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Inspection carried out on 1 June 2017

During a routine inspection

Field Lodge provides accommodation, nursing and personal care for up to 72 people, including people living with dementia. Field Lodge opened in February 2014 and offers accommodation on three floors. Each floor has a number of sitting areas and each dining room has a kitchenette.

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.

Inspection carried out on 19 February 2015

During a routine inspection

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.

Inspection carried out on 22 May 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• 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.