The Fields Care Home

Updated 1 November 2018

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 home, and to provide a rating for the home under the Care Act 2014.

The first day of this inspection was unannounced and took place on 24 September 2018. This meant the provider did not know we were coming. The second day was announced and took place on 25 September 2018.

The first day of the inspection was carried out by one adult social care inspector and an inspection manager. The second day of the inspection was carried out by one adult social care inspector.

Before the inspection we reviewed other information we held about the service and the provider. This included previous inspection reports and statutory notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send to CQC within required timescales. We contacted the local Healthwatch team and obtained information from the local authority commissioners for the service and the local authority safeguarding team. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During our inspection we spoke with five people who lived at The Fields. We spoke with the provider, manager, three senior carers, three care workers, the cook and the maintenance person. We also spoke with three relatives of people who used the service, and with two visiting health care professionals.

We looked around the home and made observations of people and staff interacting. We viewed a range of records about people’s care and how the home was managed. These included the care records of four people, medicine administration records of four people, recruitment records of three staff, training and supervision records and other records in relation to the management of the service.

Updated 1 November 2018

The Fields is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Fields accommodates up to 24 people in one building and provides accommodation over four floors which are served by a lift. At the time of our inspection, 18 people were accommodated in the home. These were older people who require personal care, including people who live with a dementia or sensory impairment. The home is not registered to provide nursing care.

This inspection took place on 24 and 25 September 2018 and the first day was unannounced.

At our previous focused inspection on 16 and 24 May 2018 the home was overall rated ‘Requires Improvement’. At this inspection we found that there had been improvements and the service is now rated as ‘Good’.

At this inspection there was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. The manager of the service has submitted an application to be registered but that is yet to be assessed by CQC.

Where risks were identified to people who used the service or to the environment these were assessed and plans put in place to reduce them. Risks in the environment identified at the last inspection had been removed.

People received their medicines safely and were supported to access the support of health care professionals when needed. Medicines processes were being monitored and actions taken when errors occurred.

People were protected from the risk of abuse because staff understood how to identify and

report it.

There were enough staff to meet people’s needs and people told us they felt safe because staff were available to help them. Staff had been recruited in a safe way and checks made to ensure they were suitable to work with vulnerable people.

Staff told us they received training to be able to carry out their role. The manager monitored this and had planned the training updates required so that staff continued to have the necessary knowledge and skills. We saw that staff had received recent training to meet the needs of people living in the service.

Staff received effective supervision and we saw that their appraisals were in progress for this year. They told us they found the manager very supportive and that they were given the daily supervision they needed to do their jobs effectively.

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. Staff were not always clear about which people were deprived of their liberty, but care files were updated to make it easier for staff to access this information.

People received a varied and nutritional diet that met their preferences and dietary needs. The service provided homemade food and drinks which were adapted for different diets.

The interactions between people and staff showed that staff knew the people well.

Care was planned and delivered in a way that responded to people’s assessed needs. Care plans contained detailed information about people’s personal preferences and wishes as well as their life histories. We found that the care files we checked had inconsistencies as people’s needs had changed and sections had not been updated correctly. We spoke to the manager and staff and saw that practices reflected current needs and care plans were updated immediately once we highlighted these errors.

The management team were approachable and they and the staff team worked in collaboration with external agencies to provide good outcomes for people. People, relatives and staff felt any concerns would be taken seriously and acted on.

The provider and the manager had a commitment to work together to improve the service and both were present in the service and took their part in monitoring its quality and effectiveness.

Processes were in place to assess and monitor the quality of the service provided and drive improvement. This included in relation to incidents, accidents and complaints. We found that systems had improved to better identify shortfalls and address these where they occurred.

Areas of the home had been adapted to better meet the needs of people living with dementia based on good practice principles. Some further improvements to the environment were planned.

Further information is in the detailed findings below.