Archived: Fieldway Care Home

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.

At our last inspection we rated this key question good. At this inspection, the rating has remained good. This meant people continued to be 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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People were encouraged and supported to raise safety concerns with the provider. Managers and staff understood the importance of reporting safety concerns and learning lessons when things went wrong.

Systems were in place to support staff to report and record safety concerns and events when they arose. Managers investigated safety concerns and events and used the learning from these to support staff to continually improve their practice, reduce risk and keep people safe. For example, a recent internal audit conducted by the providers quality assurance team identified some people’s personal emergency evacuation plans were missing. An improvement plan was put in place immediately and appropriate action taken in a timely manner to resolve this record keeping issue.

The service 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.

Staff obtained information from people, and others involved in their care, about people’s individual needs and risks they might face. The staff used this to develop individualised electronic care and risk management plans to ensure people received safe and appropriate care and support from the moment they moved into the care home.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.

Managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “I would report any abuse I might see straight away to the person in-charge.” Another added, “I know we have to tell the local authority safeguarding team, the CQC and the police if need be, if people we look after are being abused or neglected in anyway.”

People told us they felt safe living at the care home. Typical feedback included, “The staff are always checking on and looking out for residents whenever they pass their bedrooms. They always check my [family member] whenever I report any minor pains or discomfort, I am confident that they keep her safe,” “I am quite confident that the staff keep my [friend] safe at all times” and “My [family member] seems happy with the staff around her and feels safe with them. I feel confident the management would deal with any allegations of abuse.”

The registered manager worked proactively with the relevant external health and social care professionals and bodies when a concern was raised and took appropriate action to safeguard people from further risk, when this was required. An external care professional told us, “From a community health and social care professional perspective we currently have no safeguarding or quality concerns about the care home.”

The service was working within the principles of the Mental Capacity Act 2005 (MCA). Staff understood people’s capacity to make decisions about the care and support they received. Managers and staff had received up to date safeguarding, mental capacity and Deprivation of Liberty Safeguards (DoLS) training.

Staff confirmed they had received up to date falls and pressure wound prevention and management training. A relative told us, “The whole team are fully aware of the needs of my relative, follow their risk management plans and know how to keep them safe.”

Staff were aware of the risks people might face and the steps they needed to take to prevent or safely manage them. Staff were attentive and alert to any changes that might indicate people needed support for any anxiety or discomfort they might be experiencing.

Individualised and thorough risk assessments and management plans were in place for everyone who lived at the care home. Staff had a good understanding of risk and systems were in place to ensure identified risks people might face were continually assessed, monitored and reviewed.

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

The premises were kept free of obstacles and hazards which enabled people to move safely around the care home. An external care professional told us, “They [staff] do ensure our clients live in a safe environment.”

There were effective arrangements in place to monitor the safety and upkeep of the premises. Regular checks were completed to help ensure the safety of the care home’s physical environment and fire safety equipment. Managers and staff told us they had clear guidelines available to help them deal with emergencies. In relation to fire safety, we saw emergency evacuation plans were in place to help staff evacuate people in an emergency. Staff confirmed they regularly participated in emergency evacuation drills of the premises.

General risk assessments were regularly reviewed and updated including, reference to equipment used to support people, such as mobile hoists. This equipment was regularly serviced and maintained.

Action had been taken to make the care home more dementia friendly. For example, some people’s bedroom doors had been painted different contrasting colours and easy to read pictorial signage put up around the care home to help people living with dementia orientate themselves and identify the function of rooms that were important to them. However, further improvements were required to make the care home even more dementia friendly. We discussed this issue with the registered manager at the time of our site visit. They agreed to consider current best practice guidance and consult reputable sources in relation to making the care home even more dementia friendly.

The service 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.

Staffing levels matched the staff duty rota on the day of our site visit. Staff were visibly present throughout this inspection and were quick to respond to people’s questions and requests for support. For example, we saw several instances of staff responding promptly to people who had activated their call bell alarm. People told us the care home was adequately staffed. A relative said, “There always seems to be staff everywhere, who are always friendly and engaging with us and the residents. I am impressed by the number of staff they have on duty.” Another added, “There are usually enough staff to deal with all the residents needs and keep them safe.” The care home had been heavily reliant on temporary agency staff in recent years because of workforce pressures and having large numbers of staff vacancies. However, most of these vacant staff positions had now been filled following a successful staff recruitment drive in the last 12 months. A member of staff told us, “We did use lots of agency staff here, but that’s all changed since we’ve employed a lot more new staff.” A manager added, “I would say we have enough permanent staff now who know the residents well on duty in the home 99% of the time these days, which is a vast improvement in the way it was here. We almost have our full complement of nursing and care staff which is great news.”

Staff were well-trained to meet people’s individual needs, in line with their choices and preferences and encouraged to continually improve in their role. Staff received a mixture of e-learning and in-person practical and theoretical training, which was routinely refreshed as frequently as staff required it including, competency-based assessments. People told us staff were competent. A relative said, “Staff are well-trained and competent.” Another added, “The staff are well-trained and very patient and kind with my [family member] when they become distressed at times.” Managers and staff were equally complimentary about the training staff received. A member of staff told us, “The training we receive is always relevant and is constantly being updated and refreshed.” A manager added, “The service is now over 90% compliant in relation to staffs mandatory training which is a significant improvement compared to even last year. We plan to continue moving in the right direction regarding staff training and there’s a big push to achieve at least 95% compliance in relation to staff training by the end of 2025.”

Newly employed staff were subject to a probationary review and records showed staff received an induction to their role and ongoing training and support to ensure they could meet the needs of people living in the care home.

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff had regular individual and group meetings with their fellow peers and line managers. A member of staff said, “I have a 1 to 1 meeting with my line manager every quarter and I do feel supported by them and all my colleagues who work here.”

The provider continued to operate safe recruitment practices and only fit and suitable staff were employed to work at the care home. Staff files contained evidence of robust recruitment checks including application forms where gaps in employment were explored, professional and personal references, right to work and identity checks. The provider maintained a recruitment tracker to monitor staff recruitment and completed Disclosure and Barring Service (DBS) checks. A DBS check helps employers make safer recruitment decisions by processing requests for criminal record checks of individuals applying for certain jobs, particularly those involving children or vulnerable adults.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had an in-house domestic team who maintained high standards of cleanliness throughout the care home. We observed this team follow structured cleaning schedules to keep people’s rooms and the communal areas visibly clean and tidy. This was confirmed by people we contacted. A relative told us, “Cleaning of Fieldway is outstanding. It's always kept very clean, odour free and is routinely cleaned throughout the day.” Another added, “The home is bright, clean and odour free whenever I visit my [family member], which is quite often.”

Staff had received relevant infection control and food hygiene training and had access to resources and equipment to help them reduce the risk of infections spreading in the care home. We observed staff using personal protective equipment [PPE] when they were about to meet peoples intimate personal care needs. A relative said, “They [staff] have plenty of PPE to hand.” The provider’s infection prevention and control policy was current and reflected national guidance.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Medicines systems were well-organised and safely managed. A relative told us, “My [family member] is always given their prescribed medicines on time and I have never had any issues regarding this.” Another added, “The staff are trained to a high standard in managing medicines and they always ensure my [family member] gets their prescribed medicines at the correct intervals.”

Care plans included detailed guidance for staff about how people needed and preferred their medicines to be administered. Staff received relevant training and their competency to continue managing medicines safely was routinely assessed. Staff were clear about their roles and responsibilities in relation to the safe management and administration of medicines. There were regular audits of medicines at the service. This included regular checks of staff’s practice to ensure they remained competent to administer and manage peoples prescribed medicines safely.

The provider had policies in place relating to the safe storage and administration of medicines. Staff were able to demonstrate how to correctly store controlled medications as per the providers policy.