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
- Inspectors found effective risk assessments, enough staff, safe recruitment and safe medicines systems. Some wooden surfaces needed re-varnishing and bathroom light pulls needed covers to support effective cleaning.
- Effective?
- Good
- This key question was not inspected during this focused visit. The report says ratings for key questions not inspected were carried over from the last inspection.
- Caring?
- Good
- This key question was not inspected during this focused visit. The report says ratings for key questions not inspected were carried over from the last inspection.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The report says ratings for key questions not inspected were carried over from the last inspection.
- Well-led?
- Good
- Inspectors found effective audits, open communication, positive feedback from professionals and a culture of improvement. The home reported significant incidents to the CQC as required.
What inspectors found, May 2023
The Old Vicarage was rated Good; inspectors found safe, kind care, with minor infection-control improvements made during the visit.
This was a focused inspection on 20 and 25 April 2023. Inspectors looked at whether the home was safe and well-led, after concerns about poor staff conduct. One inspector visited, with the first day unannounced.
The home supported nine people with mental health conditions, learning disabilities and/or autism. Inspectors spoke with people, a family member, staff and healthcare professionals. They reviewed care plans, medicines records, recruitment files, incident records, complaints, training and management checks.
The home was rated Good for Safe and Well-led. Inspectors found safe recruitment, enough staff, safe medicines systems, good risk planning and effective management oversight. They found some wooden surfaces and bathroom light pulls needed attention for infection control, and the home took action during the inspection.
The overall rating remained Good. The previous overall rating was Good, published in August 2019. This inspection did not assess Effective, Caring or Responsive, so those areas were not newly judged.
Clear risk planning
Risk assessments were updated and gave staff clear guidance. People were involved in managing their own safety where possible.
“Risk assessments were updated and clear guidelines in place to guide staff as to how to support people.” from the report
Safe medicines
Medicines were ordered, stored, administered and checked safely. Staff had training and regular competency checks.
“People received their medicines safely. They were ordered, received, stored, and administered appropriately.” from the report
Kind and respectful care
People were supported by staff who knew them well and used positive, respectful language.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Activities and choice
People were supported to take part in activities and social interests they had chosen.
“People were supported to participate in their chosen social and leisure interests on a regular basis.” from the report
Effective oversight
Management checks and audits identified areas for improvement. The report also found a culture where suggestions were listened to and acted on.
“Regular governance checks and audits were conducted by staff at the home and the provider, and these were effective at identifying where improvements could be made.” from the report
Infection-control surfaces
needs fixingSome wooden surfaces needed re-varnishing and bathroom light pulls were not covered, making effective cleaning and disinfection harder. The home ordered covers and arranged for the woodwork to be varnished during the inspection.
“We found some wooden surfaces needed re-varnishing to ensure effective cleaning and disinfection could be carried out.” from the report
- 01Have all the wooden surfaces been re-varnished, and how do you now check that they can be cleaned and disinfected properly?
- 02Have covers been fitted to all bathroom light pulls?
- 03What action did you take in response to the concerns about poor staff conduct?
- 04How do you make sure staffing levels and one-to-one time continue to match each person's needs?
- 05What were the ratings for Effective, Caring and Responsive at the last comprehensive inspection?
This was a focused inspection of Safe and Well-led after concerns about staff conduct; Effective, Caring and Responsive were not inspected and their ratings were carried over from the previous inspection. This explanation was written from the published report of 16 May 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 2019
The Old Vicarage was rated Good overall, but inspectors found staffing and support planning needed improvement to keep care consistently safe.
The inspection took place on 13 August 2019. One inspector spoke with five people, two relatives and seven staff. They also checked care records, medicines records, recruitment, training and management records.
The home was rated Good overall. Effective, caring, responsive and well-led were all rated Good. Safe was rated Requires Improvement, which means some aspects of care were not always safe.
People and relatives generally said they felt safe and were positive about staff. Inspectors found caring relationships, personalised support, community activities and good involvement in decisions.
Inspectors found that staffing was not always flexible enough around people's needs. They also identified improvements needed in behaviour support plans, recording incidents, documenting restraint and some record-keeping. The previous overall rating was Good, published in March 2017.
Kind relationships
Inspectors found warm and caring relationships between people and staff. Relatives were positive about the support and said staff knew their family members well.
“We observed warm, caring interactions between people using the service and staff.” from the report
Personalised support
Care plans included people's backgrounds, support needs and life goals. Staff understood how to help people work towards larger goals in smaller steps.
“People's care plans gave information about individual support needs, backgrounds and life goals, to guide staff.” from the report
Choice and community life
People chose activities and trips, maintained important relationships and took part in local church, shop and pub activities.
“People actively took part in church activities and regularly visited the local shop, as well as the pub.” from the report
Involvement in decisions
People and families were involved in planning and reviewing care. Staff sought consent and supported people to make choices.
“People and their families were involved in decisions over care, as well as the planning and review of it.” from the report
Staffing flexibility
needs fixingStaffing problems sometimes meant people had to wait to go out, and the service relied at times on staff working longer hours or extra shifts. Inspectors recommended a review of recruitment, planning and deployment.
“At times, staffing issues had meant that people needed to wait to go out, for example if required staff were not available until the afternoon.” from the report
Behaviour support and restraint records
needs fixingBehaviour support plans needed to become more proactive. Inspectors also found that restraint was not always clearly supported by relevant risk assessments.
“We also identified that the use of restraint was not always clearly supported by relevant risk assessments.” from the report
Incident recording
needs fixingInspectors said incidents and debriefs needed to be recorded more robustly. The manager changed the incident forms after the inspection.
“We discussed the need to robustly record incidents and debriefs to reflect and prevent occurrence, as well as reducing need for restraint-based interventions.” from the report
Incomplete end-of-life planning
minorSome people's advance wishes were recorded, but the manager was still developing these plans for everyone.
“Some "When I die" end of life plans were in place detailing people's advanced wishes.” from the report
- 01How do you make sure there are enough suitably experienced staff when people want to go out?
- 02How are new staff being supported to learn each person's specialist support needs?
- 03How have behaviour support plans been changed to provide more proactive support?
- 04How do you record, review and learn from incidents, debriefs and any use of restraint?
- 05Does every person now have an end-of-life plan that records their wishes?
This was a planned inspection covering all five key questions, but inspectors reviewed a smaller number of records because they were checking whether the previous Good rating had been maintained. This explanation was written from the published report of 29 August 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
3 rated inspections over 6 years: the service has held its Good rating throughout.
- May 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2019Goodstayed GoodSafe: Requires improvementWell-led: Good
- March 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015
Registered with the Care Quality Commission on 30 July 2015.
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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