Archived: The Old Rectory

Updated 6 July 2016

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 inspection visit took place on 14 April 2016 and was unannounced. The inspection team consisted of two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise was with older people and people living with dementia.

We checked the information we held about the service and the provider. This included notifications that the provider had sent to us about incidents at the service and information we had received from the public. We also spoke with the local authority who provided us with current monitoring information. We used this information to formulate our inspection plan.

We also had a provider information return (PIR) sent to us. A PIR is a form that asks the provider to give some key information about the service. This includes what the service does well and improvements they plan to make.

We spoke with six people who used the service, three relatives, three members of care staff, the cleaner, the registered manager and the provider. We also spoke with two visiting professionals. Some people were unable to tell us their experience of their life in the home, so we observed how the staff interacted with people in communal areas.

We looked at the care plans of five people to see if they were accurate and up to date. We were unable to review any staff files as they had been taken to the company office for payroll changes to be completed. We were therefore unable to see the records about how staff were recruited and how staff were trained and supported to deliver care appropriate to meet each person’s needs. However we did speak with staff about this. We also looked at records that related to the management of the service including the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement.

Updated 6 July 2016

This inspection was unannounced and took place on 14 April 2016. The service was registered to provide accommodation for up to 26 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection 13 people were using the service.

There was a registered manager in post. 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.

At our last inspection on 18 August 2015 we asked the provider to make improvements to ensure people who used the service were protected from avoidable harm or risk of harm. This was specifically in relation to the environment. At this inspection, we found that the provider had made, and was in the process of making improvements to the home. By doing this, the risks identified previously were minimised.

We had also asked the provider to make improvements in how individuals care needs were planned and assessed. At this inspection we saw that some improvements had been made however we saw information was missing that would have assisted staff to understand and respond to people’s care needs better.

The provider had not been effective in the use of the audits to identify improvements that were needed. We asked them to make improvements so they had an effective and consistent way of analysing incidents and accidents to identify emerging trends. At this inspection we saw that some improvements had been made. However we did not see that an overall analysis of trends took place which would have brought each piece of individual information together.

People were not always supported to make choices. When they were unable to make decisions, it was not clear how the provider had acted in their best interests. The home environment lacked signage to enable people to find their way around the home. People enjoyed the food and were supported with their nutritional needs, but the meal time experience was not a positive one for everyone.

People’s interests and hobbies were not always considered and there was little stimulation for people. Not everyone was aware how they could raise concerns and the way of doing this was not accessible to all the people who lived there.

We found that people were protected from harm and staff were aware of the different types of abuse that could happen and were confident in how to raise any concerns. Risks were managed and there were enough staff to keep people safe. Medicines were managed safely. Staff had the knowledge they needed to support people and people were supported to maintain their health.

People were treated with kindness and their dignity and privacy were promoted and respected. People were encouraged to be independent and when possible were enabled to make choices and have some involvement with the planning of their care. Visitors were made to feel welcome.

There was a visible management presence and people spoke positively about the overall culture of the home.

You can see what action we told the provider to take at the back of the full version of the report.