We carried out a review of the data available to us about Field House 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 House, you can give feedback on this service.
Field House Care Home is a residential care home providing personal and nursing care to 34 people aged 65 and over at the time of the inspection. The service can support up to 39 people.
Field House Care Home is laid out over three floors and divided into areas: Orchard View and the Main House. Orchard view provides accommodation for people living with dementia and is laid out over one level. There are bedrooms, toilet and washing facilities, a kitchen and lounge-diner. The Main House offers accommodation across three floors, provides toilet and washing facilities, a hairdressing room, two lounges and dining area. There are additional ‘nooks’ or areas where people can sit throughout communal areas in the home. All floors can be accessed by a lift and there is access to other areas in the home via a stairlift. People have level access to large gardens. The registered manager’s office is adjacent to the main entrance.
People’s experience of using this service and what we found
People told us they received support from staff who were kind. People’s equality characteristics were met by the provider. The provider supported people to express their views and be involved with decisions about their care. Staff spoke confidently about how they would support people in a dignified way.
Care plans we reviewed were person-centred and people were supported to access information that was important to them. The provider ensured people were able to maintain relationships and people were supported to access relevant activities. Complaints were reviewed and managed appropriately, the registered manager maintained a log of compliments. People were supported to create treatment escalation plans (TEPs) and the provider was working to develop end of life care plans.
People received care that was effective; people’s needs and choices were assessed and reflected in their care plans. Mobility assessments for people who used specialist equipment were not completed in line with published guidance. Also, they did not include all the information required by the provider’s template. Staff told us they were supported to carry out their roles through supervision and training. People were supported to eat and drink enough. People retained 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. People told us they were supported to access the healthcare they needed.
People told us they felt safe. People received safe care; risks were identified and assessed, guidance was available for staff about how they could lower potential risks to service users. Staff spoke confidently about how they would identify potential abuse and what they would do if abuse was suspected or witnessed. The provider used a staffing dependency tool to deploy staff across the service in accordance with people’s needs. People and staff told us they felt there were times when staffing levels in the home were insufficient. Medicines and creams were managed and administered safely. Recruitment processes were in place, these included checks with the applicant’s previous employers and disclosure and barring service (DBS).
The service was well-led, there were governance systems in place to identify errors and omissions and the registered manager was aware of their responsibility to act in an open and transparent way. Staff we spoke with talked about people in a person-centred way and there was a clear staffing structure in place. The provider had built links with local organisations and worked in partnership with others to improve the experiences of people. People and relatives were provided with opportunities to feedback their experiences of the service.
Rating at last inspection: The last rating for this service was good (published July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated Good
People felt safe at the home and with the staff who supported them. One person said “I feel very safe living here and I am very happy.” The provider’s staff recruitment procedures helped to minimise risks to people who lived at the home. Training for all staff made sure they were able to recognise and report any suspicions of abuse.
There were sufficient numbers of staff to keep people safe and to provide care and support in an unhurried manner. People told us staff were always kind and caring. Throughout the inspection there was a cheerful, relaxed and caring atmosphere. There was a consistent staff team with some staff working at the home for a number of years. It was evident staff knew people well.
There was a full programme of activities including a strong relationship with the local community and schools. People had access to extensive grounds which were used for events which involved the local community. However they also had access to a safe garden where they could sit and enjoy the good weather.
People received effective care and support from staff who were well trained and competent in their roles. Staff monitored people’s health and made referrals to healthcare professionals according to their individual needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The registered manager’s philosophy was to provide a, “homely, comfortable atmosphere with friendly and approachable staff, a home from home.” This philosophy could be seen throughout the inspection and through talking with staff, people living in the home and relatives. Staff spoke passionately of the people they cared for and how they could make people feel at home and relaxed.
People were cared for by kind and patient staff who respected their privacy and dignity and helped them to maintain their independence.
People benefitted from a management team who were open and approachable and had systems in place to seek people’s views. People were always asked for their consent before staff assisted them with any tasks and staff knew the procedures to follow to make sure peoples legal and human rights were protected.
There were systems in place to monitor the care provided and people’s views and opinions were sought regularly. Suggestions for change were listened to and actions taken to improve the service provided. All incidents and accidents were monitored, trends identified and learning shared with staff to put into practice.
Further information is in the detailed findings below
Field House is a care home which is registered to provide care for up to 36 people. The home specialises in the care of older people but does not provide nursing care. There is a registered manager who is responsible for the home. 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 and associated Regulations about how the service is run
On the day of the inspection there was a calm and relaxed atmosphere in the home and we saw staff interacted with people in a friendly and respectful way. People were encouraged and supported to maintain their independence. They made choices about their day to day lives which were respected by staff.
People said the home was a safe place for them to live. One person said “I wouldn’t want to live anywhere else. I have never been mistreated since I have lived here and I have never seen anyone else treated badly. I would certainly speak up if I had, you can be sure of that.” One visitor said “It was such a relief knowing that (my relative) was being well cared for in a safe environment when before she was so far away and having falls.” Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns. Staff spoken with were confident that any allegations made would be fully investigated to ensure people were protected.
People said they would not hesitate in speaking with staff if they had any concerns. People knew how to make a formal complaint if they needed to but felt that issues would usually be resolved informally. One person said “I did have one issue but the manager sorted this out immediately.”
People were well cared for and were involved in planning and reviewing their care. There were regular reviews of people’s health and staff responded promptly to changes in need. People were assisted to attend appointments with appropriate health and social care professionals to ensure they received treatment and support for their specific needs.
Staff had good knowledge of people including their needs and preferences. Staff were well trained; there were good opportunities for on-going training and for obtaining additional qualifications. Some staff members had lead roles such as end of life care and dementia care so they were able to guide staff practice in these areas. Comments about staff included “They know how to care for me. If you ask them to do anything for you they will do it” and “The carers are wonderful they will do anything.”
People’s privacy was respected. Staff ensured people kept in touch with family and friends. Each visitor we spoke with told us they were always made welcome and were able to visit at any time. People were able to see their visitors in communal areas or in private. One visitor said “The staff are so supportive and we are able to visit whenever we want to.”
People were provided with a variety of activities and trips. People could choose to take part if they wished. One person said “There’s lots going on. We have film shows, bingo, games and exercises. We do flower arranging and a lady comes in to help us with sewing. You join in if you want to; you don’t have to.” Staff at the home had been able to build strong links with the local community.
There was a management structure in the home which provided clear lines of responsibility and accountability. The registered manager showed a great enthusiasm in wanting to provide the best level of care possible. Staff had clearly adopted the same ethos and enthusiasm and this showed in the way they cared for people.
There were effective quality assurance processes in place to monitor care and plan ongoing improvements. There were systems in place to share information and seek people’s views about the running of the home. People’s views were acted upon where possible and practical. In addition to the resident’s committee and the ‘Friends of Field House’, the service gained feedback from ‘themed conversations’ with people, stakeholder surveys, complaints and compliments to continually develop the service.
One person told us, "I'm very happy here. Staff are good to me. I feel safe and comfortable".
People were engaged with in an unhurried and supportive way. We saw that staff treated people with consideration and respect. Staff were able to recognise when people wanted assistance and responded promptly, we observed care being provided in a dignified manner.
The service demonstrated practice that ensured that people were safeguarded against abuse. One person told us, "this place is safe and the staff support me to make decisions about my care. I am happy here".
Care practice and record-keeping were clear with regular auditing procedures. This meant that care plans were current and reflected how to meet people's needs.
There were effective processes in place for how staff were supported such as regular supervision, training and appraisals.
The provider had quality assurance systems in place to check that the quality of the service people were receiving met their needs.
People were able to comment directly on their care so we spent time speaking with them and their relatives.
People spoken with told us they were very happy with the care and support they received at Field House. One person told us, 'They are just so good, nothing is too much. They respect my privacy and always knock on the door. I can't ask for more really'. Another person told us, 'They are marvellous really, they think of everyone equally'. A visiting friend told us, 'I didn't think homes like this existed, they are so caring and polite, I felt really welcomed. My friend says they are happy here and that is all that matters really'.
We observed staff organised meaningful activities and treated people who lived in the home with respect and dignity. People were encouraged to be involved in staff recruitment. This meant people maintained some control over their lives.
We found care planning was person centred and agreed by the individual, a family member or an advocate. Regular reviews were carried out and involved the individual.
We found the receipt, storage and administration of medication was managed safely within the Royal Pharmaceutical Society guidelines.
Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the registered manager. The provider had quality assurance systems in place that ensured people were safe and changes could be made to improve the service provided.