We carried out a review of the data available to us about Field Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Field Lodge, you can give feedback on this service.
Field Lodge is a residential care home providing personal and nursing care to up to 72 people. The service provides support to people who require nursing care, older people and some may also be living with dementia. At the time of our inspection there were 63 people using the service.
The care home accommodates people in four units over three floors. There is a lounge/diner and assisted bathrooms and toilets on each floor. On the ground floor there is access to a large garden a tuck shop, cinema, hair salon and nail bar, as well as a coffee shop.
People’s experience of using this service and what we found
People felt safe living at Field Lodge and received care in line with their needs and wishes. Staff had received training in safeguarding and knew how to identify and report concerns. Any safeguarding issues had been reported in line with guidance.
Accidents, incidents and falls were documented and reviewed to identify any patterns and trends, with lessons learned considered to help reduce future risks. A relative said, “Staff are aware of [family members increasing inability to judge any risks for themselves. From what I can see, they are aware of any potential risks.”
There were enough well-trained staff available to meet peoples care and support needs.
Medicines were managed safely by trained staff. People had received their medicines on time and as prescribed.
The building was clean, with effective cleaning and infection control processes in place. People, relatives and staff told us the service was well run and there was a positive environment.
People's views were sought through regular meetings and via questionnaires. Relatives were complimentary about the service, Comments included; “Extremely well cared for. It is the caring nature of such young carers, who are extremely dedicated and who are very fond of my [family member]. That much is obvious.” “I do feel that [family member] is well cared for. I really rate all the carers, there is not one that I have not warmed to.”
Feedback about actions taken was shared with people and displayed on a noticeboard within the home. Information was communicated to staff through meetings and handovers.
The service used a range of systems and processes to monitor the quality and effectiveness of the service provided. Actions plans were used to document any areas for improvement. We found any actions had been addressed timely.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was requires improvement (Published 2 June 2020). For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
There was an area where visitors could visit their family member/friend by appointment. There was a screen to promote social distancing, a sound system and an emergency call bell. Visitors would be expected to wear Personal Protective Equipment (PPE) and PPE would be made available. A lateral flow device test, a temperature check and a COVID-19 declaration would also be completed. There were gaps between each visit to prevent people encountering other visitors, staff or people from the home. These visits were currently suspended due to the COVID-19 outbreak at the home.
People were supported by staff to use computer tablets to video call family and friends. This was to promote people’s social well-being.
On arrival into the building, external visitors including a health or social care visitor would complete a series of COVID-19 checks in line with government guidance before entering. Hand sanitiser was also available in different corridors throughout the home.
Peoples named relative had been communicated to re COVID-19 restrictions and updates including vaccinations. People isolated if they had been to an external health appointment or were recently admitted into the home. They were asked to remain in their rooms for 14 days. The service had halted admissions on the floors where there was a COVID-19 positive person.
There were two infection control leads within the home. They were supported by the organisation’s infection control leads. If a person tested positive for COVID-19 there were processes in place to reduce the risk of infection spreading via laundry and or used crockery and cutlery.
Staff had internal COVID-19 training via e-learning. Handwashing/hand hygiene checks using ultraviolet lights and PPE checks were completed on staff. Staff seen wore their PPE correctly including face masks. Staff were bare below the elbow and were wearing a minimum amount of jewellery that promoted good infection control.
The areas in the home visited looked visibly clean. A staff member told us how frequently touched areas such as handrails, chairs, tabletops, handles and furniture were cleaned and that this was recorded. Communal areas seen appeared uncluttered to aid with effective cleaning.
Windows were opened to promote good ventilation. There was a fogging machine used to also help clean communal areas of the home.
Nurses at the home had taken on district nurses delegated tasks since March 2020.
Field Lodge is a residential care home providing personal and nursing care to 68 people aged 65 and over at the time of the inspection. The service can support up to 72 people. The care home accommodates people in four wings over three floors. Two wings accommodate people who need nursing care, one of which caters for people living with dementia. Two wings accommodate people who need personal care, one of which caters for people living with dementia.
People’s experience of using this service and what we found
Field Lodge gave people a modern, spacious, clean home, with a warm, homely and lively atmosphere. People showed and told us how much they liked the staff and enjoyed living there. A relative wrote, “[I write this] to express the family’s utmost gratitude for the exceptional care my [family member] experienced during [their] years at Field Lodge. Some of the carers are so young yet they are so dedicated. It never ceases to amaze me how kind and professional they are….All the staff have been so supportive during this time (death of spouse) – “thank you” seems so inadequate for the love and care my [family member] has been shown.”
The whole staff team, led by the lifestyle lead, provided an exceptionally wide, varied and interesting range of things for people to do so that people were kept as meaningfully occupied as they wanted to be. Staff frequently ‘went the extra mile’ to make sure people had the care they needed.
Some improvements were required as the information in some care plans was not always consistent; not all risks had been assessed and not all risk assessments were up to date or accurate; some charts such as food and fluid charts were not always completed correctly or monitored; and equipment to keep people safe, such as sensor mats, was not always in place when needed and was not regularly checked. The provider had a quality assurance system in place but it had not identified these issues.
People were not always supported to have maximum choice and control of their lives nor in the least restrictive way possible; best interest decisions were not always made and recorded. People’s privacy and dignity was not always upheld.
Staff knew people well and treated people equally and without discrimination. They were kind and caring and supported people to maintain or regain their independence. Staff were motivated, knowledgeable and skilled to provide care to each person and had undertaken training in a range of subjects relevant to their role. Some risk assessments were in place and a new, electronic system was in place to support staff to manage people’s medicines.
The provider had systems in place to ensure that people, their relatives, staff and visitors to the home were involved as much as they wanted to be in the running of the home. There was a registered manager in place who worked hard to improve the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 18 August 2017).
Why we inspected
This was a planned inspection based on the previous rating. Following the first day of the inspection we received the report of a safeguarding investigation raised in May 2018, involving two people who lived at Field Lodge. The report highlighted a number of improvements needed. We carried out day two of the inspection to make sure the improvements had been made and sustained.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This inspection took place on 1 and 6 June 2017. The visit to Field Lodge on 1 June 2017 was unannounced. At the time of this inspection there were 63 people in residence.
At our last inspection the service was rated as good. At this inspection we found the service remained good overall. However, the question ‘are services at this location responsive?’ had improved to outstanding.
The service was safe because there were enough staff on duty to meet people’s needs and staff understood their responsibility to keep people safe from harm and abuse. Potential risks to people had been assessed and guidance given so that staff knew how to minimise risk. Medicines were managed safely and staff recruitment ensured that only people suitable to work at this home were employed.
The service was effective because people’s needs were met by staff who were trained and supported to 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. 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, compassion and respect. People had choices in all aspects of their daily lives and people knew that the staff genuinely cared about them. People were supported to be as independent as possible. People’s privacy and dignity were not always maintained.
The service was very responsive because staff knew people’s needs and lifestyle choices extremely well and supported them to lead the life they wanted. People and their relatives were involved in developing fully personalised care plans, which gave staff detailed guidance on every aspect of the care each person needed. People were given numerous, individualised and creative opportunities to fulfil their wishes and dreams and to keep their minds and bodies active. Any complaints were listened to and addressed.
The service was well led because there was a manager in post who was dedicated, approachable and provided good leadership. A quality assurance system was in place to check that the service provided was of the highest possible quality. People, their relatives and other visitors to the home were given opportunities, and encouraged, to share their views about the service being provided.
Further information is in the detailed findings below.
Field Lodge is registered to provide accommodation and care, with nursing, for up to 72 people. The home is purpose-built and opened in February 2014. Accommodation is offered on three floors, in distinct ‘units’ each with lounge, dining and kitchen facilities. All bedrooms are spacious single rooms with an en suite shower room. Some of the bedrooms have a lockable door to link to the next room so that they can be used for people who wish to share. There is a café, hairdressing salon and cinema room in the home’s reception area, which are open to members of the local community.
This inspection took place on 19 February 2015 and was unannounced. There were 44 people in residence. The last inspection of this home was on 22 May 2014 when the provider was found to be meeting the regulations we assessed.
There was a registered manager in place. 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. On the day of the inspection the registered manager was on leave, so the deputy manager provided support to our inspection.
People, their relatives and visitors to the home were very complimentary about all aspects of the service offered at Field Lodge. They praised the staff and the managers and said how much they appreciated the comfortable, spacious environment and outside spaces.
The service was safe because there were enough staff on duty to meet people’s needs. Pre-employment checks had been carried out before staff started to work at the home and staff had been trained to recognise and report abuse. Any potential risks to people were managed so that the risks were minimised and people were given their medicines safely.
The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. People’s capacity to make decisions for themselves had been assessed by staff trained to do so. This meant that the rights of people not able to make their own decisions about aspects of their care were protected.
People were given sufficient amounts of nutritious, appetizing food and drink and were supported to make choices about all aspects of their daily lives. Special diets were provided for people who needed them. People’s health was monitored and maintained by staff with the involvement of a range of healthcare professionals.
Relationships between people who lived at Field Lodge and the staff were very good and staff showed they cared about the people they were looking after. Staff treated people well and respected their privacy and dignity. People were encouraged to remain as independent as possible.
People and their relatives were involved in the planning and reviewing of their care. Detailed information was available to staff so that each person received the care and support they needed in the way they preferred. A wide range of activities, outings and entertainments were offered to people as well as people’s individual hobbies and interests being supported.
The home was managed well. People, their relatives and the staff were encouraged to give their views about the home and put forward their ideas for improvements. The provider’s complaints procedure was well advertised and people said they felt comfortable to raise any issues with the management team. An effective system was in place to monitor and audit the quality of the service being provided.
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
Below is a summary of what we found.
Is the service safe?
People we spoke with said they felt safe and that they knew staff would not hurt them. Staffing levels were high so that there were enough staff on duty to meet people's needs. Assessments of any potential risks to people had been carried out and actions put in place so that staff knew how to minimise and manage any risks.
Staff had undertaken training in protecting vulnerable adults from abuse. They showed us that they had learnt how to recognise if abuse was taking place, and that they knew to whom they would report any concerns. Telephone numbers for external agencies, such as the local authority's safeguarding team, were available for staff to use should they have needed to. Staff were also aware of the provider's whistleblowing policy, which was displayed on the board in the staff room.
Staff had undertaken training relating to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager had made applications to the local authority and we saw documents on file to show that a standard authorisation had been granted for one person. This meant that any restrictions to this person's liberty had been agreed as being in their best interest. This showed that appropriate action had been taken to ensure people's rights were protected.
Is the service effective?
One relative told us, 'I think this is perfect for my [family member]. It's a community for her and she's happy here.' People said they were happy at Field Lodge, their needs were met by staff in the way they wanted them met and they liked the staff. Care plans gave staff good, detailed guidance about how each person preferred their care and support to be given.
Is the service caring?
On the day we inspected, a thank you card arrived in the post, from a person who had had a respite stay at the home. They wrote, 'I can't thank you enough, you are all so caring.'
We saw that people got on well with the staff and were comfortable with them. Staff had a friendly, caring attitude and showed that they respected the people who lived at Field Lodge. People told us that staff helped them to maintain their privacy and independence.
Is the service responsive?
People's needs were assessed before they were admitted to the home, and a care plan developed to meet each person's individual needs. The care plans were reviewed monthly, or more frequently if required, to make sure that the planned care and support was still meeting the person's needs.
A number of activities and entertainments were organised, which people could join in if they wanted to, and people were supported to maintain contact with friends and relatives. People and their relatives were given opportunities to express their views about the running of the home.
Is the service well-led?
Field Lodge had only opened a few months before this inspection. The manager demonstrated that they were fully involved in all aspects of the service being provided to people. People told us they would be happy to speak with the manager or any of the staff if anything was not right.
The provider had a robust quality assurance system in place to make sure that the service provided by the staff was of a very high standard. A range of audits and action plans ensured that all aspects of the service were closely monitored.
Staff told us they liked working at Field Lodge. One member of staff told us, 'I really love my job.' Those we spoke with praised the manager and senior staff, who they found to be very supportive.
We found that the provider was compliant with the regulations in all the areas we assessed. If you wish to see the evidence supporting our summary please read the full report.