Field House

Updated 26 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

Field House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Our planning considered information we held about the service and included information about events and incidents the provider must notify us about. We asked commissioners, the local authority and professionals who worked with the service for their experiences of the service.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We looked around the home, reviewed records relevant to the running and quality monitoring of the service, the recruitment records for all new staff employed in the last year and policies and procedures. We looked at training and supervision records. We looked at care records and the records of medication administration, medicines storage and management.

We spoke with four people who lived at Field House to ask about their life there. We observed people’s daily routines and staff interaction.

We spoke with three staff members on duty about their experiences of working for this service and the registered manager, who was present throughout the day.

After the inspection

We continued to seek clarification from the manager to corroborate what we found. This included recruitment and maintenance records.

We obtained more feedback from four health and social care professionals and commissioners who were involved with people living at the home.

We contacted a relative of a person who lived at Field House who was happy to speak with us.

Updated 26 October 2019

About the service

Field House is residential care home providing personal care for up to seven people with mental health needs, learning disabilities and/or autism. At the time of the inspection, seven people were living within the home.

The home is two storey detached house that has been adapted for its current purpose a single level property in a residential area of Burton on Trent. There is a large garden and a multi-use Astro turf sports pitch. Public transport is easily accessible and provides links to the local and wider community

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The principles reflect the need for people with learning disabilities to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. There were deliberately no identifying signs to indicate it was a care home Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

People’s experience of using this service and what we found

Staff were kind and caring towards people and had developed very trusting and mutually respectful relationships with them, knowing them in detail, including their histories, likes and dislikes. The service provided exceptionally responsive, person-centred support and focused on highly individualised support, which had achieved some exceptional outcomes for people.

The registered manager and staff were highly responsive and skilled at helping people achieve positive outcomes, building confidence, independence and helping develop life skills. People had been introduced to new activities, which had led to the development of new interests, healthier lifestyles and educational opportunities. Through highly detailed and focused care planning and support people had become significantly more independent.

Visiting professionals consistently told us the service was focused on providing person-centred care and support to help people achieve their personal goals and life ambitions. They told us the registered manager and staff had worked collaboratively with other agencies and families to achieve some exceptional outcomes for people that had greatly improved their quality of life.

The provider had safeguarding systems to protect people from the risk of abuse or unsafe care. Staff were aware of the procedures, had received training on it and knew what action to take. We saw that staff treated them with kindness, compassion and respect and made sure their dignity was maintained.

The registered manager and staff team clearly understood the importance of supporting people in their personal and spiritual needs and when they experienced bereavement and loss. Staff were skilful in supporting people to express their feelings.

Staff assessed and reviewed people's physical, mental health and social needs and were supported with the proper and safe use of medicines. Detailed care plans had been developed with the close involvement of the person and where appropriate their families to give a vivid picture of the person and their needs.

The provider had policies and procedures to support the safe recruitment of staff. The registered manager made sure sufficient numbers of appropriately trained staff were on duty throughout the day and night to make sure people received the support they needed.

People received support to maintain good nutrition and hydration in line with their personal choice. People’s healthcare needs were well understood and met promptly. Staff worked with other agencies and professionals to support people’s health and well-being.

People's communication needs were thoroughly assessed and understood by staff. This helped to support people's communication needs and the Accessible Information Standard (AIS).

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Governance and quality assurance were exceptionally well-embedded within the service. The registered manager and staff used recognised monitoring tools to analyse trends and highlight areas they could work on to improve support for people. Staff felt valued and respected by their manager and included in decisions about service development. They demonstrated consistently high levels of commitment and morale.

The leadership of the service promoted a positive, open culture. The registered manager was open and transparent throughout our inspection and it was evident that the ethos of the home was to promote an open and transparent approach in all they did. The registered manager displayed knowledge and understanding around the importance of openness and working closely with other agencies and healthcare professionals to make sure people had good care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection The last rating for this service was good (Published 8 March 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.