CQC report explained · a residential care home
What the CQC found at The Vicarage
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and risks were assessed and reviewed. Staffing levels were adjusted to people's needs, medicines were managed safely and the home was clean.
- Effective?
- Good
- Staff were trained and supported, and worked with health professionals. People received suitable food and support with eating, drinking, health care and communication.
- Caring?
- Good
- Staff were kind, compassionate and respectful. People were supported to make choices, keep their privacy and develop their independence.
- Responsive?
- Good
- Care plans reflected people's needs, routines, preferences and communication methods. People could take part in activities, access the community and raise concerns through an accessible complaints process.
- Well-led?
- Good
- Managers and staff were described as approachable and caring. Audits, feedback and partnership working were used to monitor and improve the service.
What inspectors found, November 2019
Rated Good; inspectors found safe, kind and personalised care, with all five areas rated Good.
This was an unannounced planned inspection on 22 October 2019. One inspector spoke with people, relatives, staff and health professionals. They observed care and checked care plans, medicine records, staff files and management records.
The home provides short respite stays for up to five adults with learning and/or physical disabilities. Inspectors found that people felt safe, received their medicines correctly and were supported by trained staff who knew their needs.
People were treated with kindness, dignity and respect. Staff supported choice, independence, communication and activities. The home worked with relatives and health professionals to provide consistent care.
The overall rating was Good, and each of the five areas was also rated Good. This was unchanged from the previous inspection, published on 18 May 2017.
Familiar staff
The home had a stable staff team. Inspectors found that familiar staff helped reduce people's anxiety during respite stays.
“People were supported by a stable staff team which helped to reduce people's anxieties when they stayed at The Vicarage as the staff team were known to them.” from the report
Safe medicines
Medicine storage, checking and records were found to be safe. Staff were trained and their practice was assessed regularly.
“People's medicines were stored and managed in line with best practice and guidelines.” from the report
Kind and respectful care
Staff understood people well and treated them with kindness, dignity and respect. They adapted how they communicated and encouraged independence.
“Staff had developed strong relationships with people and their relatives and gained a good understanding of their needs and preferences.” from the report
Personalised support
Care plans included people's routines, preferences, communication methods, health needs and interests. People were supported to choose activities and access the community.
“People's care plans reflected people's support requirements as well their eating and drinking needs, medicines support and other day to day activities.” from the report
Good management
The managers used audits and feedback to monitor quality. Relatives and professionals expressed confidence in the management and staff team.
“Comprehensive audit systems were used to monitor the safety and quality of the care being delivered and the home's environment and equipment.” from the report
Oral health plans still developing
minorThe home said it would introduce more detailed oral health care plans after staff completed specialist training. Families should ask whether this work has now been completed.
“We were told that oral care health plans would be implemented after staff had received specialist training in oral health care.” from the report
End of life arrangements
minorNo one needed end of life care during the inspection. The managers were developing systems and planned further staff training, but said they would not normally provide care at the final stages of life.
“The managers had undertaken a palliative awareness course and were making progress in developing systems and had plans to train staff to support people in end of life care if required.” from the report
- 01Have the personalised oral health care plans now been completed, and how will staff support my relative with mouth care?
- 02How would you manage my relative's specific health risks, such as epilepsy, swallowing difficulties, choking or changes in behaviour?
- 03Which staff would usually support my relative, and how would you provide familiar staff if extra cover was needed?
- 04How would you respond if my relative became seriously unwell during a respite stay, including decisions about end of life care?
- 05How would my relative communicate choices, worries or complaints if they cannot communicate easily using speech?
This was an unannounced comprehensive inspection covering all five key questions, and the home and the care provided were both looked at. This explanation was written from the published report of 15 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.
What inspectors found, May 2017
Rated Good; inspectors found kind, personalised respite care, with some records not always complete.
This was an unannounced comprehensive inspection on 21 and 25 April 2017. Inspectors observed care, looked at records and staffing checks, and spoke with staff, relatives, carers, and health and social care professionals. Three people were staying at the home.
The home provides short-term respite breaks for up to five adults with learning disabilities and/or physical disabilities. Inspectors found that people received individual care, were treated with dignity, and were supported to make choices and remain as independent as possible. Staff supported people's health, dietary needs, medicines and activities.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. It was also rated Good at the previous inspection in July 2014, so the overall rating remained Good. Inspectors found some gaps in recording, but the report says managers took prompt action on some issues.
Personalised care
Care reflected people's preferences, routines and wishes. Staff encouraged people to make choices and be as independent as possible.
“People received individualised care which reflected their personal preferences, wishes and routines.” from the report
Kind and respectful staff
Inspectors saw warm exchanges and respectful communication. Relatives and carers also spoke positively about the care.
“We saw many warm exchanges between people and staff.” from the report
Safe medicines support
Staff responsible for medicines had training and their skills were checked. Medicines were stored and administered appropriately, with no gaps in the MAR charts.
“Medicines that had been prescribed to be used 'as required' had additional guidance in place for their use” from the report
Good health and dietary support
Staff knew people's food preferences and supported special diets and swallowing needs. They involved health professionals when people's health changed.
“People who had special dietary needs or risks around their eating and drinking were supported and catered for.” from the report
Feedback used to improve
The home sought views from people, relatives, carers and staff. Managers acted on suggestions and used monitoring systems to check the service.
“People's views were sought as part of the quality assurance process to drive through improvements to the service.” from the report
Injuries and skin markings were not always investigated in records
needs fixingBody maps recorded injuries or marks, but there was no recorded evidence that their causes had been investigated. The manager took prompt action by introducing new forms.
“there was no recorded evidence that staff had investigated the cause of the markings or injuries.” from the report
Some emotional support was missing from daily notes
needs fixingDaily records did not always describe people's mental well-being or the emotional support and reassurance staff provided.
“However some people's daily notes did not always record people's mental well-being and the support staff gave people with their emotional needs and reassurances.” from the report
Risk controls were not consistently recorded
needs fixingStaff managed people's risks, but the agreed control measures were not always written down consistently. This could make it harder to check that the planned approach was followed.
“the details of the agreed controlled measures put in place to manage their risks was not consistently recorded.” from the report
Some quality actions were not documented
minorManagers acted on shortfalls found through checks, but records did not always show that the work had been completed.
“Any shortfalls or areas of concern found in the checks were acted on but not consistently recorded to show that the work had been completed.” from the report
People's beliefs were not always explored
minorManagers recognised that people's diversity and beliefs were not always explored. They said they would consider how to support people to share these views safely.
“However they recognised that this was an area which was not always explored with people” from the report
- 01How do you now record and investigate any injuries or marks found when someone arrives for a respite stay?
- 02How do your daily notes record a person's mental well-being and any emotional support or reassurance provided?
- 03How are agreed risk-control measures recorded and checked for each person?
- 04What guidance do staff follow before giving medicines prescribed for use 'as required'?
- 05What was the outcome of the consultation about the future of the short-break services?
This was an unannounced comprehensive inspection covering all five questions, and the report says the overall rating remained Good from July 2014. This explanation was written from the published report of 18 May 2017 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 Vicarage
3 rated inspections over 5 years: the service has held its Good rating throughout.
- November 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 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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38 live-in carers within about an hour of Gloucestershire
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 £1,030 to £1,360 a week. 31 can care for a couple. 12 years' experience on average.
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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.