Field House Care Home

Updated 7 November 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Field House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. Field House Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service and 10 relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, regional manager, deputy manager, nurses, care staff, activities and catering staff. We spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed 5 people's care files and 2 staff personnel files. We also reviewed records relating to managing the service.

Updated 7 November 2023

About the service

Field House Care Home is a residential care home providing personal and nursing care to up to 35 people. The service predominantly provides support to older people, some of whom may be living with dementia but could also support younger people with medical conditions. At the time of our inspection there were 27 people using the service.

People’s experience of using this service and what we found

Staff did not always provide respectful, dignified care. We have issued a breach related to this.

People’s end of life care plans were not personalised. We have made a recommendation related to this. We observed a lack of meaningful activity during both our visits. Discussion with staff, people and relatives suggested people were either happy with what was available or chose not to participate. However, we were concerned the limited options meant people lacked motivation to become involved.

The provider had not ensured there were enough staff for people to receive good quality care. People were supported by trained staff to take their medicines. However, there were issues with stock level recording.

Risks to people's safety were assessed and monitored and there were systems to safeguard people from the risk of abuse. The service’s infection prevention control measures were effective.

The provider had made some changes to the environment and further improvements were in progress. However, the home lacked atmosphere with few homely features throughout.

People were supported by trained, competent staff and supported to access other healthcare services when needed. People gave positive feedback about the food.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Managers had not identified the issues we found in the quality of care provided. The provider had not ensured there were sufficient staffing levels and meaningful activities available. People, relatives and staff felt comfortable raising any concerns and giving feedback. Staff felt supported by their managers and colleagues. The provider had systems to monitor the quality and safety of the service and staff worked effectively with other health professionals to support people's health and wellbeing.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 22 October 2019).

At our last inspection, we recommended staffing levels were adapted when needed based upon people's changing needs. Although some changes had been made, we found there were not enough staff to meet people’s needs.

We recommended the provider ensured the environment was suitable for people living with a sensory or cognitive impairment and that individual preferences, cultural and support needs were reflected in how premises are adapted or decorated. Some improvements had been made; LED lighting and signage had been added.

In addition, we recommended the provider review the activity provision to ensure they were person-centred and encouraged people to maintain hobbies and interests. We found this had not improved.

The last rating for this service was requires improvement (published 22 October 2019). The service remains rated requires improvement. This service has been rated requires improvement for 2 consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified a breach in relation to staff not always treating people with dignity and respect.

We have made a recommendation for the provider to ensure people’s end of life care plans are personalised.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.