11 April 2019
During a routine inspection
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