The Fields

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The provider had systems and processes in place to monitor accidents and incidents and learn lessons from these. Accidents and incidents were monitored for themes and trends and overarching governance was in place, to ensure action was taken in response to incidents. This included falls monitoring and analysis. Regional managers were aware of all incidents in the service.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Professionals told us staff worked well with them and acted upon their advice. A professional said, “I have moved several people to The Fields over the years, and every time I have received excellent communication and support from management to support workers. We have a great working relationship to ensure what’s in the best interest for each single person.” Staff supported people to transition between services and where people required a stay in hospital, records were available to share with hospital staff, which gave them information about people's needs. Staff referred people to external professionals, to promote their health and minimises risks.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Staff understood their responsibilities to report concerns and were trained about how to spot signs of abuse. Staff told us they felt comfortable to whistle-blow on poor practice. A staff member said, “I have never had to whistle-blow, but feel comfortable to if needed. People are safe, people's risks are mitigated. It a lovely, friendly environment.” People told us they felt safe living at the service. A relative said, “The Care Plan is fluid and moves as our relative changes. We have no concerns about safety because of the way they are. The staff team operate around our relative. I don’t know what else they could do. They know our relative and we trust them 100%.” Safeguarding incidents were reported to the local authority. However, we found an incident which we had not been notified about, this was brought to the attention of the managers on the day of our assessment and a report was retrospectively made. Where staff had raised concerns, we found appropriate action was taken and these were thoroughly investigated.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People had up to date risk assessments and associated care plans in place. This included where people were at risk of choking, falls and malnutrition. Monitoring was in place to keep people safe, including monitoring people's weights, mobility and during meal-times. We observed people being given food and fluids in line with their assessed needs, and information was available to staff in care records and communal areas. Where people were at risk of pressure wounds, equipment, repositioning and monitoring was in place, to reduce risks to people developing these.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.The provider did not always detect and control potential risks in the care environment. During a tour of the home, we found some hazardous cleaning material items to be unlocked and some razors in a communal bathroom, which could pose a risk to people. This was brought to the attention of staff and immediately rectified. We also spoke with the management team about ensuring items were appropriately locked away. We also found some kitchenette areas to be untidy and dirty. Maintenance checks were in place and all equipment and environmental safety checks were completed. Fire safety systems were in place, including safety equipment, staff training and evacuation exercises. People had personal evacuation plans in place and emergency grab bags were in place.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Staff were recruited safely and appropriate pre-employment checks were in place, such as references and police records checks. Staff were trained in a range of subjects to enable them to carry out their roles effectively, such as communication, catheter care, enteral feeding, learning disabilities, wellbeing and epilepsy. A staff member said, “The provider has funded me to do my nurse training, I am really fortunate to work here, I couldn’t have done this without their support.” Staff received regular supervisions and appraisals and were involved in regular team meetings. We observed enough staff to meet people's needs. People, professionals and relatives told us there were enough staff. A person said, “Staff take me to hospital health appointments, they take me to visit my mum and I am going on holiday soon, to the lakes. I do lots of activities.” A professional said, “There’s always staff around, giving us notes and information in a timely manner.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff were trained in relation to infection, prevention and control and we observed staff wearing personal protective equipment appropriately. Systems were in place to promote safe infection control practices, and relatives and professionals told us the home was clean and welcoming. A relative said, “The best thing about here is that they are good at keeping in contact, their bedroom is clean, and they make the room nice for my relative. They have a small fridge in their room where they keep cans of beer. Everything is clean and well looked after.” The service had recently had a food hygiene rating score of 5. People had their own ensuites with their own toilet and sink areas.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Medicines were managed safely. However, we found some records relating to as required medicines required updating, to ensure guidance was in place for staff about how and when to administer these. Staff completed medicines administration records and people told us they received their medicines as prescribed. Medicines were appropriately stored and disposed of. Staff were trained to deliver rescue medication to people in the event of a seizure and staff had their competencies assessed prior to administering medicines to people.