The Old Vicarage

Updated 11 December 2018

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 comprehensive inspection was carried out on 23 and 26 October 2018. The first day of the inspection was unannounced; the inspection team consisted of one adult social care inspector, and an expert by experience. An expert by experience is a person who has experience of using, or caring for someone using, this type of service. The second day of the inspection was announced and completed by one adult social care inspector.

We reviewed all information the Care Quality Commission (CQC) held about the service before the inspection. This included all contacts about the home, previous inspection reports and notifications sent to us. A notification is information about important events which the service is required to tell us about by law. We also reviewed the Provider Information Return. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We met the majority of people who lived at the home and spoke with seven to gain their views about the service. We also spoke with three relatives to ask for their views.

We met with both registered managers, the business and premises manager, deputy manager, care co-ordinator, senior care staff, care staff, housekeeping staff, the catering manager and the office manager.

We looked at three people's care records and five people’s medicine records. We looked at quality monitoring information such as health and safety checks, cleaning schedules and audits. We also looked at three staff records, which included training, supervision and appraisals and staff rotas. We sought feedback from commissioners, and health and social care professionals who regularly visited the home and received a response from two of them.

Updated 11 December 2018

This comprehensive inspection of the Old Vicarage took place on 23 and 26 October 2018. The inspection was unannounced. This meant that the provider and staff did not know we were coming. The second day of the inspection was announced.

The Old Vicarage is a care home providing personal care to a maximum of 26 older people. The home is a detached house located in the small village of Otterton situated in the coastal area of East Devon, mid-way between Sidmouth and Budleigh Salterton. On the first day of the inspection there were 22 people staying at the service. One person was staying at the service for a period of respite (planned or emergency temporary care provided to people who require short term support).

The Old Vicarage is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate 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 service remained Good overall, with one key question now being rated as ‘Outstanding’. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. Some parts of this inspection report are written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

The service provided people with exceptional care and support from staff who valued them as individuals. Staff were highly motivated to ensure people received care which was compassionate, friendly and kind. They treated people with respect and dignity. There was a friendly atmosphere at the home and a strong ethos from all staff regarding it being a family and people’s home. The registered managers and staff daily went above and beyond what was required to support people. We were told numerous incidences where this had been the case. The registered managers and staff were committed to ensuring people experienced end of life care in an individualised and dignified way.

People remained safe at the service. People said they felt safe and cared for in the home. People were protected because staff knew how to recognise signs of potential abuse and how to report suspected abuse. People’s care needs were assessed before admission to the home and these were reviewed on a regular basis. Risk assessments were undertaken for all people to ensure their individual health needs were identified and met.

People were protected from unsafe and unsuitable premises. Risks for people were reduced by an effective system to assess and monitor the health and safety risks at the home. The home had a pleasant homely atmosphere with no unpleasant odours and was very clean throughout. The furnishings were of a good quality and in good condition.

The service has two registered managers. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. Since our last inspection the provider had recruited a second registered manager to work alongside and support the registered manager who is one of the directors.

The service was well led by the registered managers. The culture was open and promoted person centred values. People, relatives and staff views were sought and taken into account in how the service was run. There were effective systems in place to monitor the quality of care provided. The registered managers made continuous changes and improvements in response to their findings.

There were sufficient and suitable staff to keep people safe and meet their needs. Thorough recruitment checks were carried out. New staff received an induction that gave them the skills and confidence to carry out their role and responsibilities effectively. People received effective care from skilled and experienced staff, who had regular training and supervision.

People enjoyed a varied and nutritious diet. There was a designated activity staff member to support people to engage in activities they were interested in, on an individual and group basis. There were regular outings to places of interest.

People knew how to make a complaint if necessary. They said if they had a concern or complaint they would feel happy to raise it with the management team.

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.

People were supported to lead a healthy lifestyle and have access to healthcare services. Staff recognised any deterioration in people's health, sought professional advice appropriately and followed it. People received their medicines on time and in a safe way.

Further information is in the detailed findings below.