Field House Residential Care Home for the Elderly

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 assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were 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 provider had a proactive and positive culture of safety, based on openness and complete honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The management team demonstrated a good culture of learning and continuous improvement. Accidents and incidents were recorded and analysed to identify areas of learning or how practices could be amended to reflect people’s individual needs. The registered manager ensured any learning from incidents was shared promptly with the staff team. For example, the registered manager ensured that the circumstances around any falls that had occurred were thoroughly analysed at the end of each month. From this patterns and trends, good practice and areas to improve were identified. This information was then shared with staff in written form and discussed during team meetings.

Staff felt empowered to speak up, raise concerns and make suggestions. A staff member told us, “I have confidence I would be listened to, and any concerns would be acted upon.” There was a culture of “learning and improving together” at the service, where incidents were discussed openly. A family member told us, “Like anywhere there are sometimes issues, but it is how they are dealt with. Any concerns are discussed with me. [Registered Manager] takes action and follows through.”

The provider 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. Assessments to identify people’s needs before they moved into the service were completed by the management team.Staff worked collaboratively with people, their relatives and health and social care professionals to ensure care plans were reflective of people’s needs and were regularly reviewed. A relative told us, “They did a care package, and I sat with them to let them know what [family member’s] needs were – They asked for my input; they always communicate…there are regular reviews”.

People and relatives told us that staff knew people well and we observed this during our visit. We were also told how the transition for people into this service was a positive experience for many, as staff were friendly and took time to get to know people and understand how people wanted to be supported. A relative told us, “[Staff] took the time to enquire about [family member]’s life and things that they like. I think they know us pretty well by now.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff 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 provider shared concerns quickly and appropriately. People told us they felt safe. A relative told us, “I can go home and not be worried and know [family member] is safe.” Staff had received safeguarding training and had a good understanding of what to do to make sure people were protected from harm or abuse. Records showed safeguarding incidents were investigated and lessons learned were shared with the team.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS) which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service.

We found the registered manager and staff ensured people’s capacity to make decisions was assessed. Where people lacked capacity, any restrictions imposed to keep them safe, such as the use of sensors to alert staff, were in people’s best interest and the least restrictive option available. Staff understood when Deprivation of Liberty Safeguards (DoLS) authorisations would need to be sought and what to do if there were conditions imposed.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff took a balanced and proportionate approach to risk. People’s rights and choices about their care and their lives were respected. Risk assessments were completed when people moved into the service and were regularly reviewed. People and their relatives felt confident staff understood them and could support them to manage any risks posed. A family member told us that when their relative had a loved one had a fall, staff “were on the ball and did all the right things- I think they definitely manage any risk very well.”

At the last inspection, the provider had not ensured all environmental risks were managed appropriately, particularly in relation to fire safely. At this inspection, we found the provider detected and controlled potential risks in the care environment, as required. They made sure equipment, facilities and technology supported the delivery of safe care. Relatives told us they had no concerns regarding the home environment. A relative told us, “I have no concerns about the environment, [name] is safe at the home, and they do everything to keep [name] happy and comfortable there. I have not raised any concerns with the home that has not been resolved or explained.”

The environment was safe, clean, and homely, with regular checks on fire safety, water quality, and equipment. People lived in a home which was personalised, well maintained and met their needs. Equipment was regularly serviced and risk assessments were regularly reviewed. This ensured the provider monitored the risks to people, managed and mitigated concerns when people’s needs changed. Personal Emergency Evacuation Plans (PEEPs) were tailored to individuals should people need to be evacuated in an emergency.

The provider 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. The registered manager reviewed the needs of people at the service regularly, which enabled them to identify how many staff were required. People and their relatives told us there were enough staff. A relative told us, “They always have staff there, I have never found them to be short of staff – You can always find someone, and nothing is too much trouble.” Staff told us they worked well as a team and there were sufficient staff on duty to meet people’s needs in a timely manner.

Staff were recruited safely and had the knowledge and skills to meet people’s needs. The provider promoted a learning culture and ensured staff had access to a wide range of training. Staff had received mandatory and condition specific training. Staff supervision sessions were completed in line with the provider's policy. Staff told us they felt well supported by the management team. A staff member told us, “We have team meetings, communication is good, we talk about different things, depending on what is happening…feedback is balanced and they tell us what we have done well, and where any improvements can be made.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The home was clean and staff worked throughout the day to ensure all areas remained tidy. Staff had sufficient supplies of Personal Protective Equipment (PPE). They received training to help them maintain good standards of infection control. Staff told us they followed procedures for the use and disposal of their PPE. People and relatives also confirmed staff followed safe infection control practices.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Storage areas were secure, and temperature checks were recorded. Medicine Administration Records (MAR) were accurate. During the assessment we found staff had not always administered medicines in line with the prescriber's instructions. This was isolated to 1 person and their specific medicine. No harm had come to this person, and the manager did take immediate action to investigate and rectify the concern. Medicines audits were carried out routinely to check that systems were safe. If any issues were identified action plans were implemented to address them, and staff were reminded of best practice. Staff had received training, and their competence was assessed regularly.