INSPECTORS have told a Herefordshire care home it must improve after concerns were raised over the safety of residents, and the way they were treated.

The Old Vicarage in Wigmore, near Leominster, has been rated as "requires improvement" after an unannounced inspection held in January.

The home, in Ford Street, provides support to 13 elderly people, some of whom have dementia. It was previously judged to be "good" after an inspection back in August 2017.

The latest Care Quality Commission (CQC) inspection was prompted by the length of time since the last inspection, and focused on looking at safety and leadership in the care home. But due to problems found during the inspection, the CQC widened the scope of its report to also evaluate how effective and caring the home was.

The report said "the service was not always safe, effective, caring or well-led" meaning there "was a risk that people could be harmed, the effectiveness of people's care and support did not always achieve good outcomes, people were not always supported, care for or treated with respect, and the service management and leadership was inconsistent".

In one reported example, inspectors said a resident was being given medicine "covertly", so they did not know they were taking medicine. But staff had not completed mental capacity assessments to identify if this person was able to consent to taking medicine. The report said: "The provider was not always in line with the Mental Capacity Act.

"People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through mental capability assessment procedures."

Other problems uncovered included a lack of support for residents to eat a balanced diet, a lack of security on a medicine cupboard and trolley, and ineffective systems being in place for recording accidents and incidents, including allegations of abuse and one resident having unexplained bruises.

There were also privacy concerns, with criticism of glass panes on people's walls and displays showing continence products that inspectors said compromised residents' dignity. But the CQC report said that after receiving feedback, the home removed the signs and covered the glass panels. 


The CQC report said: "We have identified breaches in relation to management of risks, medicines, dignity, safeguarding and governance. We have told the provider to take action.

"We will request a plan from the provider, work to monitor progress and continue to monitor the service, which will help inform when we next inspect."

It added: "Suitable arrangements were not in place to ensure people were treated with dignity and respect consistently.

"An effective system was not fully in place to assess, monitor and manage risk in relation to the environment, medicines, and infection.

"Processes were not effective in safeguarding people from potential abuse. 

"Systems were not robust enough to assess, monitor and improve the quality and safety of the service or mitigate the risks relating to the health and welfare of people."

There were also positives outlined in the report and among them were the goats and chickens kept on the property, which one resident said they enjoyed, and drinks being readily available for people to stay hydrated. 

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Staff also received adequate training, with courses available to improve their skills and knowledge. They worked with other agencies, like the GP and nurse practitioner, to make sure people had access to health professionals.

One resident told inspectors: "They have always been very good and know me as a person not just a resident and are very approachable."

The Old Vicarage has been approached for comment.