Archived: Field View

Updated 25 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The service was last inspected in May 2016 when we found the provider was not meeting the essential standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Improvement was required for the service to be Safe, Effective, Caring, Responsive and Well Led. At our comprehensive inspection in January 2017, we found improvements had been made, but further improvements were required. This was our first inspection since the change in registration,

The inspection visit took place on 31 January 2017 and was unannounced. The inspection was conducted by two inspectors.

Prior to the inspection visit we reviewed the information we held about the service. We looked at information shared with us by relatives and the statutory notifications the provider had sent us. A statutory notification is information about important events which the provider is required to send to us by law. We contacted the local authority commissioners to find out their views of the service provided. Commissioners are people who contract care and support services paid for by the local authority. They had no new information to share about the service.

We spoke with five people and two relatives about what it was like to live at the home and a visiting healthcare professional. We spoke with three care staff and the cook about what it was like to work at the home, and one member of staff who worked nights sent us information via email after our inspection visit. We spoke with the provider, the registered manager and the deputy manager about their management of the service. We observed care and support being delivered in communal areas and we observed how people were supported at lunchtime.

Many of the people who lived at the home were not able to tell us in detail, about how they were cared for and supported because of their complex needs. However, we used the short observational framework tool (SOFI) to help us assess whether people’s needs were appropriately met and to identify if people experienced good standards of care. SOFI is a specific way of observing care to help us understand the experiences of people who could not talk with us.

We reviewed two people’s care records to see how their care and support was planned and delivered. We checked whether staff had been recruited safely and were trained to deliver the care and support people required. We looked at other records related to people’s care and how the service operated including the service’s quality assurance audits.

Updated 25 February 2017

The inspection took place on 31 January 2017 and was unannounced.

Field View is a residential home which provides care to older people including some people who are living with dementia. Field View is registered to provide care for up to 20 people. At the time of our inspection there were 15 people living at the home.

There was 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.

At our previous inspection in May 2016 we found breaches of the regulations related to managing risks to people’s safe care and treatment, staffing levels and the governance of the home. We also identified the provider's registration status with us had not been updated to confirm that there was now only one owner with responsibility for the registered regulated activity at the home. This meant the provider’s' registration status with us was not correct which was a breach of Regulation 21 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following our visit, the provider sought professional advice regarding the registration of a new legal entity. The registration was completed at the beginning of December 2016 which meant the service was appropriately registered in accordance with our registration regulations and the responsibility for the regulated activity remained with the same person before and following the new registration.

At this inspection we looked to see if the provider had responded to make the required improvements. We found sufficient improvements had been made to meet the regulations previously breached. However, we identified some incidents in the home had not been recognised as potential safeguarding issues that should have been reported to us and the local authority safeguarding team.

People and their relatives were confident they received safe care and support from staff who knew people well. Staff were available to respond to people’s requests for assistance, and there was always a member of staff in the lounge area where people sat during the day. Care plans did not always include detailed risk assessments, but staff were knowledgeable about people's individual risks. Staff understood their responsibilities to report any concerns they had about people's health or wellbeing. The character and values of staff were checked prior to employment, to ensure they were of a suitable character to work with people living in the home.

Medicines were stored safely, but improvements were required to ensure medicines were given in accordance with people’s prescriptions.

Staff were encouraged to keep their training and skills up to date and had regular meetings with their managers to discuss their role and any training or development needs.

The registered manager understood their responsibility to comply with the requirements of the Deprivation of Liberty Safeguards (DoLS). They had applied to the Supervisory Body for the authority to restrict people’s rights, choices or liberty in their best interests. Staff understood and acted within the principles of the Act to support people to make their own decisions.

People were offered food that met their dietary needs. People were encouraged to eat their meals and offered regular drinks to maintain their hydration. People were supported to access medical professionals when they needed to. Relatives were kept informed of any changes in their family member’s health.

People were cared for by staff who were kind and caring and who acknowledged the importance of respecting and ensuring people’s privacy was maintained. Staff had a friendly approach to people and were responsive to their needs. Staff understood the value of knowing people’s personal history and of engaging people in conversations that were meaningful. People were able to choose how they spent their day and were supported to socialise or spend time alone, according to their preferences.

Care was planned to meet people’s individual needs and abilities, although care records were not always up to date. However, staff were able to respond to how people were feeling and to their changing health or care needs because information was shared with them between shifts.

The provider had taken action following our last inspection visit to address the concerns we identified. Improvements had been made to the management of risks around people falling and action taken to ensure the environment was safer for people and environmental risks managed. However, some audits to monitor the quality of care provided needed to be implemented more effectively and consistently to identify areas where the service could improve.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.