CQC report explained · a nursing home
What the CQC found at The Old Vicarage Nursing and Residential Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Rated Good; inspectors found safe, kind care and stronger management, but the inspection only checked Safe and Well-led.
This was an unannounced focused inspection on 7 and 8 March 2023. Inspectors spoke with people, relatives, staff and health and social care professionals. They checked care records, medicines, staffing, recruitment, safety checks and management records.
The home was rated Good for Safe and Well-led. Inspectors found people were protected from harm, received medicines safely and lived in a clean environment. They also found that care plans, records and quality checks were effective.
Some relatives and staff said there were not always enough staff, although inspectors saw enough staff during the visit and rotas showed sufficient cover. Some fire safety work was still being completed, but essential issues had been addressed and inspectors were satisfied people were safe.
The overall rating improved from Requires Improvement at the last inspection. This change was based on this focused inspection and the other ratings carried over from the previous inspection.
Kind and safe care
People received safe care from kind staff. Relatives said they felt confident that their family members were safe.
“People received safe care from kind and caring staff.” from the report
Safe medicines
Staff were trained to give medicines and their practice was checked. Controlled medicines were handled according to strict procedures.
“Staff were suitably trained to administer medicines and checks on their practice had been carried out.” from the report
Strong management checks
The home had established systems for checking care quality, records and safety. Managers had identified and dealt with issues before the inspection.
“Quality assurance systems, audits and checks were robust and embedded within the service.” from the report
Improved leadership
People, relatives and staff were generally positive about the management team. Staff said the new manager had brought greater stability.
“Staff felt valued and enjoyed working at the home.” from the report
Clean environment and infection control
The home and equipment checked were clean. Visiting and infection control arrangements were considered safe.
“At this inspection, all of the items we checked were clean.” from the report
Staffing concerns raised
needs fixingSome relatives and staff said there were not always enough staff. Inspectors did not see a shortage during the visit and rotas showed sufficient staff had been planned.
“Some relatives and staff members told us there weren't always enough staff available to support people appropriately.” from the report
Remaining fire safety work
minorAn external fire safety review had identified some items needing attention. Essential issues had been dealt with, but other work was still being completed.
“Some items that required attention were still in the process of completion.” from the report
- 01How many staff are planned for each shift now, and how do you respond when staffing levels fall short?
- 02What fire safety actions were still outstanding after the inspection, and have they now been completed?
- 03What were the ratings for Effective, Caring and Responsive at the previous inspection?
- 04How are medicines training and staff competency checks kept up to date?
- 05How do you record and share lessons when accidents, incidents or safeguarding concerns happen?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive carried over from the last comprehensive inspection. This explanation was written from the published report of 18 March 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, April 2022
Requires Improvement; inspectors found safer care and better leadership, but infection-control and management follow-through still need work.
This was an unannounced, focused inspection on 17 March 2022. Inspectors checked Safe and Well-led, spoke with people, relatives, staff and professionals, and reviewed care, medicine, recruitment and management records.
There had been clear improvement since the previous inspection. Risks were assessed, medicines were managed safely, staffing was sufficient and accidents were reviewed. People and relatives said they felt safe and had seen improvements in care.
The home still needed to improve its cleaning systems and ensure staff used masks correctly. Managers identified problems more effectively than before, but staff did not always complete the necessary actions. The overall rating and both inspected areas were Requires Improvement.
The previous overall rating was Inadequate and the home had been in Special Measures. It was no longer in breach of regulations and was no longer in Special Measures after this inspection, but CQC said it would continue to monitor progress.
Risk management
Staff assessed people's risks accurately and responded promptly when health or care needs changed. Records showed regular monitoring and appropriate referrals.
“Risks to people's health, safety and well-being were appropriately assessed and managed by staff in order to reduce the risk of harm.” from the report
Medicines
Medicines were administered in line with instructions. Staff had regular competency checks and medicine areas were clean and organised.
“Medicines were managed and administered safely in line with best practice and prescriber instructions.” from the report
Staffing and safeguarding
There were enough staff and they were deployed so people could get help when needed. Recruitment checks and safeguarding procedures were in place.
“There were enough staff to meet people's needs. Staff were now deployed appropriately around the home to ensure people received support when requested.” from the report
Improved teamwork
Staff and relatives described better teamwork and visible management since the previous inspection. External professionals also reported improved care planning and support.
“These changes had been instrumental in the improvements made to the service.” from the report
Cleaning was not consistent
needs fixingSome wheelchairs and communal chairs were unclean, despite records showing that cleaning was needed. Cleaning schedules also did not clearly cover communal areas and high-touch surfaces.
“However, some equipment such as wheelchairs and communal chairs were found to be unclean.” from the report
Mask use
needs fixingSome staff were not following the correct guidance for wearing masks. The provider's existing disciplinary process had not made compliance reliable.
“Some staff were observed not following correct guidance in the use of masks.” from the report
Actions were not always completed
needs fixingQuality systems were better at finding problems, but staff did not always carry out the actions needed to put them right.
“However, further improvements were needed to ensure staff took necessary action; such as completing required cleaning tasks and following correct usage of PPE.” from the report
Management communication
minorRelatives received updates about individual care but said communication from managers about the home itself was not good enough.
“Family members told us that whilst they received regular updates from staff about their relatives' care, they felt improvements were needed in relation to communication and engagement from managers about the service.” from the report
No registered manager
needs fixingThere was no registered manager in post at the inspection. The provider had begun recruiting a replacement after the previous manager resigned.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01What has been done to make sure wheelchairs, communal chairs and high-touch surfaces are cleaned as often as required?
- 02How do you check that all staff follow the correct mask and PPE guidance?
- 03Who is managing the home while there is no registered manager, and when do you expect a replacement to be in post?
- 04How will relatives receive timely information about issues and changes affecting the home?
- 05What actions from this inspection have been completed, and how can families see evidence that they remain effective?
This was an unannounced focused inspection of Safe and Well-led; the other key-question ratings were carried forward from the previous inspection. This explanation was written from the published report of 28 April 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 Nursing and Residential Care Centre
6 rated inspections over 6 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Old Vicarage Nursing and Residential Care Centre →
- April 2022Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at The Old Vicarage Nursing and Residential Care Centre →
- September 2021Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- January 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- December 2018Goodstayed GoodSafe: GoodWell-led: Requires improvement
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Report published without a new overall rating.
- September 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- May 2013
Registered with the Care Quality Commission on 28 May 2013.
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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