently supported to take part in designing or reviewing their care. The home recognised this and was working on approaches suited to each person's communication needs.
“There was a risk that people's views about their care were not always included in care reviews, and their opinions would be overlooked.” from the report
Quality checks did not drive timely action
needs fixingAudits identified several problems, but some improvements had not been made promptly. This included health systems and staff training records.
“Quality assurance processes to ensure people's care was safe were not consistently implemented or effective.” from the report
- 01How do you now report safeguarding concerns promptly to the local authority and CQC?
- 02Which health care plans and monitoring records were incomplete, and how do you check that follow-up actions are completed on time?
- 03How do you make sure there are enough trained staff for people's assessed needs, including planned outings and unexpected absences?
- 04How are complaints and concerns recorded, investigated and followed through to a clear outcome?
- 05How will my relative be involved in designing and reviewing their care in a way that suits their communication needs?
This was an inspection of the overall service and all five key questions, including the care, accommodation, records, staffing and management systems; the circumstances of the specific police-referred incident were not examined. This explanation was written from the published report of 13 March 2018 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 3 years: the service has held its Good rating throughout.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2017Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 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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62 live-in carers within about an hour of Derbyshire
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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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