The Old Vicarage is registered to provide accommodation and personal care for up to 14 people who may have learning disabilities or autistic spectrum disorder. At the time of this inspection the service was providing accommodation to 13 people. Accommodation is provided over two floors.

The home is situated in extensive grounds alongside a smaller regulated service registered for 3 people and run by the same provider; this service is known as Vicarage Lodge. Each of the services is run independently of each other, with people from each of the services meeting up for planned social events when they chose to do so. Local amenities for example, church, village shop, local public house and the village community centre are all within walking distance of the service.

At the last inspection in March 2014, the service was rated good.

At this inspection we found the service remained good.

People who used the service were supported by staff who understood the importance of protecting them from harm. Staff had received training in how to identify abuse and report this to the appropriate authorities. Staff that had been recruited safely were provided in enough numbers to meet the needs of the people who used the service.

Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. Medicines were managed safely with an effective system in place. Staff competencies, around administering medication, were regularly checked.

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 able to choose meals of their choice and staff supported people to maintain their health and attend routine health care appointments. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met.

People who used the service had access to a wide range of activities and leisure opportunities and were encouraged to continue to participate in activities and hobbies that they had enjoyed prior to accessing the service. A wide range of activities were provided and included involvement and use of the local and wider community based facilities.

The service had a clear process for handling complaints which the registered manager had followed. The provider used an external agency to obtain regular feedback from relatives about their experience of the service.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance processes were in place and regularly carried out by both the provider and the registered manager to monitor and improve the quality of the service.

Feedback was sought from people who used the service through regular ‘resident meetings’ and feedback forms. This information was analysed and action plans produced when needed.

Further information is in the detailed findings below:

We used a number of different methods to help us understand the experiences of people who used the service. These included observation, looking at records and talking to staff. This was because most people who used the service had complex needs which meant they were not able to tell us their experiences.

People were involved as far as they were able in making decisions about their care and welfare. Where people found this difficult the person who should act on their behalf was identified.

People were provided with a nutritious, healthy diet and were involved in the formulation of menus and the preparation of food.

People lived in an environment which was suitably designed and maintained. All areas both communal and private were clean, tidy and free from clutter.

The provider’s recruitment and selection procedures ensured people who used the service were not exposed to staff who should not be working with vulnerable adults.

People who used the service could make complaints and these were looked into and resolved where possible to the person’s satisfaction.

People who used the service had complex needs which meant they were not all able to tell us their experiences directly. We used some different methods to help us understand the experiences of people using the service.

People found the service “very good” in meeting their needs. One person told us, “I like it here.”

People told us they appreciated the staff that worked with them and one person said, “Most of the staff are all right; most of the staff I get on with.”

People attended regular meetings held for residents. One person told us, “I went to a resident meeting last weekend. I would talk to the team leader if I had a complaint. If it was about the manager I would speak to the assistant manager.”

The Old Vicarage is registered with the Care Quality Commission (CQC) to provide care and accommodation for a maximum of 14 adults who have a learning disability. It is situated in the village of Stallingborough near to Grimsby.

The service had 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.

This inspection was unannounced and took place over two days. The previous inspection of the service took place on 27 January 2014 and was found to be compliant with all of the regulations inspected.

Medicines were kept safely and were stored securely. A locked controlled drugs cupboard was attached to the wall for medicines requiring tighter security. Records confirmed medicines were handled only by suitably trained staff.

The registered provider had policies and procedures in place to safeguard vulnerable people from harm and abuse.

Risk assessments clearly identified hazards people may face and provided guidance to staff to manage any risk of harm.

Staff told us they had been recruited into their roles safely. Records confirmed references were taken and staff were subject to checks on their suitability to work with vulnerable adults.

Staff told us they felt there were enough staff on duty and that they were well trained and supported by the management.

The care plans we reviewed contained assessments of the person’s capacity when unable to make various complex decisions. When people had been assessed as being unable to make complex decisions there were records of meetings with the person’s family, external health and social work professionals, and senior members of staff.

We saw lunch being prepared by the care staff in the main kitchen. Fresh ingredients were being used and the meal looked appetising. In all cases people’s intake of food and drink throughout the day and night was recorded using an electronic recording system.

We reviewed the staff training records and found the registered manager used an electronic system to monitor and plan training for all 40 members of staff. We saw staff received training which was relevant to their role and equipped them to meet the needs of the people who used the service.

People who used the service were supported to be as independent as possible. Although people who used the service had limited communications skills, care plans were written with maintaining and developing independence in mind.

Records showed each person who used the service was invited to the monthly meeting of their core team of care staff.

We observed high levels of interaction from staff. Staff spoke with people in a calm, sensitive manner which demonstrated compassion and respect.

Care plans provided staff with a summary about the person they were supporting including communication methods, diagnoses, allergies, and relations’ birthdays. Care plans were written around the specific levels of care each person required.

Each person had an activity plan which had been discussed with them at their monthly meeting. People who used the service were supported to participate in a number of activities which included visits to the local theatre, football matches, shopping, and going to discos and other social clubs.

The registered provider had a complaints and compliments policy in place which was displayed in pictorial format around the service and was issued to people’s relatives.

There were monthly records of accidents, incidents, injuries, and safeguarding referrals. These had been evaluated and action plans created to address any shortfalls.

Records showed people who used the service and the relatives were frequently asked for their views at the various monthly meetings and at the ‘my review, my say’ meetings held every six months.

Staff meetings were held monthly in which the care for each person who used the service was discussed.

There were systems in place to monitor the quality of the service. Monthly audits included: medicines management, pressure care, infection prevention and control, and care plans. Again, action plans had been created to address any shortfalls.