Archived: The Old Rectory

Updated 8 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on 3 and 5 December 2018. It was carried out by one inspector and one inspector manager on day one and one inspector on day two.

Before the inspection, we requested and received a Provider Information Return (PIR) from the service. This is a form that asks the provider to give some key information about the service, what the service does and improvements they plan to make. We reviewed this information and in addition looked at notifications which the service had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We also spoke with the local authority quality improvement team to obtain their views about the service.

We spoke with six people and seven relatives. We also spoke with the registered manager, the cook, activity lead, domestic staff and six care workers. We looked at six care records, four Medicine Administration Records (MAR) and spoke with three healthcare professionals including a nurse practitioner, GP and district nurse.

We looked around the service and observed care practices throughout the inspection. We saw three weeks of the staffing rota and the staff training records, and other information about the management of the service. This included accidents and incidents information, medication records, compliments and complaints, equipment checks and quality assurance audits.

We used the Short Observational Framework for Inspection (SOFI). This is a way of observing care to help us understand the experience of people who could not talk with us.

We asked for information to be sent to us following the inspection which was received.

Updated 8 January 2019

This unannounced inspection took place on 3 and 5 December 2018.

The Old Rectory provides accommodation and personal care for up to 25 people. There were 19 people living in the home at the time of our visit, some of whom were living with dementia.

The Old Rectory is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe. They were supported by staff who demonstrated a good understanding of how to safeguard people from experiencing harm or abuse. People had personalised risk assessments which helped minimise risks to their health and well-being.

There were enough staff to meet people’s needs and respond flexibly. Recruitment checks were in place and demonstrated that staff employed had satisfactory skills and knowledge needed to care for people. This included carrying out checks to make sure they were safe to work with vulnerable adults.

Medicines were managed safely, and people got their prescribed medicines on time and at the correct dosage. Accidents and incidents were reported, investigated and the learning shared with the staff to reduce the chance of them happening again.

People had thorough pre-assessments which supported their move to the home and identified their needs, abilities and achievable outcomes. Staff received training and received an induction on starting. Staff had supervision which was used as an opportunity to reflect on practice, performance issues and discuss career aspirations.

People were supported to eat a well-balanced diet and could choose from a variety of fresh foods on offer. Where people required extra support at meal times this was provided in line with guidance from health professionals.

People were supported to attend appointments to maintain their health and well-being. Where people’s health needs changed there was timely contact with relevant health professionals such as GP, chiropodists and district nurses.

The home was decorated in a way that gave it a homely feel and people liked this. People could move around the home freely and could enjoy spending time with those important to them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people lacked capacity to make particular decisions they were supported by staff who were trained and worked in line with the principles of the Mental Capacity Act 2005.

People were supported by staff who were consistently kind, caring and attentive. Staff knew people and their relatives well which supported natural, easy conversation. People told us they were supported and encouraged to express their views about the care they received and could live their lives how they wished to live them. People’s privacy and dignity was supported.

People’s care plans were personalised and regularly updated. They included details of people’s communication needs and preferences.

There was a wide range of activities supported at the home and in the local community. People had choice about what they participated in and could feedback their thoughts on the activities programme during the resident and relatives’ meetings.

Complaints were acknowledged, investigated and resolved in line with the provider’s policy. Staff were trained to support people at the end stages of their life and had a good understanding of how to maximise a person’s comfort at this time.

The home was well led. There was an open and inclusive culture where everybody’s views were sought and considered. Annual surveys were used to find out where people, relatives and staff thought improvements could be made. The home had developed good working relationships with healthcare professionals.

Further information is in the detailed findings below