Fieldhead Park

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has changed to inadequate. This meant services were not planned or delivered in ways that met people’s needs. The service was in breach of legal regulation in relation to person-centred care.

This service scored 29 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People were not placed at the centre of their care. Care had not been planned or reviewed in collaboration with people and often their needs, wishes and preferences were not considered.

People did not always have their personal care needs met in line with their needs and preferences. For example, 1 person’s records showed they had not received support with oral hygiene on 14 out of 28 days. Another person told us, “They give me a strip wash. I’ve not had a shower it would be nice to have a shower.” A relative told us, “I clean [Name]’s glasses and watch because they [staff] don’t always do it. Sometimes after lunch [their] mouth needs a wipe, and they don’t always do it. [Name]’s nails need cutting. I would appreciate being told when [they have] a bath. I’m not sure [they have their] teeth cleaned.”

The environment was not person-centred and appropriate to meet people’s needs and preferences. For example, 1 person had no personal items or items of decoration in their room. The walls were bare, marked and the paint was peeling. We observed the person laid in their bed, which was positioned so that they could not see the TV. In addition, the environment on the dementia unit was not designed to fully meet the needs of people living there. Dementia friendly design and adaptation was minimal. Some people had memory boxes outside their rooms, but others did not have anything.

The lunch time experience on the dementia unit was not person-centred to meet the needs of people living with dementia. The meal was served on yellow plastic plates. There were no tablecloths or table decoration, and no condiments available for people to use. People were given a disposable paper bib to protect their clothing. There were no show plates utilised to support people living with dementia to make a choice. Interactions with people during lunch was task-based. There were no positive interactions between staff and people to maintain their wellbeing and promote their personhood. One person told us, “One day they missed my tea and at 6pm I asked for sandwiches. They brought me egg sandwiches, yoghurt and a banana, which I don’t eat. It’s like they don’t understand, and they said I had refused my tea, I didn’t refuse, it’s just that I don’t eat what they brought me.” In addition, a relative told us, “They have once forgotten to bring [Name]’s tea up, the week before last. They forget [Name] at lunchtime if [they] forget to go down to the dining room.”

There were significant shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not joined-up, flexible or supportive of choice and continuity.

The service mainly supported older people with physical health needs and/or living with dementia, yet the needs of those people were not fully understood or met. There were significant shortfalls in provisions for people, in relation to care, activities and the environment. We observed staff practices that did not meet the diverse needs of people.

The service had some links with external communities, which were available for some people. However, for many people those links were not evident as they were not provided with the opportunity to participate.

The provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People did not have information regarding their care and support available to them. For example, copies of their care plans and risk assessments. Accessible and easy read information was not available for people who needed it. The registered manager told us there were some communication cards available that were not in use at that time. It was not clear why they were not in use when some people were less able to communicate.

The provider’s systems and processes to obtain feedback were ineffective in ensuring all people were listened to and improvements made. People were not always involved in decisions or told what had changed as a result of their feedback.

Information relating to complaints showed conflicting information regarding the number of complaints received. There was no evidence of analysis, lessons learnt, or actions taken following complaints. There was no evidence of complaints information being shared with staff or action taken to improve the service.

The provider started to obtain feedback from people and relatives via a survey as a result of the initial assessment concerns raised following the first site visit. There were responses from 7 relatives and 4 people provided. There was no evidence of prompt action taken following the initial survey feedback. For example, 1 person’s survey documented that they would like to have a hot drink when they are awake early in the morning and another person said they waited a long time for assistance. Neither of these concerns were promptly addressed as we found people were waiting for a long time in the morning for a drink and people were waiting for long periods of time to have their needs met, throughout the assessment.

Meetings were held with people and relatives. However, meeting minutes did not document who attended and details were minimal regarding what was discussed. It was not clear what action was taken following the meetings. There was no evidence of attempts being made to support people who were less able to communicate to give their views.

The provider did not make sure that all people experienced equity in accessing the care, support and treatment they needed when they needed it.

People were not always supported to experience equality in the care they received. People who were living with dementia and those who were less physically able, did not have the same opportunities as other people living at the service. For example, opportunities to participate in activities, access the outdoors, or experience meaningful engagement. In addition, information was not available for people with differing communication needs, in an adapted format. Improvement was also required to ensure people’s care was person-centred, reflecting their needs, choices and preferences.

Leaders and staff did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this.

There was a failure to maintain effective oversight and monitoring of the experiences of people who were physically less able, and people living with dementia. Inequality in the experiences of these people was evident throughout the assessment. The provider and registered manager failed to identify and address these shortfalls to improve the lives of these people.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

During the inspection we did not observe anyone actively receiving end of life care. Care records showed that some people had end of life care plans in place. Where these were in place some required improvements to ensure they were person-centred.