Field House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this location under the newly dual registered provider. This key question has been rated Outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (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 was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People were truly at the heart of the service and were empowered to make decisions about their care and daily lives. One relative told us, “It is all person led here.”

Staff regularly went above and beyond to support people's individual interests, beliefs and aspirations. For example, when a person was no longer able to attend church due to their health needs, the service worked closely with their local church to ensure weekly services could be live streamed to a television in the home's quiet lounge. The church also held a monthly service within the home, enabling the person and others to continue practising their faith and maintain important community connections. Another person, who had a passion for reading, was supported to attend a local bookshop's book club, helping them maintain an interest that was important to them and reducing the risk of social isolation.

People and their relatives consistently described the provider's approach as highly personalised and centred around each individual's unique needs, preferences and aspirations. One relative told us, “They do person-centred care very well. They make sure they get to know the person, their likes and dislikes and what works for them.”

Staff demonstrated an exceptional understanding of people, using detailed knowledge of their preferences, histories and routines to enhance their wellbeing and comfort. For example, when one person participated in a keep-fit activity they particularly enjoyed but had difficulty with maintaining their body temperature, staff proactively ensured a fan was available, recognising the person's individual needs and enabling them to continue engaging in a meaningful activity comfortably. Throughout the inspection, we observed staff naturally incorporating people's life histories, favourite music and past occupations into conversations and interactions, creating warm, personalised experiences that promoted people's sense of identity, belonging and wellbeing.

The provider went above and beyond to ensure people had meaningful opportunities to shape their experiences. Through the ‘Resident of the Day’ initiative, people could choose personalised activities or outings based on their interests and wishes. People had been on a multitude of outings including barge trips and visiting museums as a result of their ‘Resident of the Day’ requests. People were also supported to take friends with them if this was their wish. They were also able to request their favourite meals, which were specially prepared by the chef in line with their wishes. This highly individualised approach enabled people to maintain choice and control, feel valued as individuals and experience care that was consistently centred around their preferences, goals and wellbeing. As a result, people received exceptionally personalised support that enhanced their quality of life and promoted positive outcomes.

People's choices consistently influenced how care and support were delivered, creating a culture where staff were exceptional at ensuring care was centred around what mattered most to each person. For example, people had the opportunity to put their wishes for activities or changes to the care home into a wishing well. These wishes were then made into reality where possible to ensure people received care and had opportunities they dreamt of. As a result, people experienced meaningful, personalised support that enhanced their wellbeing, independence and quality of life. One person attended Craven Arms Discovery Centre and met their friend as this was what they had requested through the wishing well. They commented, “It was lovely to have the chance to do something that I would have when I lived at home.”

The provider had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The provider developed exceptional relationships with local health and community groups, empowering people to actively contribute through fundraising and community initiatives. For example, people were encouraged to choose charities that were meaningful to them and the provider supported them to undertake a wide variety of fundraising events, held both at the home and in the community. We saw money had been raised for charities supporting Parkinson’s Disease and Cancer charities for example. People's involvement created meaningful benefits for both people at the home and the wider community, promoting inclusion, purpose and positive social impact.

People benefited from highly consistent and flexible care provided by a stable and experienced staff team who they had developed trusting relationships with. The service did not rely on agency staff, and many staff had worked there for several years and in a number of diverse roles. This meant people experienced exceptionally well-coordinated care that promoted outstanding outcomes, wellbeing and continuity of support. Care was highly personalised and delivered consistently by staff who had a thorough understanding of people's needs, preferences, life histories and aspirations. This familiarity and focus on person-centred care enabled staff to recognise changes in people’s health, mood and behaviour and respond promptly.

The provider recognised that despite people living in a residential setting, they were increasingly living with complex health conditions and introduced additional clinical expertise within the service. For example, following a deterioration in one person's health, staff had immediate access to clinical guidance which enabled them to assess the person's changing needs, liaise effectively with external healthcare professionals and adapt their support without delay. This reduced fragmentation between health and social care and enabled the person to continue receiving safe, individualised care in their own home.

The leadership team went above and beyond in respect to monitoring clinical records and monitored them daily rather than at the audit frequency required by the provider. As they knew people exceptionally well, this enabled them to proactively identify subtle or unusual changes in people’s presentation. Where this was identified, the leadership team promptly sought clinical advice and worked with healthcare professionals to put additional monitoring and treatment in place. This resulted in people receiving timely treatment in familiar surroundings and avoided any unnecessary admissions to hospital.

Care plans were comprehensive, regularly reviewed and proactively updated in response to changes in people's circumstances, ensuring support remained responsive, effective and centred around the individual.

The provider demonstrated a strong commitment to partnership working and had developed highly effective relationships with a wide range of health and social care professionals. Staff worked seamlessly with GPs, specialist nurses, community teams and other external agencies to ensure people had timely access to advice, treatment and support. Communication was proactive and exceptionally well managed, with professional recommendations implemented promptly and embedded into care planning. Where professionals did not attend when expected, the leadership team were proactive in following this up. For example, if nurses had not attended to provide support with skin integrity by 11:30am, staff made contact with them to ensure they would be attended to provide the clinical care people needed. Staff recorded interactions with health professionals on their records so this was shared in real time and all staff had access to any guidance in place. This collaborative approach helped people achieve positive health outcomes and reduced the risk of avoidable deterioration.

Staff advocated strongly on behalf of people, ensuring their preferences, needs and wishes remained central to decision-making during periods of transition. People and their relatives consistently spoke highly of the joined-up approach to care and told us they felt fully involved in decisions about support. One relative told us, “They are proactive with getting medical support and the communication was great there.”

The provider went beyond expected standards to coordinate care across services, removing barriers and ensuring people received holistic support. For example, where people found it difficult to attend appointments outside of the home, professionals were welcomed into the home to educate and inform people regarding health conditions, adaptations and falls prevention. As a result, people experienced seamless, integrated care that enhanced their quality of life, promoted independence and consistently delivered positive outcomes.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People were provided with the information they needed to make informed decisions about their care and support. The provider ensured information was available in a clear and accessible format, enabling people and their relatives to understand the services available and how their needs would be met. People were supported by staff who took the time to explain information in a way they could understand and were available to answer questions when needed.

Care plans contained relevant information about people's needs, preferences and support arrangements, helping them remain involved in decisions about their care. People and their relatives were kept informed about changes to care and support and were encouraged to share their views and raise any concerns. Staff understood the importance of effective communication and adapted their approach to meet individuals' communication needs where required.

The provider promoted an open and transparent culture and ensured people had access to information they needed including safeguarding and complaints procedures. This helped people understand their rights and how to seek support if needed. As a result, people felt informed, involved and supported to make decisions about their lives and the care they received.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

People were empowered to have a strong voice in how their care and support was planned, delivered and reviewed. Staff consistently took time to understand what mattered most to people, ensuring care plans were highly personalised and reflected their preferences, aspirations and desired outcomes. People told us they felt genuinely listened to and valued, and were supported to maintain maximum choice, control and independence in their daily lives. People were supported by a key worker who had been matched specifically with them to build rapport and to promote optimum communication between them which people valued. The provider told us about people going for meals out and for activities with their key worker to promote and build their rapport and further reinforce positive communication between them.

The provider had developed innovative ways for people to contribute to the running of the home. Two people had been appointed as the home's 'ambassadors'. They played an active role in welcoming visitors, meeting new people moving into the home, providing tours and helping them settle in and build connections. This peer-led approach helped people feel welcomed, reduced anxiety and promoted a sense of belonging from the outset. They also took part in interviews for new staff ensuring people’s voice was always heard and central in decision making that impacted them.

The service demonstrated a proactive and inclusive approach to involving people and, where appropriate, their relatives in decisions affecting their care. Regular reviews were meaningful and collaborative, enabling people to influence how support was provided as their needs and preferences changed. For example, one person told the management team their freedom meant more than anything to them. As a result, this was discussed with the person and their relative and it was agreed they would access the community independently when they wanted but with a GPS tracker they had consented to, to mitigate risks around their mobility. This enabled them to maintain their independence and control over their life improving their quality of life and wellbeing.

Staff actively sought feedback through surveys, meetings and ongoing conversations, creating multiple opportunities for people to share their views. The regional manager had also undertaken meetings with relatives to get feedback via video calls. The home held monthly resident and family and friend meetings which gave relatives the opportunity to feedback. Guest speakers were invited to regular residents’ meetings. An occupational therapist had spoken at a recent meeting and people had provided positive feedback. One person who had been reluctant to use mobility aids had found this really empowering and they had started using their mobility aids with more dignity and confidence.

Feedback was not only welcomed but used to drive improvements, with survey results analysed, shared and acted upon to enhance people's experiences. The provider had completed a reflective study of survey results since 2021 and had spoken with people and relatives in more detail where needed to ensure the feedback they received was sufficiently beneficial for them to act on it and make improvements to the service. Where people had fed back regarding activities and outings they would like to participate in, these ideas were taken on board and implemented to enable people to enjoy the opportunities they wanted and improve their independence and quality of life.

People were confident their opinions mattered and felt comfortable raising concerns, suggestions or ideas for service development. One staff member told us, “I think what we do best is help people fulfil the rest of their lives, it’s not like a care home here, people do meaningful things. I think the fact that residents are very confident to speak up and air their opinions is testament to this”. Records showed the provider responded positively and transparently to feedback, fostering trust and strengthening engagement.

A strong culture of openness, respect and partnership was embedded throughout the service. As a result, people consistently felt heard, respected and actively involved in shaping both their own care and the wider service. This person-centred approach led to positive outcomes and helped people experience a genuine sense of ownership over decisions affecting their lives.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People experienced fair and equitable access to care, support and services. The provider took account of people's diverse needs, backgrounds and protected characteristics to help ensure everyone received the support they required. Assessments were completed in a timely way and considered any adjustments needed to enable people to access care and participate fully in daily life. For example, where one person had religious needs and was unable to attend their place of worship, a live stream was arranged of the service to support them with practising their faith. This was also adapted to provide subtitles where a person had a hearing impairment.

Staff understood the importance of treating people as individuals and worked to reduce barriers that could affect access to support. Information was provided in formats that met people's communication needs, and staff adapted their approach to ensure people could understand information and make informed decisions about their care.

The provider worked collaboratively with healthcare professionals and community organisations to ensure people had access to specialist services, appointments and additional support when required. Records showed referrals were made appropriately, and staff followed up outcomes to help ensure people's needs were met.

People and their relatives told us they felt included and respected and that staff treated people fairly. There was a culture of promoting equality, diversity and inclusion throughout the service. As a result, people were supported to access care and opportunities in a way that recognised their individual circumstances, promoted independence and helped achieve positive outcomes.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People experienced care and support that promoted equitable outcomes and ensured their individual needs, preferences and circumstances were understood and responded to. The provider recognised that people had different backgrounds, abilities and life experiences and took these into account when planning and delivering care. This helped to ensure people had equal opportunities to achieve positive outcomes and maintain their wellbeing.

Assessments and care plans were person-centred and identified any support required to reduce barriers people may face. Staff understood people's diverse needs and adapted their approach accordingly, ensuring people received care in a way that respected their culture, beliefs, communication needs and personal preferences. Reviews were used to monitor outcomes and ensure support remained effective and responsive to changing needs.

People told us they were treated fairly and with respect, and that staff took time to understand what was important to them. Relatives also spoke positively about the service's inclusive approach and told us people were supported to achieve goals that reflected their individual wishes and aspirations. Where needed, staff worked with families and external professionals to help people access additional support and opportunities that could improve their quality of life.

The provider had a positive culture that promoted equality, diversity and inclusion. Staff were encouraged to recognise and address any inequalities that could impact people's experiences. As a result, people received personalised care that supported good outcomes, enhanced wellbeing and helped ensure they had opportunities comparable to others using the service.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

People approaching the end of their lives received exceptionally compassionate, person-centred care that reflected their individual wishes, preferences and values. Staff were highly skilled in recognising and responding to people's changing needs and worked proactively with healthcare professionals to ensure people remained comfortable and pain free. One staff member told us, “I think the end-of-life care is fantastic, people are treated with dignity and their wishes followed. Families are also supported.”

End of life care plans were highly personalised and contained detailed information about what was important to each person, including their preferred place of care, cultural and spiritual needs, family involvement, and decisions regarding treatment and support. The provider had gone above and beyond to ensure people’s full end of life plans were known and had been discussed with them in depth and with compassion and sensitivity. They had spoken with one person about their organs being donated for medical research and had spoken to another about their fears in relation to this stage of their life and what support they needed to promote their wellbeing. Where one person had expressed fears regarding going to hospital, they had discussed in depth what they would be happy to be admitted with and when specifically, they wished to remain at Field House.

Where people reached the end stage of their lives, care plans were reviewed and amended immediately to ensure staff were kept aware of up-to-date guidance and knew how to support people at the end of their lives. This detailed planning helped to ensure people received dignified, coordinated care that reflected their choices and promoted comfort, wellbeing and quality of life during their final stages of care.

When one person reached the end of their life, the provider demonstrated an exceptionally compassionate and person-centred approach to supporting the wider community within the home. The resident ambassador was invited to share the news with other people, enabling this to be communicated sensitively by someone who knew the person well. The ambassador spoke about the person and their life, creating an opportunity for people to reflect, remember them and express their grief together. People were also offered the opportunity to take part in prayers where this brought them comfort. This thoughtful approach recognised that the end of a person’s life affected not only their relatives but the friendships and relationships they had developed within the home, ensuring people were supported emotionally and spiritually through bereavement.