Background to this inspection
Updated
16 January 2020
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 was carried out by one inspector and one assistant inspector.
Service and service type
Thomas Fields Care Centre 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. However, the registered manager had been away from their post since August 2019, so the deputy manager had accepted a fixed term contract as the manager. Throughout the report this person will be referred to as, ‘the manager’.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection, this includes notifications the provider is legally required to send to us when certain incidents happen. We sought feedback from the local authority and professionals who work with the service.
During the inspection
We spoke with five people who used the service and five relatives about their experience of the care provided. We spoke with ten members of staff including the manager, service manager, senior care workers and care workers. We spoke with three professionals who regularly visit the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included six people’s care records and all medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, staff rotas and deprivation of liberty records.
Updated
16 January 2020
About the service
Thomas Fields Care Centre is a residential care home providing accommodation and personal care to 16 people at the time of the inspection. The service can support up to 20 people. The service is located within a sheltered accommodation building which is owned and managed by a housing association so run separately from the care home.
There are 20 en-suite bedrooms located over two floors. There is a dining room, activity room and a smaller meeting room on each floor. There are adapted bathrooms and kitchens on both floors. People can receive care on a long- or short-term basis, some people stay for a short time to receive community support.
The service is registered to care for older people, people living with dementia, physical disability, sensory impairment, mental health conditions, an eating disorder, younger adults and people with a learning disability or autistic spectrum disorder. Although there were no people with learning disabilities, autistic spectrum disorder, eating disorder or younger adults living there at the time of the inspection.
People’s experience of using this service and what we found
Governance systems were not robust enough to assess, monitor and improve the quality of the service provided. Staff told us the manager was supportive and fair. The manager was available to support staff and led care delivery by example.
Safeguarding was not always given sufficient priority to protect people from abuse and avoidable harm. Some safeguarding concerns had not been reported to the relevant professionals. Staff employed by the provider were safely recruited.
We recommended the provider review their procedure to ensure agency staff are safely recruited.
Some documentation about staff training was not clear, this was identified by the inspection team and addressed by the manager after the inspection. People had access to a choice of meals, drinks and snacks and told us they enjoyed the food. The home was purpose built and was suitable for people who were physically independent and people with significant physical disability. The home was easy for people living with dementia to navigate
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.
Staff were kind and caring. We saw many occasions where staff were companions to people and went out of their way to make people feel content. People told us they were happy there.
Care was person-centred, and people were respected as individuals. People were supported and encouraged to take part in activities that interested them.
Rating at last inspection
This service was registered with us on 09 November 2018 and this is the first inspection.
Why we inspected
This was a planned inspection based on inspection methodology.
Enforcement
We have identified breaches in relation to safeguarding, governance and failing to submit notifications required by law. We found evidence the provider needs to make improvement. Please see the Safe, Effective and Well-led sections of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk