Fielder Lodge

Updated 26 November 2019

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 Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

We carried out our inspection on 16 and 17 June 2019

What we did before the inspection

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

During the inspection

We spoke with four people who used the service about their experience of the care provided. We spoke with seven members of staff including the area director, head of specialist services, two service managers, and support workers.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 26 November 2019

About the service

Fielder Lodge is a women only high support unit providing support and accommodation to eight women aged 18 to 65 with extremely complex mental health needs. Partially designed by women who used the service, it provided a secure, therapeutic environment with eight self-contained flats and a respite flat, a communal kitchen and lounge, therapy room, and office area.

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

Fielder Lodge is a high-level support facility supporting extremely vulnerable women who had all previously spent much of their lives in secure hospital accommodation. Following the Hope and Recovery model of mental health support, the service was focused on providing exceptional standards of person-centred care and support.

All the women we spoke with told us they felt Fielder Lodge provided a safe and secure environment. They said that they had developed strong, meaningful relationships with the staff and built up trust and confidence whilst being supported. One told us, “I have trust in the staff, I know they will keep me safe. I never had trust in anyone, never did, but I know here they won't let me down."

There were safe recruitment systems in place. The service provided an all female staff team to ensure privacy and dignity were respected, quell anxieties, and provide empathy. Staff were highly motivated, resilient and skilled in their role. They had undertaken appropriate training. 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; People were respected and valued as individuals and empowered as partners in their care in an exceptional service.

The ethos of the service was totally focussed on meeting the needs and aspirations of each individual. Staff were highly motivated and offered care and support which was exceptionally compassionate and kind. Visiting professionals told us that staff were ‘amazing’ and, “Able to work with people to explore their issues in a sensitive and kind way." Staff showed empathy and had built open and honest relationships with the women they supported. They respected privacy and were mindful when sharing confidential information.

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.

The women who lived at Fielder Lodge were fully involved in planning their care and had choice and control about how their care would be provided. A full transition period as each new person was admitted into the service allowed time to get to know people, understand their preferences and how they wanted their support to be delivered. Detailed support plans accurately captured personal preferences and histories, allowing staff to adapt the way they delivered support in a truly person-centred way. The service recognised and understood different cultures and backgrounds, and service delivery reflected people’s values and traditions.

People were very clearly at the heart of the service. The service was extremely well led by managers who were dedicated to providing a service which was responsive to need. The women living at Fielder Lodge were encouraged to support quality assurance measures and consulted in all aspects of their care and support. Effective reviews and audits helped to drive forward quality. Staff told us that they were proud to work in a service which provided a quality of life for women who would otherwise face a lifetime within a hospital setting.

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

Rating at last inspection

The last rating for this service was Outstanding (Published 19 December 2016)

Why we inspected

This was a planned inspection based on the previous rating. Prior to our inspection we had received notification about two specific incidents. We reviewed these incidents during our inspection and are satisfied that the service responded and has subsequently made improvements to minimise the risk of any future occurrences.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.