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Archived: Field House Rest Home Requires improvement

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Reports


Inspection carried out on 8 May 2015

During a routine inspection

The inspection was unannounced and took place on 8 May 2015.

Field House is registered provide accommodation and personal care for a maximum of 54. There were 47 people living at home on the day of the inspection. 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

People told us that they felt safe and well cared for with enough staff to meet their needs. Staff were able to tell us about how they kept people safe. During our inspection we observed staff were available to meet people’s care and social needs.

People received their medicines as prescribed and at the correct time. Systems and processes were in place so medicines were stored and able to be identified correctly. People who required medicines as needed received them when required.

People told us they liked the staff and felt they knew how to look after them. Staff were provided with training which they felt reflected the needs of people who lived at the home. However, the registered manager had not consistently applied the Mental Capacity Act 2005 (MCA).

Assessments of people’s capacity to consent and records of decisions had not been completed in their best interests. The provider could not show how people gave their consent to care and treatment or how they made decisions in the person’s best interests. Therefore, people had decisions made on their behalf that may not have been in their best interest.

People were supported to eat and drink enough to keep them healthy. We found that people’s health care needs were assessed, and care planned and delivered to meet those needs. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs although these had not always been followed.

People told us and we saw that their privacy and dignity were respected and staff were kind to them. Staff had been understanding and supportive of people’s choice and decisions. People had been involved in the planning of their care. Relatives told us they were involved in their family members care and were asked for their opinions and input.

People told us they got to do things they liked during the day and said that they did go out occasionally. People we spoke with told us they did not have any concerns but knew to approach the manager if they were not happy with their care.

The provider and registered manager made regular checks to monitor the quality of the care that people received and look at where improvements may be needed. However, we found that improvements were needed to ensure that the audits helped the provider to take action where they had identified areas for improvement.

Inspection carried out on 15 July 2014

During an inspection in response to concerns

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found.

Is the service safe?

The people who lived in the home told us they were pleased with the care provided. They said that their views were respected and listened to.

We saw that there were enough staff to attend to people’s needs.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

People told us that they were happy with the care they received. They told us that the registered manager and the staff had asked them what their needs were and how they would like them met. One person said, “They ask you what you want”.

Care records confirmed people’s needs and preferences had been recorded and care and support had been provided in accordance with their wishes.

People said they were happy to discuss their personal problems and preferences with staff. They said that staff obtained help for them if they were ill. This meant people were supported to keep in good health, had access to health care services and received ongoing support.

We found that the generally staff received the support and training that enabled them to meet the needs of the people living in the home At the time of our visit the provider was part way through ensuring all of the staff team had received necessary training.

Is the service caring?

People we talked with told us their choices and wishes were respected and they were able to live their lives as they wished. Staff took the time to find out about people’s background. Staff knew people’s needs well and how they wished to be cared for. This meant that staff cared about the person as an individual and were concerned about their well-being.

People that we talked with told us that they found the registered manager and the staff easy to approach about any issues they had. This meant that people were listened to and they felt that their views mattered.

Is the service responsive?

People had been assessed before they moved into the home so that arrangements could be made to meet their needs.

People told us they talked with the registered manager and the staff about what was important to them. They talked the about activities they took part in and their meals. They told us that their care packages had been changed as a result.

Is the service well led?

The management and staff treated people with compassion, dignity and respect. Staff we talked with showed they understood those values as they discussed their role and responsibilities in their work. This meant the service promoted an open culture that was centred on the individual and empowered them to take control of their life as much as they were able.

Inspection carried out on 14 October 2013

During an inspection looking at part of the service

Following our inspection in May 2013, we set a compliance action in one outcome area where we had concerns. This was about the storage and auditing of boxed medicines.

At this inspection we found that progress had been made in the storage and checking systems for people’s boxed medicines. This meant that where we had previously had concerns we found that improvements had been made.

We saw that there were systems in place that checked people’s boxed medicines to ensure people always received these at the right time as prescribed. This made sure people's health needs were effectively met.

Inspection carried out on 7 May 2013

During a routine inspection

We spent time at the home watching to see how staff supported people. We also talked with people about life at the home. People were very positive about life at the home and the support they received. One person said: "I’ve made friends and don’t feel lonely". Another person told us: "I like them (staff), they are nice to me".

Staff knew how to support people to meet their needs and referred people to other health professionals. Staff followed advice from other professionals to ensure people's health and well being. A relative told us that staff always let them know about any appointments and how their relation was.

We found that improvements needed to be made to the management of people’s boxed medicines as some records were not always accurate. Therefore we could not tell whether people were always receiving these types of medicines as prescribed to meet their health needs.

There were no unpleasant smells in the home. Improvements had been made since our last inspection as we saw equipment was clean for people to use and staff had received training to meet people's needs.

During this inspection we found that people's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. We also saw that the manager was developing the arrangements in place for monitoring the quality of the service to ensure improvements were made and sustained for the benefit of people who lived at the home.

Inspection carried out on 15, 16 November 2012

During a routine inspection

When we inspected Field House Rest Home 48 people were using the service. During our inspection we spent time with people in each of the lounges. We talked with four people in detail and more people for a short period of time. We also spoke with the registered manager and staff on duty.

Visitors to Field House told us that they were happy with the care and support that their relation received. People visiting told us that they found Field House to be, “Very Homely” with, “Very nice staff”.

Throughout the inspection we saw examples of staff caring and supporting people when they needed assistance.

While we were having a look around the home we found that appropriate standards of cleanliness were not always being maintained. Some equipment was found to be unclean and not suitable for people to use.

We saw that the management of medication needed to be improved. Medication was not always secure and records were not always accurate.

We spoke with staff and found that they were knowledgeable about different types of abuse and their responsibilities to report any suspicions or allegations of abuse. Staff were not able to tell us when they had received training in some areas. The records showed that some staff had not received training while others had not received refresher training.

Effective systems were not in place to assess and monitor the quality of care provided for people and as a means to identify where improvements were needed.

Inspection carried out on 9 March 2012

During an inspection looking at part of the service

We carried out a review of this location in October 2011. We found that there was non compliance with three outcome areas, and two outcome areas required improvement. Following our review, the registered provider gave us assurance that improvements would be made, and provided us with an action plan confirming how they would make improvements.

We carried out our March 2012 review to check that improvements had been made and found that they had.

We spent most of our visit time in the lounge and dining areas where we could observe staff interacting with people, and the daily routines.

We spoke with a range of people during our inspection visit, these included; people who live at the home, care staff and the care manager. The manager and staff told us that there had been improvements in the daily running of the home since our last visit. People who live at the location told us they were happy with the care and support provided by the staff. We saw that improvement had been made in record keeping such as care plans and managing risks, which meant people, receive improved care.

Inspection carried out on 6 October 2011

During a routine inspection

Health and social care professionals told us their concerns about a number of practices at the service. These included delays in seeking medical treatment, failure to recognise and respond to people in need of pain relief, and unexplained skin tears and injuries to people. We were told that there was a lack of equipment to lift people and that staff may not have adequate training in handling techniques or caring for people who have dementia.

We spoke with people from each of the three houses, who told us that they were happy and comfortable, and that staff were helpful and caring. We spoke with a visitor who was very positive about the care their relative received.

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