Archived: The Field View Residential Home

The Field View Residential Home provides accommodation and personal care for up to 20 people. It provides care to older and younger people living with dementia, people with mental health issues and people with sensory impairments. During out visit 19 people lived at the home.

People’s experience of using this service and what we found

The systems in place to monitor people's health and wellbeing and assess the quality of the service were now effective and led to good outcomes for people. Feedback from people, relatives and staff, together with observational checks and audits, took into account people's experiences of living in the home to drive improvement.

Improvements had been made to ensure staff had the guidance they needed to minimise people’s identified risks. Staff understood their responsibilities for keeping people safe and could explain the processes to follow if they had concerns.

Environmental risks had been assessed and actions taken to maintain oversight of assessed risks. The home was clean and tidy and infection control practices minimised the risks of infections spreading.

There were enough staff with the appropriate skills, knowledge and experience to effectively and safely meet people's needs. Medicines were managed in a safe way and people’s prescribed medicines were available to them.

People's nutritional and hydration needs had been identified and assessed and meals were adapted to meet people’s individual preferences. People saw healthcare professionals when required to monitor and manage their health and wellbeing.

Staff were caring and interactions between staff and people were warm and respectful. The registered manager complied with the Equality Act 2010 and people’s diversity and individual lifestyle choices were respected. People contributed to care planning to ensure their daily routines reflected their choices and preferences and key information about their likes and dislikes was known and recorded.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires Improvement (published 27 April 2019) and there were three breaches of Regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The Field View Residential Home is a residential home providing accommodation and personal care for up to 20 older people. Some people at the home live with dementia, a mental health condition, sensory impairment or a physical disability. The home is a two-storey building with bedrooms on both the ground and first floor. At the time of our visit, 19 people lived at the home.

People’s experience of using this service and what we found

Systems and processes were in place to safeguarding people from abuse. Staff received training and understood their safeguarding responsibilities. Action was taken to ensure people were protected from abuse.

People were relaxed and comfortable in the presence of staff and relatives provided positive feedback about safety. People were clean and well kempt and looked well cared for.

People were happy with the food and most people’s weight remained stable. Where people had lost weight, this was being monitored and referrals were made to other healthcare professionals where necessary. Improvements were required to the variety of food choices available and further staff training was needed to ensure special and modified consistency diets were well managed.

People’s moving and handling needs had been assessed and plans were in place to ensure these were managed safely. Action had been taken to involve other healthcare professionals with people’s moving and handling needs. Due to the coronavirus pandemic, some healthcare appointments had been cancelled. Action was taken during our inspection to re-book these.

Most staff and relatives told us the home was well managed. Positive feedback was received about the registered manager and staff had regular opportunities to discuss the service and any issues. Resident meetings were held to gain regular feedback of the service provided. Despite this, some staff did not feel listened to by the provider who acknowledged communication in the home could be improved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (27 April 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We undertook this targeted inspection to check on specific concerns we had received about unexplained bruising, poor personal care practices, moving and handling, nutritional risks related to food shortages and the overall governance of the home

CQC have introduced targeted inspections to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question. Therefore, the overall rating for the home remains requires improvement.

We found no evidence during this inspection that people were at risk of avoidable harm from these concerns.

Follow up

We will continue to monitor information we receive about the service and work with partner agencies until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service:

• Risk’s associated with people’s planned care and within the building were not always identified or managed safely.

• Staff were not always recruited safely.

• Medicines were not always safely managed.

• Referrals to other healthcare professionals were not always made in a timely way.

• Advice from healthcare professionals was not always followed.

• Systems and processes were not effective. Where areas of concern had been identified, action had not always been taken to make improvements.

• Most people felt safe and spoke positively about their care. People told us staff were caring and kind.

• People’s individual needs were assessed to ensure they could be met by the service.

• People made decisions about their care and were supported by staff who understood the principles of the Mental Capacity Act 2005.

• People’s told us their privacy and dignity was respected.

• People’s nutritional needs were met.

• People’s care plans lacked detail. Further information was required to help staff provide personalised care.

• Systems were in place to manage and respond to any complaints or concerns raised.

• The registered manager and the director were open and transparent and took some immediate actions to resolve concerns found at our visit.

This is the second consecutive time the home has been rated as Requires Improvement.

The registered provider was in breach of Regulations 12 and 17 of the Health and Social Care Act 2008(Regulated Activities) Regulations 2014 and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

Rating at last inspection: At the last inspection the service was rated as requires improvement. (The last report was published on 5 April 2018).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service continues to be rated as ‘Requires Improvement’ overall.

Enforcement: Action we told provider to take (refer to end of full report)

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The Field View Residential Home is a home which provides care to older people including some people who are living with dementia. The home is two storeys with bedrooms on the ground and first floor. There is lift access to the first floor. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Field View Residential Home is registered to provide care for up to 20 people. At the time of our inspection there were 16 people living at the home.

The provider had taken over the home as a ‘going concern’ in July 2017. This was their first ratings inspection since taking ownership of the home.

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. The previous registered manager had recently left the home. The provider had appointed a new manager who had been in post for eight weeks at the time of our inspection visit. The new manager had submitted their application for registration.

People felt safe living at The Field View Residential Home because there were enough suitably qualified and experienced staff to keep them safe. The provider had a programme of training to ensure staff refreshed their knowledge and kept their skills up to date.

Care plans included risk assessments related to people's individual needs and abilities. However, there were no risk management plans to advise staff how to support people who could demonstrate behaviours if they became anxious or frustrated because of their medical condition. Some environmental risks had not been identified. Improvements were needed to ensure the checks and audits that kept people safe and protected were always implemented effectively.

People’s needs were assessed before they moved to the home and they were supported to obtain advice from their GP or healthcare professional when their health needs changed. People received their medicines as prescribed to manage their medical conditions, but guidelines to support good medicines management were not always in place.

The provider was keen to promote a caring environment and led by example. People told us the staff were kind, caring and approachable and took time to understand them as individuals. Care staff recognised and respected people's diverse needs and promoted their independence.

Staff worked within the principles of the Mental Capacity Act 2005. They explained how they used their knowledge of the legislation to support people in line with their choices or known preferences. Staff used different methods of communication to ensure people consented to the care they received. Where restrictions on people's liberty had been identified, the appropriate applications had been submitted to the authorising authority.

Each person had a care plan which contained the basic information staff needed to meet people’s needs safely. However, some care plans needed additional information to help staff respond to people’s emotional and communication needs and provide consistent care and support. Care plans included information about people’s dietary needs and staff supported people to eat and drink enough to maintain their health.

The provider understood the importance of ensuring people had stimulation and engagement to maintain the social aspect of their lives. Improvements were being made to the activities provided, but when staff were busy they had limited opportunities to keep people occupied and interested.

The home was clean and staff understood their roles and responsibilities in relation to infection control and hygiene. The provider had procedures to manage risks in the event of an emergency.

The provider and new manager were working together to raise standards, keep people safe and encourage staff. Staff spoke highly of the commitment and motivation of the provider. They told us the provider visited the home regularly and took time to understand the service, the people who lived in the home and the staff who worked there. The new manager was described as ‘hands on’ and had introduced new processes to make the home safer.

People and relatives were encouraged to engage in the community of the home and to provide feedback and share their experiences so outcomes for people were improved.