Field House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this location under the newly dual registered provider. This key question has been rated Outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 93 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

Leaders had created an exceptionally positive, open and inclusive culture where people, relatives and staff were at the heart of the service. There was a clear shared vision and set of values that were consistently understood and embedded throughout daily practice. The manager told us the vision of the home was “embodying a person-centred approach, maintaining individuality for residents, providing an outstanding level of care and being adaptable and fluid.” Management described people at the home as like a family to them and this was echoed by staff. One staff member told us, “It’s lovely here, we’re like a family.”

Staff spoke passionately about their roles and shared a strong commitment to delivering high-quality care. One staff member told us, “It’s a lovely team, everyone is willing to help each other and there is no hierarchy based on what your job role is. Everyone is treated equally.” The manager told us staff went above and beyond to support people to meet their needs. The manager told us, “The team are so passionate, and they always do that little bit extra when they are out and about.” This reflected the open, respectful and collaborative culture promoted by leaders.

Leaders led by example, promoting transparency, continuous learning and innovation, which fostered a culture of excellence and accountability. People, relatives and staff were actively involved in shaping the service, resulting in a strong sense of ownership and shared purpose. Feedback was overwhelmingly positive, with consistent evidence that the service's values translated into outstanding experiences and outcomes for people receiving care.

The management team were motivated to keep values fresh and up to date and adapted to ensure new staff truly aspired to follow the values of the home. The manager told us they were currently reviewing their home values as they had new staff and they wanted to ensure they were incorporated in the process and keep it current.

The provider had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

Leaders were exceptional role models who consistently demonstrated compassion, integrity and a commitment to excellence. Staff spoke overwhelmingly positively about the leadership team, describing them as supportive, inspiring and genuinely caring. They told us leaders prioritised their wellbeing and professional development, creating an environment where they felt confident, motivated and able to provide the highest standards of care. There was a strong emphasis on staff being treated equally with leaders proactively removing barriers and ensuring everyone had opportunities to be heard and succeed.

Field House had a new manager who had been in in post for around six weeks and was in the process of applying to be registered with the Care Quality Commission. The new manager was being supported and mentored by the previous registered manager, both of whom had an exceptional knowledge of the service and the people who lived there. The desire of both managers to deliver the best person-centred care they could and deliver outstanding outcomes for people shone through in the passionate way they spoke about the service and what they wanted to provide to people living at the home.

The transition from the previous registered manager to the new manager was barely noticeable due to the positive way in which both had managed the transition. One relative told us, “It's been a seamless transaction with the new manager. We dealt with the new manager quite a lot anyway who has always been amazing as was the previous registered manager. We haven't noticed any difference at all”.

The new manager’s experience gained from other roles in the home was overwhelmingly evident by their knowledge of people who lived there and the knowledge they had gained from working under the previous registered manager. Since they had started their role, they had continued to embed the positive work implemented by the previous registered manager which meant people continued to receive the same exceptionally personalised, compassionate and well led service they had done previously. The new manager continued to work proactively, undertake quality monitoring effectively and provide person centred care that focused on achieving the best outcomes for people living there and giving them the best quality of life they could.

The new manager and previous registered manager were passionate about ensuring people received the best care and led staff in a way that promoted best practice and meeting people’s needs in the way they wanted. They maintained a detailed understanding of the service and were actively involved in daily life which meant they understood how to manage the service in a way that promoted the best outcomes for people. This was recognised by their senior leaders who described Field House as a beacon service amongst the group and told us, “We talk about delivering care following the Barchester Way but it's what they do above and beyond that.” We saw multiple examples where senior leaders had shared outstanding practice at Field House across other homes in the provider group due to the positive impact it had had on people.

The management team fostered a culture where people were treated like family and fully included in meaningful life events. When the manager got married, the wedding was streamed live to the home, enabling people who wanted to, to share in the celebration. People enjoyed a wedding meal and cake, and one person was honoured as the home's bridesmaid, wearing a matching dress to the bridal party. This demonstrated the exceptionally warm, inclusive and genuine relationships that existed within the service. Staff were also involved in people’s birthday celebrations and took them out in the community for celebrations when this was their preference.

They had created a highly inclusive culture where people, relatives and staff felt valued, respected and empowered to contribute to the development of the service. Leaders were visible, approachable and actively engaged with people using the service, ensuring their views and experiences directly influenced decision-making and improvements. Staff told us leaders were happy to help with care when needed and did not recognise a hierarchy when it came to providing quality care to people. The manager told us, “We discuss a lot about how to empower the team. We really value the entire team, it’s not about just do as you’re told.”

The leadership team fostered a culture of openness, learning and continuous improvement. Staff felt safe to raise concerns, share ideas and challenge practice, knowing their contributions would be valued and acted upon. Leaders actively sought feedback from people, relatives and staff and used this to drive innovation and achieve outstanding outcomes. Their compassionate and inclusive approach had resulted in a highly engaged workforce, excellent staff retention and consistently positive experiences for people receiving care. The values of the service were fully embedded throughout the organisation and were evident in every interaction we observed, creating a culture where people truly thrived.

The provider was exceptional at fostering a positive culture where people knew they could speak up and their voice would be heard.

The provider had embedded an exceptionally open and inclusive culture where people, relatives and staff were actively encouraged and empowered to speak up, challenge practice and contribute ideas without fear of repercussions. Speaking up was viewed positively as an opportunity to learn and improve, and leaders demonstrated that feedback was valued by responding openly and using it to drive improvements in people's care and experiences.

Staff consistently told us they felt valued, listened to and supported by leaders who were visible, approachable and responsive. One staff member told us, “I get the chance to speak up all the time, we have supervisions and appraisals regularly and also staff meetings and we also get sent online surveys. I know I can raise anything at any time.” Staff had a range of routes through which they could raise concerns, including access to a whistleblowing champion and a dedicated reporting telephone line. This ensured staff could choose a route they felt comfortable and confident using and demonstrated that opportunities to speak up were embedded throughout the service rather than reliant on individual managers.

The provider had strengthened this culture through HR surgeries and dedicated Freedom to Speak Up sessions led by a trained Speak Up Champion. These provided confidential opportunities for staff to discuss concerns, experiences and ideas. The Speak Up Champion met monthly with senior leaders, enabling themes and concerns to be escalated and considered at organisational level. Senior leaders also provided opportunities for staff to raise matters privately, demonstrating a proactive approach to identifying issues, including those staff may not have felt comfortable raising through routine management processes.

Where the home had received complaints that may have affected staff welfare, each staff member was given the opportunity to have a wellbeing meeting with the management team to speak up and discuss how they felt and action was taken if needed to make them feel more confident and maintain their morale and positivity in the workplace.

People and relatives were equally confident their voices mattered. One relative told us, “We do get the opportunity to give feedback regarding what happens at the home. There are surveys and feedback forms, but I could ring at any time to feedback anyway.” This reflected a culture where speaking up was part of everyday practice rather than being limited to formal complaints or consultation processes. People, relatives and staff were confident they would be listened to and that their views could influence how the service developed.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider promoted a culture where equality, diversity and inclusion were valued and respected. Staff told us they felt treated fairly and were able to be themselves at work. Leaders were approachable and encouraged an open and inclusive environment where people’s diverse backgrounds, experiences and perspectives were recognised and respected. There were processes in place to ensure staff were protected from discrimination, bullying and harassment, and staff knew how to raise concerns if needed.

Recruitment, induction and ongoing development processes were designed to provide equal opportunities for staff. Training helped staff understand equality, diversity and human rights, enabling them to provide inclusive care and support to people using the service. Staff demonstrated an understanding of people's protected characteristics and individual needs and were respectful of people’s differences.

Leaders sought feedback from staff and took appropriate action to address any issues identified. Staff told us they felt listened to and supported, and they were able to contribute ideas about how the service could improve. The provider’s commitment to equality, diversity and inclusion helped create a positive workplace culture and contributed to good outcomes for both staff and people receiving care.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Leaders used robust oversight, auditing and quality assurance systems to proactively monitor risk, performance and outcomes. They consistently acted on the best available information, identifying opportunities for improvement and implementing changes that enhanced the quality and safety of care. For example, weight monitoring tools used identified people to closely monitor even when they weren’t at risk at the time and enabled the provider to take proactive actions to reduce the likelihood of them becoming at risk regarding their weight. Learning was embedded across the service, supporting continuous improvement and innovation.

The provider had clear responsibilities, roles and systems of accountability that were well embedded throughout the service. Staff were appointed as champions of specific aspects of care such as dementia care and moving and handling. This meant they took responsibility for learning in relation to these areas and helped to upskill staff to ensure people received the best care they could.

Effective governance arrangements enabled leaders to consistently manage and deliver high-quality, sustainable care, treatment and support, while maintaining a clear focus on achieving positive outcomes for people. Quality checks in place were thorough and actions were addressed quickly. For example, where audits had identified an increase in falls, they were analysed and learning was shared amongst staff to ensure they were followed up more robustly and in a timely manner so patterns could be identified. This enabled action to be taken such as amending staff deployment where needed to reduce the risk of falls to people in certain areas of the home and inviting the falls team into the home to educate people on the risk of falls.

The provider used a clinical governance tool which gave an increased level of oversight in respect to people’s needs and risks and the home in general. This tool was reflective and identified any action taken and the impact on people. This enabled the management team to analyse if the actions were having a positive impact or whether a change to the plan was required. For example, where one person had lost weight, this was identified on the clinical monitoring tool. This enabled the management team to immediately review their food intake and take action to encourage eating and fortify meals at times nutrition intake was particularly low which resulted in their weight stabilising. Where another person had lost weight but clinical governance showed their food intake was stable, a referral was made to their GP for further input to explore the cause of the weight loss.

Audits were shared with senior managers in the provider group to ensure there was additional objective oversight away from the home. Where senior managers identified any concerns, these were fed back to the home and added to the action plan so they could be addressed.

The management team fostered an open and positive culture where staff felt supported, empowered and accountable for delivering high standards of care. Information was shared appropriately and securely with relevant stakeholders and healthcare professionals, promoting joined-up working and ensuring people received coordinated, effective support. As a result, the service demonstrated strong, sustainable leadership and governance, with a culture of continuous improvement that delivered positive outcomes for people.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

People were empowered to play an active role in their local community and were supported to maintain meaningful relationships, interests and social networks. The provider had developed extensive links with community groups, schools, faith organisations and local businesses, creating a wide range of opportunities for people to engage in activities that reflected their preferences and goals both inside and outside the home. People attended groups in the community, the provider invited the community into the home and involved them and the home genuinely felt part of the community where people lived rather than an independent care home. For example, people had attended a carers concert in the local community and attended an arts festival where they mixed with the local community. People shared with other residents how they had enjoyed these activities and how it had been fascinating to see people’s artwork and mix with others from outside the home. These partnerships had a demonstrable and positive impact on people’s wellbeing, confidence and sense of purpose.

The provider continuously sought new ways to strengthen community connections and reduce social isolation. People were supported to contribute to their communities as well as benefit from them, enabling them to feel valued, included and respected. One person was supported to attend a weekly club in the community. They commented “It’s so nice to see my old dear friends, we always seem to have so much to catch up on even though it’s only been a week since we last saw each other.” The service’s strong partnership working and commitment to community engagement consistently resulted in improved experiences and outcomes for people and reflected an outstanding culture of inclusion, innovation and person-centred care.

The provider was proactive in developing and sustaining partnerships that enhanced people’s lives and outcomes. Effective relationships had been established with healthcare professionals, community organisations and local services who often attended the home to undertake talks in people’s monthly meetings or to do presentations to enhance people’s knowledge in particular areas. This ensured people received seamless, coordinated support tailored to their needs and aspirations.

The provider put on events to raise money for local charities of people’s choice to embed their community involvement even further. For example, they raised money for a local Parkinson’s charity by putting on a soup and pudding lunch club fundraiser.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Leaders actively used feedback, audits and lessons learned to drive improvements and encouraged staff to share ideas and develop new approaches to care. For example, each person had a key worker who was matched to suit them individually. The key workers worked closely with the person and fed back to management how care could be improved for that individual. The provider was proactive in adapting care where possible.

The service implemented innovative practices that enhanced people's wellbeing and independence. For example, care planning systems enabled staff to respond quickly to changes in people's needs, while personalised life story resources helped staff deliver more individualised care. People benefited from creative initiatives such as animal therapy, community activities and projects with local schools and community groups, which promoted social engagement and emotional wellbeing. Personalised case studies were used to evidence people’s journeys at the home which included their reflections and analysis of what had worked and what had not. This learning was shared amongst staff and other homes within the provider group to ensure people received optimum care.

The provider regularly evaluated new initiatives to ensure they achieved positive outcomes and made improvements based on feedback from people, relatives and staff. For example, where new ideas were tried such as involving speakers at home meetings or new activities, the leadership team spoke with people to obtain their feedback and completed a reflective learning document which included photos of the activities and direct quotes from people to evaluate the initiative. This enabled them to make decisions on whether to continue or make changes to the new initiatives so they provided the best outcomes for people.

The manager provided examples of where the occupational therapist speaking at a home meeting about mobility had led to people taking a more proactive approach to their mobility needs and an improvement in one person’s mobility and independence.

Learning from incidents, concerns and compliments was shared effectively across the service, leading to sustained improvements in practice. Where reflective documents had been completed and there had been proven benefits to people, these were shared across the provider group so other homes could consider implementing the home’s ideas to improve the quality of care people received.

The service worked proactively with external partners to identify and adopt best practice. As a result, people experienced innovative, person-centred care that consistently improved their quality of life and demonstrated the provider's commitment to excellence. For example, the provider invited external partners to the home to share knowledge with people and relatives including financial planning advice for later life and a visit from a local dementia group to educate people on understanding dementia.