About the service: The Vicarage is a respite service offering accommodation and support for people with mental health support needs. Three people were supported at the time of the inspection.

People’s experience of using this service:

Overall people gave positive feedback about the service. People felt safe at the service. People carried on with their usual routines and their choices were promoted. There was not always an appropriate balance however between people’s independence and safety. One person did not always feel they had the privacy they needed. Action was not taken to keep another person safe when their needs could not be safely met. We identified a breach of the regulations because people’s medicines were not managed safely.

Staff told us they felt supported. Lone-working had been phased out, and improvements had been made to the premises to improve the safety of the service. Further improvements were planned, including to the premises, staff training and how incidents were logged. We identified a second breach of the regulations because systems and processes failed to effectively assess, monitor and improve the service.

More information is in the full report.

Rating at last inspection: Good (October 2017)

Why we inspected: This inspection was planned based on the previous inspection rating and was brought forward due to concerns known to CQC about the provider’s other registered services.

Enforcement / Follow up: We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment and governance. During our inspection, we prompted the provider to address our safety concerns.

We also shared our concerns with the commissioning team that arranges referrals to the service.

We did not take enforcement action on this occasion because shortly after our inspection, the provider submitted an application to de-register. We will continue to monitor this provider and service until the de-registration process is complete.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 25 August 2017 and was unannounced. This is the first time we have inspected this service since it was registered in May 2016.

The Vicarage is a respite service offering accommodation and support for a maximum of five people with mental health support needs. At the time of our inspection, two people were using the service. There was a registered manager in place who was present during our inspection. 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.

A person told us they felt safe using the service. People were often supported by lone workers who had been suitably recruited. Staff escalated any concerns about people’s health and were aware of safeguarding procedures to help protect them. People received support to take their medicines safely. Systems were in place to promote people’s safety at The Vicarage.

People were supported by staff who understood their support needs. Staff spoke positively about their training and induction. People made their own choices and prepared their own meals, receiving support from staff when needed. People were signposted to local health services and attended review meetings with their community healthcare teams to help promote their health and recovery.

People were supported by staff who were kind and caring. People had the privacy they needed and their independence was promoted. People were supported to express their views and were treated with respect. People received a service that was responsive to their needs. The registered manager told us no formal complaints had been received although people were able to complain if they needed to.

People had their needs met and systems were in place to support staff and the efficient running of the service. There was a registered manager in place. Systems did not always show that information had been analysed to assess and drive the quality of the service. We also found the provider had not completed a PIR as requested before our inspection. A PIR 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.