CQC report explained · a nursing home
What the CQC found at Vicarage Farm Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People were generally protected from abuse and avoidable harm, and there were enough staff. However, inspectors found shortfalls in stair safety, repositioning records and some medicines processes, although the home took immediate action.
- Effective?
- Good
- People's needs were assessed and care was planned around their wishes. Staff were trained and supported, people received suitable food and healthcare, and consent and legal safeguards were managed appropriately.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff offered choices, understood people's preferences and supported cultural, religious and personal needs.
- Responsive?
- Good
- Care plans were detailed and personalised. People had activities, support with communication and end of life plans, and complaints were investigated and acted on.
- Well-led?
- Good
- The provider had effective checks on care quality and acted on issues found. Management communicated with staff, relatives and healthcare professionals and had improved since the previous inspection.
What inspectors found, October 2022
Rated Good overall; inspectors found kind, personalised care, but the Safe rating remained Requires Improvement because some medicines and safety records needed fixing.
This was an unannounced follow-up inspection on 20 September 2022. Inspectors spoke with people, relatives, staff and health professionals. They observed care, checked nine care records, medicines, staffing, infection control, complaints, accidents and quality checks.
The home was clean and had enough permanent staff. People generally received their medicines safely and as prescribed. However, inspectors found problems with blood sugar monitoring equipment, recording topical medicines, changing the sites of medicine patches, stair access and repositioning records. The home acted immediately, including installing keypads and improving its recording system.
People and relatives were positive about the care. Inspectors found staff kind, respectful and familiar with people's needs. Care plans were detailed, activities were available, and people had access to healthcare. The home had improved since the November 2020 inspection and was no longer in breach of regulations.
Kind and respectful care
People and relatives described staff as kind and respectful. Inspectors saw staff reassure people and adapt their approach to individual needs.
“People were treated kindly and respectfully.” from the report
Personalised care
Care plans included people's life histories, preferences, communication needs and future wishes. Staff knew people well and used this information in daily care.
“They contained people's life history which contained details about their childhood, family members, hobbies and interests.” from the report
Staffing and training
Inspectors found enough suitable permanent staff. Staff had inductions, regular training, supervision and appraisals.
“There were enough staff on duty at any one time to meet the needs of people who used the service.” from the report
Activities and social life
People were offered varied activities and were involved in choosing them. The home supported personal interests, outdoor activities and relationships with the local community.
“People were supported to undertake activities they liked, and these were recorded in their care plans.” from the report
Improved oversight
The provider had strengthened its audits and acted when problems were found. The home was no longer in breach of the regulations identified at the previous inspection.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Medicine processes
needs fixingInspectors found that blood sugar monitoring equipment was not always managed as instructed. Topical medicines and medicine patches were not always recorded or used correctly, although the provider acted immediately.
“Staff did not always record the use of topical medicines appropriately.” from the report
Safety records
needs fixingRepositioning charts for a person with pressure ulcers were not always completed regularly or clearly. The home introduced a stronger system and said it would monitor this closely.
“However, recording on repositioning charts was not always regular or clear.” from the report
Stair access
seriousAt the time of the inspection, people could reach the stairs through an unlocked fire door and there was no keypad at the bottom. Keypads were installed on both doors the following day.
“Access to the stairs was through an unlocked fire door in both instances.” from the report
- 01What checks now show that topical medicines and transdermal patches are being recorded and used correctly?
- 02How do you check that blood sugar monitoring equipment is managed according to the manufacturer's instructions?
- 03How are repositioning records checked, particularly for people at risk of pressure ulcers?
- 04Have the new stair keypads remained in place and how is access to the stairs monitored?
- 05What improvements were made after the previous inspection, and how are they being kept in place?
This was an unannounced follow-up inspection focused on action from the previous inspection and infection prevention and control under Safe; the other key question ratings were also reported. This explanation was written from the published report of 26 October 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.
What inspectors found, December 2020
Rated Requires Improvement; inspectors found kind, personalised care but weaknesses in safety checks, risk management and records.
The inspection was unannounced and took place over 17 and 18 November 2020. Inspectors spoke with people, relatives and staff, observed care, and checked care records, complaints, incidents, audits, medicines and recruitment records.
The home was rated Requires Improvement overall. Safety and leadership were both Requires Improvement. Inspectors found that accidents and incidents were not always properly investigated, some risks were not fully assessed or managed, and some care records were incomplete or inaccurate.
There were also positive findings. People said they were happy with their care, staff were kind and knew people well, medicines were managed safely, and activities were varied. The Responsive rating was Good.
The home had been rated Good at the previous inspection, published in June 2018. The provider was told to make improvements and submit an action plan. CQC said it would monitor progress and return under its reinspection programme.
Kind and personalised care
People and relatives were positive about the care. Staff were described as kind, attentive and familiar with people's needs and preferences.
“People using the service were happy with the care they received. The staff were kind, polite and knew them well.” from the report
Medicines managed safely
Inspectors found suitable systems for ordering, storing, administering and checking medicines. The records reviewed showed no unexplained omitted doses.
“People received their medicines in a safe way and as prescribed.” from the report
Activities and relationships
The home offered a varied programme of group and individual activities, including events linked to people's interests, religion and culture.
“There was a range of different activities and social events for people living at the home.” from the report
Infection control
The home had infection prevention systems that had been updated during the COVID-19 pandemic. Inspectors found the environment clean and hygienic and saw staff using protective equipment.
“There were suitable systems for the prevention and control of infection.” from the report
Incidents were not properly reviewed
seriousRecords of falls and other incidents often lacked detail about what caused them. This meant the home could not reliably identify patterns or change care to reduce repeat incidents.
“The staff did not always assess accidents and incidents.” from the report
Risks were not always controlled
seriousInspectors found examples involving falls, bed rails and aggression where risks had not been fully assessed or managed. One bed could not be lowered and this had not been reported.
“Not all the risks to people's safety and wellbeing had been identified, assessed or managed.” from the report
Care records were incomplete
seriousSome records did not accurately show the care provided or the risks staff needed to manage. Inspectors also found an incorrectly completed resuscitation form, which was removed after it was identified.
“Some records used to describe people's needs and how they had been cared for were not complete and did not provide enough information about their care and safety.” from the report
Complaint responses were not always timely
needs fixingThe home investigated complaints, but it did not always update people promptly or fully acknowledge the concerns raised.
“However, the provider had not always given timely feedback about their actions to people who raised concerns.” from the report
- 01What changes have you made to investigate falls, aggression and other incidents, and can you show how you check that lessons are acted on?
- 02How do you now assess and manage the risk of people falling from beds or climbing over bed rails?
- 03How do you make sure care plans, risk assessments, catheter records and resuscitation decisions are accurate and kept up to date?
- 04How quickly will you update relatives after a concern or complaint, and how will you show that all points have been answered?
- 05What evidence can you provide that the improvements required after this inspection have been completed?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected, and ratings from previous comprehensive inspections were used for the other key questions. This explanation was written from the published report of 17 December 2020 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 Vicarage Farm Nursing Home
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- October 2022Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2020Requires improvementdown from GoodSafe: Requires improvementResponsive: GoodWell-led: Requires improvement
- June 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- August 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2012
Registered with the Care Quality Commission on 16 October 2012.
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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