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Inspection carried out on 9 May 2017

During a routine inspection

Field House is a service that supports older people. It provides accommodation with personal care for up to 20 people. There were 18 people living at the home on the day of our inspection.

Rating at last inspection

At the last inspection, in April 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

People continued to receive care which protected them from avoidable harm and abuse. Staff supported people's needs in a safe way, monitored risks to their safety and were available when people needed support. People's medicines were managed and stored in a safe way, and they had their medicines when they needed them. Some people managed their own medicines with safe support form staff.

Staff were supported through training and meetings where their views were listened to. Staff were encouraged to develop their skills so that they could develop their professionalism and take additional responsibilities in the home. Some of the staff had worked there for several years providing people with a continuity of care

People received care that was kind and compassionate. Care was tailored to the individual and provided by staff that were respectful, trained, well supported and managed. This ensured people received an excellent caring service.

Relationships with families and friends were cherished and developed so that people were able to maintain and develop their ties with people important to them. Friends and families built relationships with other people living in the home. This provided people living in the home with a continuation of friendships and interactions with a wide group of people that were interested in them as individuals and that enhanced their quality of life. Staff had been commended by relatives about the support they and their loved ones had received during the emotional time at the end of their loved one's life.

People received care and support that was individual to them. Their support needs were kept under review and staff responded when there were changes in these needs. People had opportunities to give feedback and make complaints about the care and support they received. They also had opportunities to make suggestions for improvements at the home and these were listened to.

People lived in a home where they felt confident to express themselves and felt comfortable to speak with staff and managers about concerns and issues that affected them. The provider had systems in place that continued to be effective in assessing and monitoring the quality of the service provided.

Inspection carried out on 8 April 2015

During a routine inspection

Field House provides accommodation for up to 20 older people who may need support with their personal care. There were 19 people living in the home at the time of our inspection. This was an unannounced inspection, carried out over one day on 8 April 2015. The home was last inspected on 12 September 2014. We asked the provider to make improvements to how they supported staff. We found at this inspection that this had been done and good support systems were in place.

A registered manager was in post. 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.

The provider had policies and procedures to ensure that people who could not make decisions for themselves were protected. People’s human rights were protected because staff understood the policies and legislation and how to apply them.

Good systems were in place to protect people from harm. All staff had been given training in keeping people safe. Staff were clear about their responsibilities to be aware of and report any incidents of abuse or suspected abuse immediately. People told us they felt safe living in the home and believed staff would do everything necessary to keep them safe. No-one shared any issues of concern. Accidents and incidents were monitored and reviewed to identify any issues or concerns. People were assessed against a range of potential risks such as poor nutrition, falls, skin damage and mobility.

The registered manager assessed people for their level of dependency and this information was used to determine the minimum staff number needed to run the home. In addition to this system they monitored people’s needs and staff feedback on the number of staff needed. The registered manager had increased the number of staff to cover events as necessary. Suitable recruitment procedures and checks were in place to ensure staff had the right skills to support people at the home. Medicines were handled safely and stored securely.

People told us they were happy with the standard and range of food and drink provided at the home. People were given a choice about what they wanted to eat at each meal. Kitchen staff kept records regarding people’s individual dietary requirements and preferences.

People told us they felt the staff had the right skills and experience to look after them. Staff confirmed they had access to training and development. Regular supervision took place and staff received annual appraisals.

People told us they were very well cared for and spoke highly of the kindness and attention of the registered manager and staff in the home. Staff knew people well and used their knowledge of people’s families and life histories to engage with them.

Staff were able to tell us about people’s particular needs and how best to support them. People’s health and wellbeing was monitored and staff regularly referred people to GPs and district nurses.

People and their families were encouraged to express their views and be actively involved in their own care and in the running of the home. There were frequent residents’ meetings and the registered manager made time to speak with people directly. Good information was displayed about the services and activities on offer. Important contact details, such as advocacy services, were made available to people and their visitors to help them maintain their independence.

People told us they rarely had to formally complain about the service. Only one formal complaint had been raised in the previous 12 months and this had been resolved quickly.

The provider had a wide range of activities and opportunities for social stimulation, both in the home and in the local community. People told us they were happy with the social activities available to them and said that staff made every attempt to meet individual preferences, as well as providing group activities.

The registered manager provided clear leadership and ensured there was an open and positive culture in the home. Staff told us they were clear about their roles and responsibilities and were proud of the quality of care they provided and were happy working in the home. They said they felt supported and respected by the registered manager.

People living in the home spoke very highly of the registered manager and said she was always approachable, positive and responsive. They said they felt listened to by the registered manager and her staff and were encouraged to express themselves freely. We were told the home had a happy and relaxed atmosphere and our observations confirmed this.

Health professionals who supported the home commented very positively on the ability and quality of the management of the home.

Inspection carried out on 12 September 2014

During a routine inspection

An adult social care inspector carried out this inspection. The registered manager was on leave at the time of our visit. The service was being managed by the general manager of another home within the company and their deputy. Both were present during our inspection. As part of the inspection we spoke with four people who used the service and the relative of one other. We also spoke with three members of staff in detail and briefly to three others. We reviewed the records relating to the management of the home. This included four care records, three staff personnel records, policies and procedures, and minutes of meetings.

Field House is registered to provide accommodation to 20 people who require personal care. On the day of our visit there were 20 people using the service.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

People told us that they felt safe. One person told us, “I feel safe and cared for”. Individual risk assessments were well completed and actions to minimise the risks identified were reflected in care plans.

The provider had systems in place to ensure the safety of the people who used the service, staff and visitors. The premises were well maintained and designed to meet the needs of the people who used the service. Service wide risk assessments, together with the actions to reduce those risks, were reviewed regularly.

The provider had effective Mental Capacity Act 2005 policies and procedures in place. Staff had received training and were clear about their role and responsibilities. The provider was appropriately applying Deprivation of Liberty safeguards.

The provider had effective medicines management policies and procedures which were applied in practice. Staff had received training and had their skills assessed. People told us that they were aware of what medicines they took and for what condition.

Is the service effective?

People's needs were assessed and care plans developed. People told us that they were involved in developing their care plans. Care plans reflected both the needs and choices of people. Staff had a good knowledge of people’s care needs.

Staff received appropriate training and professional development to meet the needs of the people they care for. Policies and procedures were appropriate, up to date, and reflected current research and guidance.

There was no evidence that staff had received regular supervision and appraisal. We have asked the provider to send us a plan to detail the actions they will take to address this.

Is the service caring?

People told us that the staff were kind and friendly. One person told us, “All the staff treat us with dignity and respect.” A relative told us that, “The care is very good.” We observed staff treating people in a friendly and caring way. People had access to a wide range of activities that they enjoyed.

Is the service responsive?

People were asked for their views about the service. Annual satisfaction surveys were undertaken. Monthly meetings were held for the people who used the service. People were encouraged to make choices about the way the service was provided.

People who used the service and staff were clear about the complaints process. People told us they were confident that any issue raised, or complaint made, would be investigated and acted upon.

Is the service well-led?

People and staff we spoke with told us they felt well supported by the registered manager. Staff said they were able to raise issues with their manager at any time and were confident they would be acted upon. Staff had opportunities to raise and discuss issues at staff meetings.

A range of audits were undertaken and the results used to improve the service. Action plans clearly identified who was responsible for implementing any change required. Lessons learnt from incidents were analysed, shared with staff, and actions agreed and monitored.

Inspection carried out on 28 May 2013

During a routine inspection

People and the relative we spoke with were happy with the care provided at the home.

At our inspection we found that people and their relatives were involved in the care and there were suitable measures in place to ensure people's nutritional needs were met.

People were cared for in a clean, hygienic environment. People told us the standard of cleanliness was good and that their clothes were laundered well.

There was an effective recruitment and selection procedure in place.

Inspection carried out on 20 November 2012

During a routine inspection

People told us that they were happy in the home. One person said, “I don’t want to be anywhere else”. People told us that the staff were, “Very helpful” and that they were, “Lovely people”. Everyone we spoke with was particularly complimentary about the home’s activities coordinator.

We saw staff treating people with respect and kindness. Staff were very attentive to people’s needs.

People told us that staff always responded promptly to any requests. One person told us that if they pressed their call bell, “They are round here before I let go of the button”.

We found that care records were detailed and gave staff all the information they needed to support people. People’s needs and preferences were clearly recorded. Staff we spoke with understood the people they were caring for well.

Staff told us that they enjoyed working at the home and they felt well supported by the manager. We found that staff training was comprehensive and up to date.

The management had robust internal audit systems in place to monitor and improve the quality of the service in the home.

Inspection carried out on 17 January 2011

During a routine inspection

People told us that they enjoy living at Field House and that they very much consider it ‘their home’. They told us that they are involved in planning their care that their views are always taken into account in the way the service is provided and delivered. People said their privacy and dignity is always respected and their independence promoted.

People told us that the home is very well run. One person said “The manager is the most wonderful leader; she has good principles and inspires her staff. I couldn’t speak more highly of her. The care is superb, it’s a happy home and I’m very well looked after here”.

People told us they are happy with their bedrooms and that they can either remain in the privacy of their own room or join other people in the range of communal areas available. They said their rooms are kept clean and when they moved in they were encouraged to bring in some of their personal belongings to make it their ‘own’.

We were told that windows to the front of the home will be replaced this year and the outside repainted.

People said the staff are kind, work hard and know them well. One person said “the freedom the staff give me makes all the difference. I’m very happy here, the food is superb and I’m looked after extremely well”.

Staff told us that they enjoy working at the home and that they are well supported. They said that they have good training opportunities. They were able to tell us about the individual needs of the people they care for.

A healthcare professional told us that staff work very hard to identify any medication or social problems an individual may have. They said that staff know resident’s individual needs very well. They said “Staff use our service appropriately and work well with us”.

Another health professional told us “I have no concerns with the home”.

Reports under our old system of regulation (including those from before CQC was created)