Church Farm at Field House

Updated 26 April 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by an inspector, a specialist advisor (nurse) and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

The service is a ‘care home’.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We did not give the provider notice of this inspection.

Inspection site visit activity started and ended on 5 March 2019.

What we did:

We reviewed information we had received about the service since the last inspection. This included checking incidents the provider must notify us about, such as serious injuries and abuse. We sought feedback from the local authority, Healthwatch and professionals who work with the service. The provider completed a Provider Information Return (PIR). This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan our inspection.

During the inspection, we spoke with nine people who used the service and three relatives. We spoke with a visiting GP, domestic assistant, two members of the care staff, a nurse and clinical lead, two directors, the head of operations and the registered manager.

We reviewed a range of records. This included six people's care records and three staff files. We also viewed training and supervision records and records relating to the safety and management of the service.

After the inspection, we asked the registered manager to provide us with a variety of policies and procedures and additional information. All information was sent within the required timeframe. We used all this information to help form our judgements detailed within this report.

Updated 26 April 2019

About the service: Church Farm at Field House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service supports older people. At the time of the inspection there were 39 people using the service.

People’s experience of using this service:

• The provider met the characteristics of ‘Good’ in all areas. This has improved from a rating of ‘Requires Improvement’ at the last inspection in 2017. More information about this is in the full report.

• The risks to people’s health and safety were now appropriately assessed resulting in safe care being provided. People were protected by staff who understood how to protect them from avoidable harm. People were supported by enough staff to keep them safe and to provide care in the way they wanted.

• Improvements had been made to the way people’s medicines were managed. The risks associated with medicines had now been reduced. Improvements had also been made to the safety of the building and the safe management of the risks associated with the spread of infection. The registered manager now had the systems in place to help them to learn from mistakes. This included the detailed analysis of accidents and incidents.

• The principles of the Mental Capacity Act 2005 were now appropriately applied and adhered to. This meant people were now supported to make decisions about their care and those decisions were acted on by staff.

• Staff training was up to date and they received on-going assessment of their practice. People were provided with care and support which protected them from discrimination. People received the support they needed to maintain a healthy diet. People at risk of weight loss or gain and dehydration were referred to health specialists. People had access to other health and social care agencies where needed. The environment had been adapted to support people living with dementia and/or a physical disability.

• People liked the staff and found them to be kind and caring. People were treated with dignity and respect. People felt involved with decisions and that staff respected their wishes. People’s records were stored securely to protect their privacy.

• People’s needs were assessed prior to them coming to live at them home. This helped to ensure their needs could be met by staff. People’s personal preferences were considered when care was planned. People had access to information in a format they could understand. People felt their complaints were responded appropriately. Complaints were responded to in line with the provider’s complaints policy. People did not currently receive end of life care. End of life care plans were basic and required more detailed reference to people’s personal preferences.

• Improvements had been made to the overall assessment of risk at the home. Audits were now effectively used to assist the registered manager and the provider in identifying and acting on risks in an effective and timely manner. Staff enjoyed working at the service and felt respected and valued. People could give their views about how the service could develop and improve. There was a continued focus on learning, development and improvement. The registered manager had a good understanding of the regulatory requirements of their role, however we did note they had not notified the CQC of one incident when required. Policies have been amended to ensure this does not happen again.

Rating at last inspection:

At the last inspection the service was rated as Requires Improvement (7 and 8 August 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to review information we receive about the service until the next scheduled inspection. If we receive any information of concern we may inspect sooner than scheduled.