CQC report explained · a residential care home
What the CQC found at The Old Vicarage Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed, staff knew how to reduce harm, medicines were handled by trained staff and there were enough staff available. Infection control arrangements were also found to be effective.
- Effective?
- Good
- People had personalised care plans and staff understood their health needs and preferences. Staff received induction, training and support, and the home followed the principles of the Mental Capacity Act.
- Caring?
- Good
- This question was not inspected during this focused visit. The report used the previous rating when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. The report used the previous rating when calculating the overall rating.
- Well-led?
- Good
- The provider had improved its quality monitoring systems and used checks to identify and make improvements. People, relatives and staff were able to give feedback and felt their views were valued.
What inspectors found, January 2023
The Old Vicarage Residential Home is rated Good; inspectors found safe, effective and well-led care, with improvements since the last inspection.
This was an unannounced, focused inspection on 16 January 2023. One inspector spoke with three people and three staff members, observed care, and reviewed care plans, medicines records, quality checks and recruitment records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found enough staff, safe medicines support, suitable risk assessments, good infection control and staff who understood people's needs. People had personalised care plans, access to healthcare and support with food and drink.
The provider had improved its monitoring systems and acted on issues without delay. The last rating was Requires Improvement, published in November 2019. The overall rating is now Good, but Caring and Responsive were not inspected during this visit and their previous ratings were used.
Safe medicines support
Staff were trained and assessed as competent before giving medicines. The home also had guidance for medicines prescribed only when needed.
“Staff members were trained and assessed as competent before supporting people with their medicines.” from the report
Enough staff
Inspectors found enough staff to respond to people promptly. Call system checks showed that requests for support were answered in good time.
“People were supported by enough staff who were available to assist them in a timely way.” from the report
Personalised care
Care plans reflected people's individual needs and preferences. Staff knew how people liked to be supported, including their personal and protected characteristics.
“People had care and support plans which were personal to them and met their individual needs.” from the report
Improved management checks
The provider had strengthened checks on care plans, medicines and the environment. Inspectors found that identified improvements were put in place without delay.
“These quality checks ensured people received the care they needed and had agreed to.” from the report
Fire safety work underway
minorAt the time of the inspection, door fittings were being reinstalled to maintain compliance with fire safety advice. Ask whether this work has been completed.
“For example, the provider was reinstalling door fittings to ensure continued compliance with fire safety advice.” from the report
- 01Have the door fittings mentioned in the report now been reinstalled, and what checks confirmed that the work was complete?
- 02How do you make sure medicines prescribed only when needed are given safely and recorded correctly?
- 03How will you keep the improved checks on care plans, medicines and the building working over time?
- 04How are residents and relatives currently involved in decisions about care and changes to the service?
- 05What activities and support are currently available to meet each resident's social and personal needs?
This was an unannounced focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used for the overall rating. This explanation was written from the published report of 28 January 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, November 2019
Requires Improvement overall; inspectors found kind, responsive care, but risks, medicines records and quality checks were not always managed safely.
This was an unannounced follow-up inspection on 7 October 2019. Inspectors spoke with people, a relative, staff and managers. They observed care and checked care plans, medicines records, staff files and management checks.
The home was caring and responsive. Staff treated people with kindness, dignity and respect. People had choices, support with activities and access to health professionals. There were enough suitably recruited staff, and the home was clean.
There were important weaknesses. Staff did not always follow moving and handling plans. Medicines records had unexplained discrepancies, and care plans did not always reflect current advice or needs. Quality checks had not yet become reliable enough to identify these problems.
The overall rating remained Requires Improvement. Safe, Effective and Well-led were also Requires Improvement. Caring and Responsive improved from Requires Improvement to Good. The home was no longer in breach of the regulations breached at the previous inspection, but CQC said it would continue to monitor the service.
Kind and respectful care
Inspectors saw staff supporting people patiently and respectfully. People were helped to make choices and stay as independent as possible.
“We observed many caring interactions. For example, during lunch some people needed to be supported with their meals.” from the report
Enough staff
Inspectors found enough suitably recruited staff to support people. People did not have to wait for help.
“There were enough safely recruited staff to keep people safe.” from the report
Activities and relationships
People could take part in hobbies, visits and events. Staff were keen to develop the activities available.
“People had the opportunity to engage in hobbies and activities or their choice.” from the report
Improved caring and responsiveness
Caring and Responsive both improved from Requires Improvement to Good since the previous inspection.
“At this inspection this key question has improved to good.” from the report
Moving and handling plans were not followed
seriousStaff used a stand aid on two occasions even though the person's plan said they needed a hoist and could not bear weight. This created a risk of harm.
“Their plan indicated they needed to be hoisted as using a stand aid caused them pain and they could not weight bear.” from the report
Medicine records did not always match stock
seriousInspectors found unexplained differences between medicines held and the records. This meant people could be at risk of not receiving medicines as prescribed.
“We found another stock discrepancy of three tablets. The MAR indicated 28 tablets had been administered, so 28 tablets should be left in stock, however there were 31 in stock.” from the report
Care plans and records were not always up to date
needs fixingPlans did not always reflect advice from health professionals or people's current needs. Recording gaps meant inspectors could not always confirm that support had been provided properly.
“People had care plans in place about their health conditions, although these were not always updated when advice changed.” from the report
Quality checks had missed problems
needs fixingNew audits and monitoring systems were in place, but they had not yet become consistently effective. They failed to identify issues with medicines, moving and handling, catheter care and hand care.
“Whilst quality assurance systems had been introduced these had not yet been fully embedded to ensure they were consistently effective and sustainable.” from the report
End of life plans needed more personal detail
minorBasic plans recorded some important information, but they did not describe people's personal preferences for the final days and weeks of life. The home introduced a revised form after the inspection.
“However, these did not go into detail about people's personalised preferences for the days and weeks prior to their death and how they wished to be supported.” from the report
- 01How do you make sure each person's moving and handling plan is followed every time?
- 02What checks now confirm that medicine stock matches the records and that prescription instructions are followed?
- 03How quickly are care plans updated after advice from a GP, nurse, physiotherapist or other health professional?
- 04How do your audits identify gaps in catheter care, hand care and other daily support?
- 05What personal end of life preferences would you record for my relative?
This was an unannounced follow-up inspection after the previous inspection; the report assessed all five key questions, with Caring and Responsive improving to Good while the other three remained Requires Improvement. This explanation was written from the published report of 19 November 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.
Every inspection of The Old Vicarage Residential Home
5 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- January 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Old Vicarage Residential Home →
- November 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
Read what inspectors found at The Old Vicarage Residential Home →
- July 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2019Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2018InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2017
Registered with the Care Quality Commission on 25 February 2017.
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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