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Archived: Field House Good

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Reports


Inspection carried out on 16 May 2017

During a routine inspection

Field House provides accommodation and personal care for up to 49 people, including people living with dementia. Nursing care is not provided by the home’s staff. The home is built on two floors and has a number of both large and small sitting and dining areas where people can choose to sit. At the time of this inspection there were 36 people in residence.

The provider is also registered to provide care to people living in their own homes in the community. At the time of this inspection there were four people using this service.

At our last inspection the service was rated as good. At this inspection we found the service remained good.

The service was safe because potential risks to people were assessed and minimised and staff understood their responsibility to protect people from avoidable harm. There were enough staff on duty to meet people’s needs and staff recruitment ensured that only staff suitable to work at this home were employed. Medicines were managed safely and people received their medicines as prescribed.

The service was effective because staff received induction, training and support that ensured they could do their job well. 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 home supported this practice. People’s nutritional needs were met and people were supported to have enough to eat and drink. A range of healthcare professionals visited the home to support people to maintain good health.

The service was caring because staff treated people with warmth, kindness and compassion. Staff showed they genuinely cared about the people they were looking after. They respected people’s privacy and dignity and encouraged people to be as independent as they could be. Visitors were welcomed and also had warm, friendly relationships with the staff.

The service was responsive because care plans were personalised and gave staff guidance on the care each person needed. A wide range of activities, outings and entertainment was provided and people were encouraged to follow their own interests. People and their relatives knew who to speak to if they were not happy with the service and were confident their complaints would be addressed.

The service was well-led because there was a registered manager in post who was dedicated, approachable and provided good leadership. People, staff and visitors to the home were encouraged to put forward their views about the service being provided. The quality of the care was monitored by a range of audits that were carried out regularly.

Further information is in the detailed findings below.

Inspection carried out on 3 May 2016

During a routine inspection

Field House is registered to provide accommodation and personal care for up to 49 people, some of whom live with dementia. The home is located in a village and close to the city of Peterborough. When we visited there were 33 people living at the home. The location is also registered to provide personal care for people living at home. There were four people receiving this service when we visited.

The inspection took place on 3 May 2016 and was unannounced and carried out by one inspector.

A registered manager was in post when we inspected the home and had been registered since 2011. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People were safe as staff were knowledgeable about reporting any abuse. The home was clean and a comfortable place for people to live. There were a sufficient number of staff employed and recruitment procedures ensured that only suitable staff were employed. Arrangements were in place to ensure that people were protected with the safe management of their medicines.

The CQC is required by law to monitor the Mental Capacity Act [MCA] and the Deprivation of Liberty Safeguards [DoLS] and to report on what we find. The provider was acting in accordance with the requirements of the MCA so that people had their rights protected by the law. Assessments were in place to determine if people had the capacity to make decisions in relation to their care. When people were assessed to lack capacity, their care was provided in their best interests. Authorised DoLS were in place and the conditions of the in-date DoLS were being followed.

Staff were trained, supported and supervised to do their job.

People were supported to access a range of health care professionals. Health risk assessments were in place to ensure that people were supported to maintain their health. People were provided with adequate amounts of food and drink to meet their individual likes and nutritional and hydration needs.

People’s privacy and dignity were respected and their care was provided in a caring and attentive way.

People’s hobbies and interests had been identified and a range of activities supported people with these. People’s care records and risk assessments were kept up-to-date. A complaints procedure was in place and staff were aware of how to support people if they wanted to raise a concern or complaint.

The provider had quality assurance processes and procedures in place to improve, if needed, the quality and safety of people’s support and care.

Inspection carried out on 23 and 29 July 2015

During a routine inspection

This inspection was carried out on 23, and 29 July 2015. Our last inspection was a desk top review that took place on 15 July 2014 and the service was found to be compliant in the areas we looked at.

Field House is a care home registered to provide accommodation and personal care for up to 33 older people some of whom are living with dementia. Field House also provides a domiciliary care service to people living in their own homes within the village of Eye. There were 33 people living at the home at the time of our visit and four people supported with personal care within their own homes. Accommodation in the care home is provided on two floors with stairs and a lift as access. The majority of people shared communal toilets and bathrooms, twenty bedrooms have en-suite facilities. There are internal and external communal areas, including lounge / dining areas, and a garden for people and their visitors to use.

There was a registered manager in place. They had been in place since 1987 and had been registered since August 2011, when the provider registered as a limited company. 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 Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. The registered manager was aware that they needed to safeguard the rights of people who were assessed as being unable to make their own decisions. There were systems in place to assess people’s capacity for decision making. Appropriate applications were made to the authorising agencies to ensure that people’s rights were protected. The majority of staff were not aware of the requirements of the MCA 2005.

People who lived in the home were supported by staff in a kind way that maintained their safety.

They had care and support plans in place which recorded their likes and dislikes, needs and wishes. People’s privacy was respected; however people’s dignity was sometimes compromised.

Risks to people were identified by staff to enable people to live as safe a life as possible. People deemed at risk were referred to the appropriate external health care professionals for support and guidance. There were arrangements in place for the safe storage, disposal, management and administration of people’s prescribed medicines.

People were supported to eat adequate amounts of food and fluid to make sure that they were not at risk of malnutrition and dehydration. The quality of the food was variable and there were limited menu choices for people.

Some areas within the home were not clean. This increased the risk of cross contamination due to poor infection control.

There was an ‘open’ culture within the home. People, their visitors and staff were able to raise any suggestions or concerns that they might have had with the registered manager and felt listened too.

There were a sufficient number of staff on duty. Staff were trained to provide effective care which met people’s individual care and support needs. Staff understood their role and responsibilities to report poor care. Staff were supported by the registered manager to maintain and develop their skills through supervision and training.

The registered manager had in place a quality monitoring process to identify areas of improvement required within the home. However, these checks were not always formally recorded with an action plan.

During a check to make sure that the improvements required had been made

During our inspection of Field House which was carried out on 03 April 2014 we looked at the provider's records. We spoke with four relatives of people living at Field House. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us within the home. We then spoke with two people using the domiciliary care agency the following day by telephone. We gathered evidence to help us answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

When looking at evidence for – is the service safe? We found that during this inspection, the provider was unable to provide us with robust evidence that people using the service had a personal emergency evacuation plan in place for any foreseeable emergencies.

The provider wrote to us and told us that they would take remedial action and this would be with immediate effect. As such, we have asked the provider to submit their evidence to us so that we could look at the action they have taken. This enabled us to undertake a desk top review on 15 July 2014.

This is a summary of what we found-

Is the service safe?

Documented evidence from the provider now demonstrates to us, robust evidence that there are personal emergency evacuation plans in place for people who used the service, in the event of a foreseeable emergency.

Inspection carried out on 3 April 2014

During a routine inspection

During our inspection of Field House we looked at records held for both the care home and the domiciliary care agency. We spoke with four relatives of people living at Field House. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us within the home. We then spoke with two people using the domiciliary care agency the following day (by telephone).

We gathered evidence to help us answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This is a summary of what we found-

Is the service caring?

People’s preferences, interests and needs had been recorded and care and support had been provided in accordance with people’s wishes. We observed how staff members treated people within Field House and saw that this was done in a kind, encouraging and attentive way. People using the domiciliary care agency told us that staff were punctual and they did not feel rushed by staff.

We saw evidence that people using the service or their relatives completed a satisfaction questionnaire. Where concerns were raised these were addressed.

Is the service responsive?

Relatives of people living at the home and people using the domiciliary care service told us that the provider had an ‘open door’ policy. This meant that they could raise any suggestions or concerns with the provider and were confident that these concerns would be listened to.

Is the service safe?

People we spoke with told us they or their relative felt safe. Risk assessments regarding people’s individual activities were carried out and measures were in place to minimise these risks.

The provider could not provide us with written evidence that people using the service had a personal emergency evacuation plan in place for any foreseeable emergencies.

The head of care set the staff rotas; they told us that they took people’s care needs into account when making decisions about the staff numbers and skills mix. This ensured that people’s needs were met.

Is the service effective?

Our observations found that members of staff knew people’s individual health and wellbeing needs. Specialist dietary needs had been identified in the care records where required.

Relatives we spoke with told us that they were able to see their relatives at any time because visiting times were flexible.

Is the service well led?

Quality assurance systems were in place that people were listened to and were safe from the risk of unsafe and inappropriate support and care.

The service worked well with external social and healthcare professionals to make sure that people received the care and support they needed and in a joined up way.

Inspection carried out on 1 May 2013

During an inspection to make sure that the improvements required had been made

Field House provides accommodation and personal care for up to 33 older people. It also provides domiciliary care to people in their own homes. The service is in a residential area in the village of Eye.

Records showed that security checks had been completed to help ensure that staff were suitable to have unsupervised contact with people who were vulnerable. These measures included obtaining employment histories so that all necessary references could be sought.

We saw that each person had an individual written plan of care. These documents described the care that people needed and wanted to receive. They also recorded the assistance that had actually been provided so that there was a clear account of how people had been helped.

Inspection carried out on 26 June and 11 July 2012

During a routine inspection

People told us that staff members explained what they were going to do before providing any care or support and asked if they were happy for it to go ahead. One visitor stated that staff members discussed any issues concerning their relative before they took action or provided additional care or treatment.

We were told that people liked living at the home and that the staff members were very good at meeting their needs. Activities were organised by staff and people could choose whether to take part or not. One visitor said they had confidence in the care their relative received.

We used the Short Observational Framework for Inspection (SOFI) in the area of the home in which people living with dementia spent their time. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We noted that staff members communicated well with people and supported those who were anxious.

Inspection carried out on 22 November 2011

During a routine inspection

We spoke with people using the service and observed the interactions between staff and residents. People told us that staff were kind, cared for them well and that there were sufficient staff on duty, however one person told us they had to wait for things such as a cup of tea or support from staff when they wanted to go to the toilet. We fed this back to the manager.

We spoke to a number of people who live in their own homes and receive a domiciliary care support. They told us the staff who assisted them with personal care were kind and reliable. They said that the service met their needs and that they had been given information about who to contact if they had any concerns.

Reports under our old system of regulation (including those from before CQC was created)