We carried out a review of the data available to us about Field House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Field House, you can give feedback on this 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.
Field House is registered to provide accommodation for up to six people with a learning disability. At the time of our inspection six people were living at the home. A comprehensive inspection was undertaken on the 31 January 2017 and the provider was rated as good overall and was meeting all the regulations that we checked relating to the Health and Social Care Act 2008.
This unannounced focused inspection was undertaken by one inspector on the 9 October 2017. We inspected the service against one of the five questions we ask about services: is the service safe. This is because we had received information of concern regarding the numbers of staff that were available to support people and the support people received in managing their behaviours. This report covers our findings and the other key lines of enquiry (KLOEs) under the question ‘is the service safe’. You can read the report from our last comprehensive inspection visit, by selecting the ‘all reports’ link for the Field House on our website at www.cqc.org.uk
People were safe with the support they received. The staff team had a good understanding of people’s identified risks and how to support them to keep safe. Staff were aware of their responsibilities to report concerns to protect people from harm. The registered manager had demonstrated their understanding regarding their responsibility to protect people from harm as they had reported concerns to the local authority safeguarding team when required.
There had been some changes in the staff team since our last inspection and new staff were in post. Some people demonstrated behaviours that put them and others at risk of harm and there was enough trained staff available to support them in a safe way. People were supported to develop their skills in independent living by staff that had guidance on how to minimise risks; to maintain people’s safety whilst promoting independence.
People received their medicines when needed and practices were in place to ensure medicines were managed safely. Recruitment checks were undertaken to ensure staff were suitable to work with people.
We inspected this service on 31 January 2017. This was an unannounced inspection. This was the first inspection since the provider’s registration on the 15 July 2016.
The service was registered to provide accommodation for up to six people with a learning disability. At the time of our inspection there were two people using the service.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were protected from the risk of harm because identified risks were managed safely, the recruitment practices were thorough, and the staff understood what constituted abuse or poor practice and people were supported to take their medicines as needed. Staff received training to support the people they worked with and supervision, to support and develop their skills. Staff felt listened to and were happy to raise concerns.
People were supported by a consistent staff team that knew them well and promoted their independence Staff understood people’s preferred communication method and the support they needed to make their own decisions. When people were unable to consent they were supported in their best interest.
People’s needs were assessed and support plans where developed with people to enable them to be supported in their preferred way. People were supported to maintain a diet that met their dietary requirements and preferences and were supported to use healthcare services. The delivery of care was tailored to meet people’s individual needs and preferences. People were enabled to develop and maintain interests at home and within the local community to promote equality and integration.
People knew how to complain and information was provided to them in an accessible format to support their understanding. There were processes in place for people to raise concerns and complaints and express their views and opinions about the service provided. The provider had systems in place to monitor the quality of the service to enable them to drive improvements.