Archived: Tewkesbury Fields

Updated 4 December 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by one inspector, an assistant inspector 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: Tewkesbury Fields is a care home with nursing. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Tewkesbury Field accommodates up to 74 people in one adapted building.

The service did not have a manager registered with the Care Quality Commission, however, a new manager had been appointed and was in the process of applying to become registered. This means that they and the provider will be 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.

What we did:

Before the inspection, we reviewed:

• Information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse.

• Feedback from the local authority and professionals who work with the service.

• We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection:

• We spent time with people in the communal areas of the home and in their rooms and we saw how staff supported the people they cared for.

• We spoke with eight people who lived at the home, to gain their views about the care provided, and three relatives.

• We also spoke with the manager, the provider’s representative, seven care and senior staff members, two activity staff and two catering staff.

• We reviewed a range of records. This included three people's care records and multiple medication records. We also saw records kept about safeguarding people’s liberty and freedoms.

• We also looked at records relating to the management of the home. These included minutes of meetings with people and staff, and systems used to check the quality of the care provided, such as residents surveys. We checked how complaints and any accidents and incident were managed. In addition, we saw checks made on the training undertaken by staff, and checks made on the safety of the premises. We saw examples of compliments received in relation to the care provided at the home.

Updated 4 December 2019

About the service: About the service: Tewkesbury Fields is a care home that was providing accommodation and nursing care to 49 people at the time of the inspection. Care is offered to people living with dementia, physical disabilities and older people.

People’s experience of using this service:

• Services that provide health and social care to people are required to inform the Care Quality. Commission (CQC), of important events that happen in the service. Provider checks had not identified this did not always happen promptly, and this had led to delays in CQC being advised of some important events.

•A registered manager was not in place at the time of the inspection, but a new manager had been appointed and was in the process of applying to become the registered manager for the home.

• People saw the manager regularly and found them approachable.

•People told us Tewkesbury Field was managed so the care they wanted was made available to them. People told us although there had been some changes in the staff running the home, and the care staff supporting them, they enjoyed living at the home, and would recommend living at Tewkesbury Fields to other people.

• Further meetings were planned by the manager with people, their relatives and staff, to ensure there were on-going opportunities to communicate information regarding the development of care and the business.

• Staff knew how to recognise the signs of abuse and understood risks to individual people’s safety and supported them to stay as safe as possible. Staff were confident if they raised any concerns these would be promptly dealt with by senior staff.

• There were sufficient staff to care for people at times people wanted assistance, but staff experienced busy periods. The manager advised us they would review the current deployment of staff to address this.

• People were supported to have their medicines safely and checks were undertaken to ensure these were administered as prescribed.

• The risk of infections and accidental harm was reduced, as staff had received training and used the knowledge and equipment provided to do this.

• People told us they had opportunities to discuss the care they wanted. Staff explained how they assessed people’s needs, and incorporated people’s, their relatives’ and other health professionals’ views into their findings. This helped to ensure people were offered appropriate care, based on their preferences.

• Training had been provided to staff and people told us staff knew how to look after them. The manager had planned further training for staff, so they would develop the knowledge and skills needed to support people.

• People were very positive about their meal time experiences and told us they enjoyed making their own decisions about dining and snacks. Where staff had any concerns about people having enough to eat and drink action was taken to support them, so they would remain well.

• Staff knew people’s health and well-being needs well, and ensured people had prompt access to the healthcare they needed from other health and social care professionals. This helped to ensure people’s health and well-being needs were met.

• 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.

• People had developed good bonds with the staff who cared for them and told us they enjoyed sharing a joke with staff, and found staff caring.

• People were confident to ask for assistance and reassurance from staff when they wanted this, and staff took time to support people as people preferred.

• Staff knew what was important to the people they cared for and ensured they promoted people’s rights to dignity, independence and privacy.

• People made their own decisions about their lives and care. Where people needed support to make some decisions staff assisted them, using people’s preferred ways of communicating.

• The views of people and other health and social care professionals were considered when people’s care was assessed, planned and reviewed, so people’s needs continued to be met.

• Staff ensured people had a wide range of opportunities to do things which they enjoyed, and which responded to their individual needs, including their sensory needs. This enabled people to be fully involved in life at the home, and to maintain links which were important to them in the local community.

• Systems were in place to take any learning from complaints and accidents and incidents, and to further improve people’s care.

• Staff established people’s wishes for their care at the end of their lives by talking to people and by consulting with their relatives and other health and social care professionals.

• The manager and provider checked the quality of the care provided and developed the service and took action to develop the home further.

• We found the service met the characteristics of a “Requires Improvement” overall.

Rating at last inspection: Good. The last report for Tewkesbury Fields was published on 30 September 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Enforcement: Full information about CQC's regulatory response to concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

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