Field House

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.

This is the first assessment for this location under the newly dual registered provider. This key question has been rated Good. This meant people were safe and protected from avoidable harm.

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 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 developed a positive learning culture where staff were encouraged to reflect on practice, report concerns and learn from incidents to improve outcomes for people. Staff understood their responsibilities for identifying and reporting accidents, incidents and near misses, and records showed these were reviewed appropriately by management.

Where accidents and incidents occurred, each record was analysed and learning outcomes were identified to reduce the risk of reoccurrence. These actions were followed up and shared with staff through team meetings, handover and through electronic communication to ensure practice was improved going forward.

Where near misses or concerns arose that did not meet the safeguarding threshold, the provider still analysed what had occurred and reported on them to ensure any learning could be identified and shared, helping to reduce the risk of similar events occurring.

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.

The provider worked effectively with health and social care professionals to plan and manage transitions between services to ensure people experience safe and co-ordinated care.

The provider shared assessments and care records with appropriate partners, where needed to ensure relevant information was provided to support people’s moves between services. This ensured important information about people’s needs, risks and preferences was shared appropriately.

Where people transitioned to new services, these were managed proactively and supported by the provider. Where one person was considering a move to another home to be closer to relatives, the provider worked with the potential new home sharing the person’s needs and preferences to allow the person to have a respite opportunity there to see if they liked it before making any move permanent.

The service worked collaboratively with external professionals, including GPs, district nurses and specialist teams, to help ensure people received timely support and continuity of care. Staff understood their roles in maintaining people's safety during periods of change and demonstrated a proactive approach to identifying and responding to 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. The provider shared concerns quickly and appropriately.

People told us they felt safe and relatives told us people were safe. The provider had effective safeguarding systems in place which protected people from abuse.

Staff had received safeguarding training and understood their responsibilities to recognise and raise concerns. The provider encouraged staff to report any safeguarding incidents. Staff were confident in raising concerns and told us they would be taken seriously and acted upon appropriately.

Safeguarding incidents were reported, investigated and monitored to ensure appropriate action was taken and lessons were learned. Records showed referrals had been made to the local authority and other relevant agencies when required. Leaders maintained oversight of safeguarding concerns through regular audits and governance processes, enabling them to identify patterns and take action to reduce risks.

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.

Risk assessments were in place that identified potential risks to people’s health, safety and wellbeing and guided staff how to manage these risks. Risk assessments reflected people’s preferences and wishes and promoted their independence, choice and control. Risk assessments were highly personalised and provided clear, detailed guidance for staff on how to support people safely while enabling them to continue activities that were important to them. For example, where a person had diabetes, the risk assessment detailed what symptoms to look for, how to respond and details regarding a person’s choices around relevant medical appointments.

Staff demonstrated a clear understanding of each person’s individual risks and the measures required to reduce these risks whilst also promoting people’s choice and autonomy. Risk assessments evidenced how staff worked with people to achieve a risk management balance. The provider created personalised case studies to share positive learning around balancing risks with staff and other homes within the provider group.

People were empowered to take positive risks and maintain control over their lives in a way that reflected their preferences, goals and individual lifestyles. The provider demonstrated a strong commitment to balancing safety with independence, ensuring risk management practices did not unnecessarily restrict people. For example, some people chose to continue activities that were important to them, and staff worked with them to identify measures that reduced risks while enabling them to maintain their preferred lifestyle.

People were supported to be actively involved in decisions about risks associated with their care. Risk assessments were regularly reviewed and updated when people’s needs changed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People lived in a safe and well-maintained environment. Regular health and safety checks including fire safety and equipment maintenance were completed and acted upon promptly where issues were identified.

People’s rooms and communal areas were free from hazards whilst still remaining personalised and homely. Staff understood their responsibilities for maintaining a safe environment and were vigilant in reporting concerns.

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.

People were supported by enough staff with the right skills, knowledge and experience to meet people's needs safely. Staff were recruited safely and received comprehensive induction, mandatory training and ongoing development opportunities. One relative told us, “The staff are exceptional. I can't speak too highly of the staff team there. They are so knowledgeable.”

Staff consistently told us they felt well supported by the provider through regular supervision, team meetings and access to management, which helped them carry out their roles effectively and safely.

Training records showed staff had completed training relevant to their roles and demonstrated a good understanding of people's individual needs, risks and preferences. One staff member told us, “I think the training we get is really good. It's a mixture of face to face an online training. We are allowed to access any of the online courses regardless of whether we've been asked to do it or not and it's a great resource for learning.” Staff spoke positively about the support available to them and felt confident raising concerns or seeking advice when needed.

Feedback regarding staffing levels and response times was mixed. While many people told us staff were available when required and provided care safely, some people reported delays in receiving support at busier times. Despite this, the provider had processes in place to monitor staffing arrangements and respond to changing levels of need and we did not observe anyone waiting for care when needed. Despite the variation in people's experiences, we found staff knew people well and were able to deliver care safely and effectively.

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.

People lived in a clean and uncluttered home that was well maintained. One person told us, “It’s clean and homely here.” Regular cleaning schedules and audits were completed to ensure high standards were maintained. One relative told us, “The home is always spotless.”

People were supported by staff who wore Personal Protective Equipment (PPE) in line with current guidance and who followed infection prevention and control (IPC) procedures consistently. Staff were aware of their roles and responsibilities in this area.

Regular IPC audits were undertaken and any actions identified were addressed in a timely manner.

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.

People’s medicines were stored safely and administered by trained and confident staff so people received their medicines as prescribed. Regular medicines audits were undertaken to identify and address any issues to help to promote safe medicines management.

Staff responsible for administering medicines were competent and demonstrated a good understanding of their responsibilities. Competency assessments were undertaken to ensure staff were able to manage medicines safely. Staff sought consent from people before administering their medicines and gave people sufficient information regarding their medicines to put people at ease.

Where required, protocols were in place for the use of 'as required' (PRN) medicines, ensuring these were used appropriately, as prescribed and in line with people's needs and preferences.

Where medicines errors occurred, these were investigated, learning was shared and action taken to reduce the risk of any reoccurrence.

People told us they received their medicines when they needed them and were involved in decisions about their medicines where appropriate.