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Inspection Summary

Overall summary & rating


Updated 25 October 2017

We carried out the inspection on the 25 and 26 September 2017. The inspection was unannounced. Fourfields is registered to provide accommodation and personal care for up to 52 people, some of who are living with dementia. At the time of the inspection there were 48 people using the service.

At the last inspection on 25 January 2016 we rated, the service requires improvement. At this inspection, we found the service had made the required improvements.

Fourfields is divided in to six units on one level, each unit had access to the garden and their own communal lounges and dining area.

Arrangements were in place to ensure there were sufficient numbers of suitable staff available to meet people’s individual needs. The provider monitored people’s changing needs regularly to ensure the required staffing levels and where we found an area that required improvement the registered manager acted immediately to ensure cover needs were met.

There was a registered manager in post. A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

Safe medicine practices were in place. However, there were some areas we identified that required improvement and the registered manager told us that following the inspection they had addressed these issues and processes were implemented to improve the management of medicines.

Safe and effective recruitment practices were in place. Staff had received training in how to safeguard people from abuse and knew how to report concerns both internally and externally.

People received support to maintain good health and had access to health and social care professionals when required. Risks to people’s health and well-being were identified and regularly reviewed. People were provided with a healthy balanced diet that met their individual needs.

People were involved in planning their care and received care that met their individual needs. Care plans included clear information to guide staff and there were varied activities available and events that encouraged family involvement. Staff were kind and caring, and people’s privacy and dignity was respected.

There were systems in place to obtain people’s feedback. The registered manager and the provider completed regular audits. We noted where improvements were identified these were accompanied by action plans to drive improvement at the home.

Inspection areas



Updated 25 October 2017

The service was safe.

People were kept safe by staff trained to recognise and respond effectively to the risks of abuse.

Safe and effective recruitment practices were followed to help ensure that all staff was fit, able and qualified to do their jobs.

Sufficient numbers of staff were made available to meet people�s individual needs at all times.

People were supported to take their medicines safely by trained staff.



Updated 25 October 2017

The service was effective.

People had their capacity assessed and best interest decisions completed to promote people�s choice.

People�s wishes and consent were obtained by staff before care and support was provided.

People were supported by trained staff that met people�s needs effectively.

People were provided with a healthy balanced diet which met their nutritional needs.



Updated 25 October 2017

The service was caring.

People were cared for in a kind and compassionate way by staff that knew them well and were familiar with their needs.

People and their relatives were involved in the planning, delivery and reviews of the care and support provided.

Care was provided in a way that promoted people�s dignity and respected their privacy.

People's confidentiality of personal information had been maintained.



Updated 25 October 2017

The service was responsive.

People received personalised care that met their needs and took account of their preferences and personal circumstances.

Detailed guidance made available to staff enabled them to provide person centred care and support.

People were supported to maintain social interests and take part in meaningful activities relevant to their needs.

People and their relatives were confident to raise concerns, which were dealt with promptly.



Updated 25 October 2017

The service was well led.

Systems were in place to quality assure the services provided, manage risks and drive improvement.

People and staff were very positive about and how the home operated and the registered manager.

Staff understood their roles and responsibilities and felt supported by the management team.