Archived: Fieldway Care Home

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.

At our last inspection, we rated this key question requires improvement. At this inspection, the rating has changed to good. This meant the service was now consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The managers described the values of the provider and explained how these were applied to ensure they employed suitable staff. Managers told us they routinely used individual and group meetings to remind staff about the provider’s underlying core values and principles. They supported a reflective practice approach, establishing a learning culture to support staff to deliver good quality, person-centred care. Care staff told us they were supported by their line managers and nursing staff to deliver consistently safe, person-centred care to people in line with the provider’s vision and values for the service. Typical feedback from staff included, “We have an excellent team spirit here which is getting better all the time under the leadership of the new managers,” “We work well together as a team which makes this such a wonderful place to work” and “We’re one big family here. Most of us do share the same values and we do try and put the people we look after at the heart of everything we do.”

The service had 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 did so with integrity, openness and honesty.

The care home continued to improve following the recent return of the registered manager. They also had a new deputy manager and clinical lead nurse which meant the care home now had a much more suitably skilled, knowledgeable and experienced management team in day-to-day charge. Managers were suitably competent and experienced and were all visible within the care home at the time of our inspection. Feedback we received from people about how the management team ran the care home was positive. Typical comments included, “From cleaning, meals, laundry, maintenance and activities, I think the service is managed very well,” “The management always seem very approachable when I need to ask for anything” and “Fieldway is managed very well. The management are accessible and approachable, and always willing to answer any questions or queries I might have.”

Staff were equally complimentary about the leadership approach of the management team who they consistently described as effective, approachable and professional. Typical feedback we received about them included, “The whole team are so pleased the manager [registered] is back in post. She is an exceptional manager. Firm, but always fair.” Another added, “The manager [registered] was missed when she was on leave and the home become a little dysfunctional during her absence. The home is now back on track with everyone on board, which I personally think has a lot to do with the leadership approach of our fairly new management team, who are marvellous.”

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The care home had an open and transparent culture where people, relatives, external care professionals, and staff were all encouraged to raise concerns without fear. A relative told us, “The managers and staff are easily accessible if you have a problem and are always very quick to act if you have any concerns, which I have to say have been very few.” Another added, “The manager's office doors are invariably open and you can pop in anytime and have a chat if you choose. We have residents and carers meetings every month but you can bring any problems to the team at any time.”

The provider used a range of methods to gather people’s views about what the care home did well or might do better. They received regular feedback through various forums people were encouraged to attend. Managers told us they explained the complaints process before people moved into the care home.

The provider valued and listened to the views of staff. Staff were encouraged to contribute their ideas about what the service did well and what they could do better during regular individual and group meetings with their line managers and fellow co-workers. The provider had a ‘Speak up’ policy that was available to all staff. Staff felt able to brings things to the attention of the managers.

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

Staff told us they were part of a diverse team, treated equally and fairly, and they felt able to speak up. Staff told us their managers were supportive and reported feeling cared for, respected, valued and listened to. A member of staff said, “We do have a voice here and the managers are very good at listening to what the staff have to say.” Another added, “We are a diverse staff team at Fieldway and we’re all treated the same by the management. I do feel valued, able to speak my mind and listened too.”

Managers understood the importance of having a fair and inclusive workplace for all staff to work in. Staff were provided support through relevant training and supervision to inform their knowledge and understanding of equality, inclusivity and fairness in the workplace.

The service 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 act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

The quality of information recorded and maintained in people’s new electronic care records, and records relating to the management of the service, had improved since the services last inspection and were now sufficiently detailed, up to date and accurate. For example, Malnutrition Universal Screening Tool assessments had been accurately calculated on the new electronic system, ensuring appropriate nutritional interventions and risk management plans were in place for everyone who lived at the care home. In addition, care plan reviews were now routinely carried out and documented, ensuring that each person’s care remains appropriate and responsive to their current needs.

Governance systems were well-established, effectively operated and used to regularly check and audit the quality and safety of the care and support provided at the care home. The outcomes of these checks and audits are routinely used to identify performance shortfalls which feed into an action plan to continuously improve the quality and safety of the service people living at the care home received. Managers demonstrated a good understanding of their governance roles and responsibilities in relation to assessing, monitoring and managing the quality and safety of the service they provided.

The managers understood their responsibilities in relation to regulatory requirements around notifiable incidents. The registered manager continued to notify the CQC in a timely manner about any incidents and events they were legally required to. They also understood their responsibility to apply duty of candour and where appropriate apologised when things went wrong. The duty of candour is a legal requirement for health and social care providers to be open and transparent with people receiving care and treatment when mistakes occur.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The provider shared information and learning with partners and collaborated for improvement. Managers and staff told us they worked closely with various external health and social care professionals and bodies who they regularly consulted and welcomed their views and advice. An external care professional said, “The home does worked closely with us at the local authority and often shares their quality assurance assessment with us.” Another added, “I have no particular concerns about Fieldway Nursing Home and overall I think that they look after their residents well.”

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice.

Managers understood the importance of having an open culture of learning and continuous improvement to ensure people consistently received high quality, safe care and support. Managers told us all the audits and checks the provider conducted were routinely analysed to identify performance shortfalls and learn lessons, so the service could continuously improve. When lessons needed to be learned, the provider developed action plans which set out clearly what, how and when they needed to take steps to improve the service they provided people. Staff confirmed information about any lessons learnt and action plans developed as a result were always shared with them during individual and group supervision meetings with their line managers.