Field House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this location under the newly dual registered provider. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs, preferences, strengths and aspirations were comprehensively assessed and regularly reviewed to ensure people received personalised care that was responsive and effective. Initial assessments were thorough and holistic, considering people's physical health, emotional wellbeing, communication needs, social circumstances, cultural preferences and future goals. The provider worked closely with people, their relatives and relevant professionals to develop a detailed understanding of what mattered most to each individual.

The provider assessed how they could support people’s life enrichment and were proactive in ensuring action was taken to meet these assessed needs. For example, one person’s assessment stated, “I enjoy the exercise classes, they get the blood flowing” and “I enjoy the nursery children coming to visit, they bring so much energy, it makes me so happy.” We saw evidence this person engaged in both nursery visits and exercise classes undertaken to meet their assessed needs and optimise and enrich their life.

People’s assessments were formally reviewed on a monthly basis and additional reviews were undertaken immediately if people’s needs changed. This meant care plans were consistently up to date, reflected people's current wishes and accurately guided staff in delivering safe, effective and person-centred care.

Staff maintained regular contact with people and closely monitored changes in their health, wellbeing and circumstances. Each person’s key worker was matched specifically to them based on their positive rapport. They were involved in ongoing assessments which were driven by a personalised statement specific to why the relationship was so special and focused on what the person wanted to achieve from their assessment. The key worker, the person and staff then worked together to meet these assessed needs.

People and their relatives told us they were actively involved in assessment and review processes and were encouraged to share their views about the care and support provided. Staff demonstrated a strong understanding of people's assessed needs and used this knowledge to deliver highly individualised support. Where specialist input was required, the provider sought advice promptly and incorporated recommendations into care planning without delay.

The provider consistently developed a detailed understanding of people's life histories, interests, routines and aspirations. This enabled people to maintain their independence, pursue meaningful opportunities and achieve outcomes that were important to them. As a result, people experienced highly responsive care that adapted seamlessly to their changing needs, promoting their wellbeing, quality of life and independence.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The provider ensured care and treatment were delivered in accordance with current legislation, national guidance and recognised best practice. People's needs were comprehensively assessed, and care plans were person-centred, evidence-based and regularly reviewed to ensure they reflected people's current needs and supported positive outcomes.

Staff had the skills, knowledge and training required to deliver safe and effective care and demonstrated a clear understanding of best practice relevant to their roles. They worked proactively with healthcare professionals to ensure care remained responsive to people's changing needs and was informed by specialist advice where appropriate.

The management team focused on monitoring practice and driving continuous improvement. They were proactive in monitoring systems in real time to measure people’s outcomes before any concerns arose. Case studies were undertaken to gather a holistic picture of specific practice in the home which included reflecting on whether people’s outcomes had been attained and what could be improved to provide optimum evidence-based outcomes. The provider embedded learning from incidents, feedback and emerging guidance to support consistently safe, effective and high-quality care.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People were supported by staff who worked positively as a team to ensure they achieved the best outcomes for people. People’s needs were assessed thoroughly and were shared immediately to the staff team and across other teams and services when required. This meant people did not have to repeatedly tell their stories and all professionals working with them were aware of their needs and preferences.

Staff valued each other and told us they worked closely together. The provider worked closely with other health professionals and information was shared promptly and effectively with them to ensure it was readily available when people moved between services.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider encouraged a strong culture of promoting healthy lifestyles and independence. Staff actively encouraged people to participate in physical activities, such as keep-fit sessions, and supported them to engage at a pace that reflected their individual preferences, abilities and goals. This personalised approach empowered people to take an active role in maintaining their own health and helped them to recognise the benefits of physical activity in reducing falls risk, maintaining mobility, maximising independence and achieving the best possible quality of life. The responsive and holistic approach to health promotion consistently helped people to live healthier lives and achieve positive outcomes.

People were well supported to maintain and improve their health and wellbeing through a proactive, person-centred approach. Staff worked closely with a range of healthcare professionals, including GPs, district nurses and occupational therapists, to ensure people received timely and coordinated support to meet their changing health needs. Records demonstrated prompt referrals and effective liaison with healthcare services, including contacting NHS 111 when urgent advice or intervention was required which helped to prevent deterioration in people's health.

The provider demonstrated a commitment to helping people achieve and maintain the best possible health outcomes through innovative and proactive approaches to healthcare support. People benefited from access to specialist clinical expertise through a dedicated clinical nurse service, which provided regular oversight of their health and wellbeing. Detailed information regarding people's clinical needs was reviewed monthly by the clinical nursing team, enabling emerging concerns and deterioration to be identified at the earliest opportunity.

This approach ensured people received timely interventions and specialist input that enabled preventative action to be taken quickly. As a result, people benefited from coordinated, responsive and clinically informed care that promoted their independence, enhanced their wellbeing and helped them live healthier lives. The proactive use of specialist clinical oversight demonstrated the provider's commitment to continuously improving health outcomes and ensuring people received the right support at the right time.

The home held a monthly clinical governance meeting where people who were at high risk clinically were reviewed, and any clinical actions were shared to ensure people maintained or improve their health. One person was an insulin dependent diabetic and was identified as high risk clinically but through weight monitoring and appropriate care and encouragement from staff at the home, they had successfully improved their health to the point they were no longer prescribed insulin.

The provider invited an audiology and eye healthcare company to the home to speak with people about different aids they could have to improve their lives and the services they provided for eye tests. This empowered and enabled people to make informed decisions about what they could do to improve their health and quality of life.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People experienced positive outcomes, because the provider had effective systems in place to monitor, review and improve the quality of care delivered. Assessments were outcome focused and were regularly reviewed to ensure they remained current and in line with people’s preferences.

People’s clinical outcomes were reviewed and analysed to determine if people required any further input from external health professionals or the provider’s internal clinical nurses.

The provider used learning from audits, incidents and feedback to implement improvements, demonstrating a commitment to achieve better outcomes for people and ensure people received care that promoted their wellbeing and quality of life.

People were asked for feedback about activities they participated in to determine if they had been successful in achieving the outcomes people had wanted from them and so changes could be made if needed to achieve people’s desired outcomes.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were supported to make decisions about their care and treatment in line with current legislation and guidance. Staff understood the importance of gaining consent and demonstrated a person-centred approach to supporting people to make choices about their daily lives, care and support. We observed staff explaining what medicine they were administering to people and how they were going to administer it and seek the person’s consent before giving it to them.

Throughout our inspection, we observed staff offering people choices and seeking their consent before providing care, respecting their preferences and promoting their independence.

Staff had received training in the Mental Capacity Act 2005 (MCA) and knew how to support people to make their own decisions wherever possible and best interest’ decisions when required. However, at the time of the assessment, no people were identified as lacking capacity to make any specific decision. Care records reflected people’s wishes, preferences and consent to care and treatment.