The Care Quality Commission
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Archived: Fieldway Care Home

Overall: Good read more about inspection ratings

40 Tramway Path, Mitcham, Surrey, CR4 4SJ

Provided and run by:
Bupa Care Homes (ANS) Limited

Important: The provider of this service changed. See new profile

All Inspections

12 May 2015

During a routine inspection

This inspection took place on the 12 May 2015 and was unannounced.

At our last inspection of the service on 9 September 2014 we found the service had breached one area of its legal requirements. It related to the management of medicines. Not all staff administering medicines had completed the required training. In addition, the application of external creams was not always being recorded. This could have affected the safety and wellbeing of people living at the home. At this inspection we found improvements had been made and the service was now meeting its legal requirements.

Fieldway Nursing and Residential Centre is a care home that provides accommodation, nursing and personal care for up to 68 older people. At the time of our inspection 63 people were resident at the home, some of whom were also living with dementia.

Fieldway is a purpose built care home with accommodation over two floors. All bedrooms are single with ensuite facilities. There is a garden to the rear of the property which is wheelchair accessible and there is also a passenger lift. At the time of our inspection, the home was undergoing a major refurbishment, all the bedrooms had been completed and work was being undertaken in the communal areas.

The service did not have a registered manager. 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.

The service has not had a registered manager in post since May 2014. We have talked with the provider who had recruited a manager who was in post for a number of months but was never registered and subsequently left . Currently the deputy manager, who is well known to the people at the home and their relatives, is in an acting position. We are following this up separately with the provider and will take action where required so they make the necessary arrangements to ensure the service has a registered manager in place as soon as possible.

People told us staff were caring and kind. One person told us, “I’m lucky to have found this place.” Other comments included, “They make a fuss of my husband and I can visit when I want. They really make me feel welcome, lovely atmosphere, homely.” Another person said, “My wife’s only been here a month, but the staff are so kind.” Our observations supported the positive view people had about Fieldway.

People’s needs were well documented in their care plans which were specific to them. These documents were reviewed regularly and updated as necessary. Staff knew how to maintain people’s privacy and dignity when providing personal care.

People were supported and encouraged to maintain social relationships. There were no restrictions on visiting and friends and relatives were made to feel welcome. The home offered a range of activities for people to participate in if they wished, thereby reducing the risk of social isolation.

Staff had been trained in safeguarding adults at risk and knew what signs and symptoms to look out for and how to escalate any concerns they might have. Risks to people’s health and wellbeing were assessed regularly so they could be managed, whilst not unduly restricting people’s independence. Accidents and incidents were monitored, and action taken to minimise a reoccurrence.

The provider ensured there were sufficient staff on duty who had been appropriately recruited to meet people’s needs. Staff were trained in their roles and responsibilities to make sure the care they were providing was safe and in line with best practice. Training was refreshed regularly.

People were supported to maintain good health by having access to healthcare professionals as and when they required them. Healthcare professionals were positive about the relationship they had with the service. People received their medicines safely. People were supported to eat and drink sufficiently to maintain good health.

The acting manager and staff we spoke with were aware of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS is a process to make sure people are only deprived of their liberty in a safe and correct way, when it is in their best interests to do so. The acting manager knew when an application was required and how to submit one. People were asked their consent to care and treatment whenever possible.

There was an open and transparent culture within the home. People were positive about the acting manager. People who used the service and staff told us they felt they could raise issues with the acting manager and these would be listened to and acted upon. There were various mechanisms for people to express their views about the service.

There were systems in place to monitor the safety and quality of the service. Where shortfalls had been identified actions had been taken to rectify the issues.

9 September 2014

During an inspection in response to concerns

Below is a summary of what we found. We spoke with nine people who used the service, two relatives, three members of staff, two visiting professionals and the deputy manager and quality manager. We looked at five sets of information about people who used the service and care home records. There were 54 people living at the home on the day of our inspection; 34 within the nursing unit and 20 within the residential unit.

If you want to see the evidence supporting our summary please read the full report.

This inspection was unannounced and was carried out by two inspectors and a specialist pharmacist inspector. This team undertook the inspection as concerns had been raised by health professionals and relatives about the care provided at the home.

We considered our inspection findings to answer five questions we always ask:

' Is the service safe?

' Is the service caring?

' Is the service responsive?

' Is the service effective?

' Is the service well led?

Is the service safe?

There were effective systems in place to reduce the risk of infection. Care plans showed that people's needs were identified and met. Any risks were assessed and reviewed to ensure people's safety was promoted whilst maintaining their independence. There were arrangements in place to deal with foreseeable emergencies such as fire and medical emergencies. There were enough staff employed to safely meet the needs of people using the service, although the level of staffing should be continually monitored.

The Care Quality Commission monitors the operation of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). We saw staff had received training and that the home knew how to make a referral to the local authority if a DoLS assessment was required. This helped to ensure that people's human rights were properly recognised, respected and promoted.

Is the service caring?

The majority of people we spoke with were positive about the care they received. One person told us, 'The staff are very helpful and I've found it very pleasant here. If I need help they're always there'. A relative we spoke with said 'I think it's very good here. My husband has settled in well and he seems much happier.'

During our inspection we observed friendly and kind interaction between staff and people who used the service. Staff seemed to know people well and there was a lot of social interaction as well as care and support.

Is the service responsive?

We found staff continually monitored people's condition and where necessary sought advice and assistance from other community based health and social care professionals.

The service had a complaints policy and procedure. The home sent out surveys for people who used the service and their relatives and other stakeholders to comment on the care provided by the home. When people had made a complaint or raised any issues, senior staff took appropriate action to investigate and resolved the issues to people's satisfaction. People told us they felt the senior managers listened to them.

There was some choice of activities available for people who used the service. However, a number of people told us they got bored as there was not enough for them to occupy their time.

Is the service effective?

Staff were aware of when they needed to obtain people's consent and we observed staff checking people were happy for them to provide care before they did so. Care plans also provided guidance and instructions for staff on how these should be met.

People's health and care needs were assessed, but the care needs were not always reviewed monthly as the provider had undertaken to do.

Is the service well-led?

The manager of the service had been in post since May and was not currently registered with the Care Quality Commission although they are in the process of registration.

We saw that a number of audits were in place to help ensure people received good quality care at all times. There were systems in place to make sure staff learnt from incidents and other untoward events.

17 October 2013

During a routine inspection

The home was generally clean and well maintained although a programme of refurbishment remained long awaited.

We spoke to ten people living in both the nursing and the residential parts of the home who were happy with the care they received. One person said, 'they treat us like human beings. Staff are always ready to help if you need them.' Another person said, 'you could not get a better place to be.'

Many people were unable to communicate but we spoke to 11 relatives who told us they were frequently in the home. They were confident about the quality of the service. One relative said, 'I feel they are fine here. My mum can't communicate but likes to see people. They have things going on all the time and I can come in when I want to.' Another person said, 'the care side is brilliant; I can't fault them on that.'

Some people did say that staff were very busy. We noted that many people required the help of two members of staff at a time and people were often unsupervised.

We spoke to eight members of staff and they confirmed that they knew what to do to keep people safe. We saw that people were cared for by well trained staff who were supported in their work.

There were good systems in place to monitor the quality and safety of people living at the home. In response to feedback received skilled workers were providing a programme of activities which engaged people and helped to create a stimulating environment much appreciated by people and their relatives.

22 October 2012

During a routine inspection

Fieldway provides nursing care for people who may have dementia however, many of them were able to speak with us about what it was like to live there.

People told us that they were able to make choices within their daily lives about what they wanted to do and where in the home they spent their time.

They told us 'the staff are nice', 'staff are hard working and pleasant' and 'I can't grumble at the attitude of the staff'. One person told us 'I can't fault the care here, the staff are wonderful'. One person we spoke with did say 'I don't like it much here' however they were not able to explain why.

Generally people enjoyed the food and told us 'the food's wonderful', 'the food here is very good' and 'the food is quite good'. Although two people did say they would like more choice.

Everyone we spoke with told us that they felt quite safe living in the home. They told us that if they did not like something they would complain to the manager.

We did note that activities arranged for people were quite limited. Several people told us that they would like more to do in the day.

Some parts of the home were looking very tired and worn. This was particularly on the dementia unit. There were cracks in the walls and woodwork and walls were scuffed and marked. We also saw that some people found the layout of the home disorientating. There were no 'landmarks' such as meaningful pictures or items to aid reminiscence which would have helped them to find their way around.