Fieldhead Park

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has changed to inadequate. This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls. The service was in breach of legal regulation in relation to person-centred care.

This service scored 25 (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 consistently treat people with kindness, empathy and compassion, or respect their privacy and dignity.

People did not always have their dignity maintained. For example, people requiring catheter care had their catheter bags visible to anyone entering the room or walking past rooms where doors remained open. We observed standard practice was to leave most people’s doors open at all times. In addition, we observed 1 person exposed from the waist down as their bedroom door was open.

We received mixed feedback from people and relatives regarding staff approach. Feedback included, “Some carers care more than others,” “Sometimes staff are a bit off if they are having a bad day. They don’t always come back when they say they will,” “They are always kind with [Name]” and “Staff are brilliant with [Name]. They are friendly and listen to [Name].”

We observed some kind interactions between staff and people. However, staff were not always empathetic and compassionate in their approach to people living with dementia. For example, 1 person who was trying to walk around was continually told to, “sit down and calm down.” In addition, we observed 2 staff members did not return to support a person who had requested their assistance.

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

There was a lack of person-centred care and individualised approach at the service. Language used did not demonstrate value placed on people as an individual and undermined their identity. For example, staff referred to people who required assistance with eating as “feeds”. We also observed people being referred to as room numbers during staff conversations.

People’s strengths, abilities, aspirations and unique backgrounds were not considered within care records. They did not always include people’s wishes, preferences, likes and dislikes. In addition. people were not always provided with an opportunity to engage in an activity that was meaningful to them and met their needs and preferences.

People did not have choice and control over their own care, treatment and well-being. People did not have appropriate, person-centred, meaningful engagement or activities available to them to meet their needs.

Some people had the opportunity to participate in activities, particularly those who did not have complex needs. However, there was a lack of opportunity for many people to have purpose in their day. For example, in the dementia unit lounge and the main lounge, we observed people being sat for long periods of time with task-based interaction only and no activities on offer. People were sat in front of the TV and at times music was also playing in the same area. People were not supported to access fresh air or outdoor space to support their wellbeing. For example, 2 people had not accessed fresh air or outdoor space for over 1 month.

There were no offerings of dementia friendly activities. A staff member responsible for co-ordinating activities spoke about the dementia unit and told us, “Oh there, I don't go round there a lot of the time. We don't have a great deal of dementia friendly things.” This demonstrated inequality for people living with dementia.

Care records further evidenced that people did not have engagement or activities to meet their needs. For example, 1 person had not been engaged in any activities for over a month. In addition, 1 person told us, “I’d like to go to the dining room, I worry that they would forget and leave me there. They say they are coming back, but they don’t. Nobody has asked me to go to any activities.”

People who were cared for in bed had minimal staff interaction demonstrating inequality for these people. One person, who was cared for in bed, told us at 14:15 in the afternoon, “No [staff don’t regularly come into my room to speak to me], just you have spoken to me today.” In addition, a staff member told us, “They are sat in their rooms with no-one to talk to.”

Feedback from staff confirmed that engagement and activities were not provided for everyone and that time pressures were an issue. One staff member told us, “They could do more, if they go on trips its always the same ones that are chatty and fun to talk to that go.”

Systems and processes had failed to identify areas requiring improvement in relation to people having choice and control over their care and wellbeing.

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

People did not always have their needs met in a timely manner or receive appropriate support. For example, 1 person was sitting in the lounge and wanted to urgently use the toilet. They asked 2 different staff members. Neither of the staff members returned to assist them. The person was crying. An inspector intervened and asked a staff member to provide support. In addition, a person was observed to be in their room, intermittently screaming out. Staff did not respond. When an inspector approached and interacted with them, they immediately stopped screaming. One person who had pressed their call bell for assistance told us, “I want to get up. They [staff] don’t come. They don’t come.”

Care records showed people’s needs were not being responded to. For example, some people who required repositioning for their skin integrity needs were not being repositioned appropriately.

There was a lack of oversight and monitoring by the provider and registered manager to ensure people’s needs were being responded to.

The provider did not always promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.

Staff gave mixed feedback regarding the support they received. Some felt supported whilst others did not. We observed staff struggling to meet the needs of people due to insufficient staffing. Workload pressures impacted on the ability of staff to provide person-centred care.