The Fields Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Care plans were not always accurate or comprehensive, and information was inconsistent across documents. Care plans were not always reviewed regularly which reduced the opportunity for staff to provide effective care. For example, one care plan we reviewed was written in December 2024 and was last reviewed in December 2025. The care plan stated that the individual has no ‘issues’ with continence and was able to tend to their own continence needs. Following a discussion with a senior member of staff, it became apparent that the continence needs of this individual had deteriorated and no longer reflected the information recorded with their care plan.

Despite these issues in documentation, we found limited impact on the care people received. One professional told us, “The quality of recording is good. Documentation I have viewed was appropriate, with relevant information recorded accurately and updated when circumstances change. Records provided a clear picture of the residents' needs and the support being provided.”
 

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

In line with the International Dysphagia Diet Standardisation Initiative (IDDSI) framework, one person required food to be prepared to a specific consistency due to an identified risk of choking. Information relating to the person's dietary requirements was not consistent across records. Their care plan stated they required a Level 5 (Minced and Moist) diet, while correspondence from the Speech and Language Therapy (SALT) team indicated a Level 6 (Soft and Bite-Sized) diet. When we discussed this discrepancy with a member of staff, they informed us the person was currently receiving a Level 4 (Pureed) diet.

In addition, the person's choking risk assessment had not been reviewed since April 2026. This meant staff could not be assured they were working from accurate and up-to-date information regarding the person's assessed needs. We raised these concerns with the manager during the inspection and immediate action was taken to review the relevant documentation. Subsequent observations of mealtime support provided assurance the person was receiving food at the appropriate consistency.
 

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Senior staff members completed daily handover meetings to ensure key information was shared with the rest of the staff team about changes to people’s needs. Staff followed guidance given by health professionals, to help people manage any health conditions. One professional told us, “In my experience, staff follow care plans appropriately. They communicate effectively to ensure the resident receives appropriate support.”
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Despite omissions in the quality and review of care records, we observed that staff closely monitored any changes in people’s health and acted promptly when concerns arose. Staff incorporated treatment plans into people’s care plans to ensure continuity and consistency of care. In addition to responding to health concerns, staff supported people to maintain their overall wellbeing by facilitating access to routine and preventative services, including dentists, opticians and chiropodists. This approach helped to reduce risks, promote comfort, and support people to maintain their independence and quality of life. One person told us, “They take me shopping and I buy the things I like. I do feel independent, but help is there if needed. I had a stroke, so some things are more difficult than they were.” Another person told us, “They encourage me to eat a healthy diet and have my ‘five a day’.”
 

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and
consistent.

The provider did not have a robust approach to monitoring the effectiveness of people's care, treatment and support to drive continuous improvement. Systems for overseeing and reviewing care were not always effective in identifying where people's assessed needs were not being consistently met.

During the inspection, we identified one person whose care records stated they should use a pressure-relieving cushion when seated in the communal lounge area. We observed the person sitting without the cushion for approximately 30 minutes before drawing this to staff's attention. Staff told us the person did not like using the cushion and would often remove it.

However, there was no evidence within the person's care plan or risk assessment to demonstrate this had been reviewed, discussed with relevant healthcare professionals, or that alternative pressure-relieving measures had been considered. This meant the provider could not be assured appropriate action had been taken to mitigate the risk of pressure damage while also responding to the person's preferences. The absence of accurate and up-to-date records increased the risk of inconsistent care and support.
 

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The provider had not ensured the requirements of the Mental Capacity Act 2005 (MCA) were consistently followed.

Staff had completed MCA training and demonstrated an understanding of the importance of seeking people's consent before providing care and support. However, the provider had not always ensured that consent arrangements were clearly documented for all aspects of people's care and treatment.

Records relating to people subject to Deprivation of Liberty Safeguards (DoLS) were maintained in line with current guidance, and relevant authorisations were available. However, the provider had not notified the Care Quality Commission (CQC) they were providing care and support to people living with dementia, as required by the conditions of registration.

We discussed this with the manager during the inspection. They acknowledged the oversight and took immediate action to review the service's registration details and submit the relevant notification to CQC. This helped provide assurance that steps were being taken to ensure the service operated in line with its regulatory responsibilities.