CQC report explained · a residential care home
What the CQC found at Vinegar House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable risk assessments, safe medicines arrangements and good infection control. One safeguarding event had not been shared with CQC.
- Effective?
- Good
- Care plans reflected people's needs, choices and goals. Staff supported people with food, healthcare appointments, independence and decisions about their care.
- Caring?
- Good
- People said staff were kind and respectful. Inspectors saw people being treated with dignity and supported to express their views.
- Responsive?
- Good
- Care was personalised and included support with daily routines, activities, education, volunteering and communication needs. People knew how to complain and there had been no complaints in the previous 12 months.
- Well-led?
- Requires improvement
- Management understood its responsibilities and people and staff gave positive feedback. However, quality checks had missed incomplete records, an unreported safeguarding event and electrical testing that had not been completed since 2011.
What inspectors found, October 2019
Vinegar House was rated Good overall; inspectors found kind, personalised care, but leadership and safety checks needed improvement.
This was an unannounced inspection on 19 September 2019. One inspector spoke with three people, four staff members and the manager. They reviewed care records for three people, staff records and other records about how the home was run.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicines practice, personalised care plans, support with health appointments, respectful staff and activities that helped people build confidence and independence.
Well-led was rated Requires Improvement. The home had not always reported safeguarding events correctly, supervision and staff discussions were not always recorded, and electrical fixed-wire testing had not been completed since 2011. The quality checks had not identified these issues.
The overall rating was Good. This means the main areas inspected were meeting the required standard overall, but the weaker well-led rating shows that management systems needed to become more reliable. The Safe rating had improved from Requires Improvement at the previous inspection, while Well-led had fallen from Good.
People felt safe
People told inspectors that the home and staff made them feel safe and secure. Risk assessments were reviewed and updated to reflect changing needs.
“People told us the service and staff made them feel safe and secure.” from the report
Kind and respectful staff
People described staff positively, and inspectors saw respectful and compassionate interactions. People were supported with privacy, dignity and independence.
“People told us the staff were lovely. One person said, "You could not ask for a better bunch of staff, they are a god send.” from the report
Personalised support
Care records included people's goals, preferences and support needs. Staff helped people develop confidence, living skills and healthier routines.
“Individual needs and wishes were incorporated into their recovery plans.” from the report
Safe medicines practice
Staff had medicine training and were checked on their competence. Inspectors found the medication records they reviewed were completed correctly.
“Medication administration records we looked at were completed correctly with PRN protocols in place.” from the report
Support for independence
People were encouraged to take part in activities, education, volunteering and everyday tasks. The report recorded that three people had moved on from the home in the previous 12 months.
“The providers information record told us there had been three people move on in the last 12 months.” from the report
Electrical testing was overdue
seriousElectrical fixed-wire testing had not been completed since 2011. Inspectors said this created a risk that the wires might not be safe.
“We also found the electrical fixed wire testing had not been completed since 2011.” from the report
A safeguarding event was not reported to CQC
needs fixingThe report says one safeguarding event had not been shared with CQC. The manager described this as an oversight and said the process would be updated.
“We noted one safeguarding had not been shared with CQC.” from the report
Staff meetings and supervision were not always recorded
needs fixingSupervision, handovers and informal staff discussions were not always recorded. Inspectors treated this as a recording issue, but the quality checks had not identified it.
“Supervision took place, but not always recorded.” from the report
Quality checks missed problems
needs fixingThe home's monitoring systems did not identify the concerns found during inspection. Management said it would review its processes and procedures.
“The quality auditing process had not identified issues we found.” from the report
- 01Has the electrical fixed-wire testing been completed, and what did the results show?
- 02What changes have been made to ensure every safeguarding event is reported to CQC when required?
- 03How are staff supervision, handovers and informal discussions now recorded and checked?
- 04How does management make sure its quality audits identify problems before an inspection?
- 05What evidence can you provide that the improvements promised after this inspection have been completed?
This was an unannounced planned inspection covering all five CQC questions; the report says CQC only inspects where people receive personal care, and not everyone at the home received it. This explanation was written from the published report of 24 October 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, November 2016
Rated Good overall; inspectors found kind, responsive care, but safety checks and risk information needed improvement.
This was an unannounced inspection on 18 and 19 October 2016. Inspectors spoke with six people living at the home, one relative and several staff. They also checked care records, medicines, staff training, recruitment records and quality checks.
People said they felt safe, liked the staff and received medicines on time. Inspectors found caring staff, enough staff on duty, good support with food and drinks, access to health services, and activities chosen by residents.
The overall rating was Good. However, Safe was rated Requires Improvement because some risk assessments lacked important detail, recruitment checks were not fully robust, some medicines instructions lacked authorisation, and not all safety systems or audits were checked regularly.
Kind and respectful staff
People spoke positively about staff, and inspectors saw friendly, supportive interactions. Staff respected privacy, dignity and people's choices.
“We saw many positive interactions as staff provided support to people and having ordinary everyday conversations and joking with people.” from the report
Enough staff
People and staff said staffing levels were sufficient. Staff numbers were adjusted around people's community activities.
“There were sufficient numbers of staff to ensure that people's needs were responded to in good time.” from the report
Food and drinks
People liked the food and could have an alternative meal. Drinks and food between meals were available, and people could make their own drinks.
“Everyone said that drinks were available at any time.” from the report
Support with health needs
Staff helped people attend appointments and referred people to health professionals when needed. Inspectors found examples of prompt action after an injury.
“There was also evidence that staff had quickly referred people to healthcare professionals if they had an injury following an accident.” from the report
Risk information was incomplete
seriousSome risk assessments did not give staff enough specific guidance to manage risks safely, including behaviour that challenged the service.
“Not all risk assessments contained enough detail to protect people's safety.” from the report
Recruitment checks were not fully independent
needs fixingMost recruitment checks were in place, but one reference came from a former line manager who was also a current assistant manager. Inspectors considered this a possible conflict of interest.
“However, we found a staff member with a reference from a current assistant manager, who was formerly the person's line manager in the past.” from the report
Some medicine instructions lacked authorisation
seriousInstructions for some as-needed medicines had not been signed by the prescriber. The manager said this would be followed up.
“However, this record had not been signed by the prescriber, who would be the GP or consultant.” from the report
Safety and quality audits were incomplete
needs fixingEmergency lighting and fire bells had not all been checked regularly. There were also no audits for several important areas, including infection control and staffing levels.
“However, we saw no audits in place regarding issues such relevant issues such as staff recruitment, food hygiene, infection control and staffing levels.” from the report
- 01What specific guidance is now in place for each resident's identified risks, including behaviour that may challenge the service?
- 02How do you ensure every as-needed medicine protocol is signed and authorised by the prescriber?
- 03How are staff references checked to make sure they are independent and suitable?
- 04Which audits are now completed for recruitment, food hygiene, infection control, staffing levels, emergency lighting and fire bells?
- 05How do you record and tell residents what action has been taken after issues are raised at residents' meetings?
This was an unannounced inspection of all five quality areas and the overall service, including care records for three people, medicines, staff records, training, recruitment and quality audits. This explanation was written from the published report of 29 November 2016 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 Vinegar House
2 rated inspections over 3 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- August 2012
Registered with the Care Quality Commission on 30 August 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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