The Old Vicarage

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.

The five questions we ask about services and what we found