CQC report explained · a nursing home
What the CQC found at Fieldhead Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, recruitment, infection control and accident reporting were found to be managed safely, although some air flow mattresses were not on the correct setting.
- Effective?
- Good
- People's needs were assessed, staff had relevant training, and nutritional, hydration and health needs were being met. The home was also working within the principles of the Mental Capacity Act.
- Caring?
- Good
- Caring was not covered by this focused inspection, so no new rating was given in this report.
- Responsive?
- Good
- Care was personalised and reflected people's preferences. Staff understood communication needs, offered activities, supported family relationships and recorded end-of-life wishes.
- Well-led?
- Requires improvement
- The home had quality systems and good communication, but its checks failed to identify incorrect air flow mattress settings. Inspectors recommended that these checks be strengthened.
What inspectors found, April 2023
Fieldhead Court rated Good; inspectors found safe, kind and responsive care, but quality checks did not always protect people from risks.
This was an unannounced focused inspection on 9 March 2023. One inspector and an Expert by Experience spoke with people, relatives and staff, and reviewed care, recruitment and management records.
The home was rated Good overall. Safe, Effective and Responsive were rated Good. Inspectors found people were safe, medicines were managed properly, staff were trained, food and drinks needs were met, and care was personalised.
Well-led remained Requires Improvement. Quality checks did not identify that some air flow mattresses were set incorrectly, which placed people at risk. The provider was asked to improve its checks.
The previous overall rating was Requires Improvement, published in May 2019. The home had improved enough to meet the legal requirements that were checked during this inspection.
Safe medicines care
Medicines were stored and given safely. Nurses understood people's medication needs, and people did not raise concerns about their medicines.
“Nurses had good knowledge of people's medication needs. Time specific medicines were documented and there were processes in place for as and when required medicines.” from the report
Kind and responsive staff
People said staff responded to requests for help. Inspectors observed staff speaking in a caring and understanding way, and relatives said staff cared about their family members.
“Staff spoke to people in a caring and empathic way.” from the report
Food and health support
The home met people's food and drink needs and offered choices and snacks. It worked with health professionals and arranged medical help when needed.
“People's nutritional and hydration needs were being met and they were offered a varied choice of foods and a range of snacks.” from the report
Personalised activities and relationships
Staff knew people's individual needs and supported people to make choices, take part in activities and maintain relationships with loved ones.
“People were actively engaged in developing the care they received.” from the report
Mattress safety checks
seriousSome air flow mattresses were not set correctly. The home corrected this after inspectors raised it, but the quality system had not identified the problem beforehand.
“Quality assurance systems were in place, but the service failed to monitor air flow mattress settings which placed people at risk.” from the report
Building updates still in progress
minorSome parts of the home needed updating. New carpets and a redecorated lounge were in place, and an action plan covered further redecoration.
“Aspects of the service needed updating. The provider had started to address this; there was a newly decorated lounge and some new carpets in place.” from the report
- 01How do you now check that every air flow mattress is on the correct setting?
- 02How often are air flow mattress settings checked, and who records and reviews those checks?
- 03What improvements from the action plan after the previous inspection have now been completed?
- 04Which parts of the redecoration plan are still outstanding?
- 05How will you involve our relative and our family in reviewing and updating their care?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected and the report says the findings in this inspection were used with previous ratings to calculate the overall rating. This explanation was written from the published report of 15 April 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2019
Fieldhead Court rated Requires Improvement; inspectors found kind care but serious weaknesses in risk management, medicines, records and quality checks.
Inspectors visited unannounced on 2 and 8 April 2019. They spoke with people, relatives and staff, observed care, and checked care records, medicines records, training and the home's monitoring systems.
People generally said they felt safe, and inspectors saw warm and compassionate interactions. Staff were trained and supported, healthcare referrals were made when needed, and the home provided activities and end of life support.
However, inspectors found that risks were not always assessed or managed properly. Medicines records, care plans, consent records and daily notes were not always reliable. The home was rated Requires Improvement overall for the second time, with two breaches of regulations.
Kind and compassionate interactions
Inspectors saw staff comfort people and interact with them warmly. People were generally treated with dignity and respect.
“During our observations throughout this inspection, staff interacted with people in a positive and compassionate manner.” from the report
Staff training and support
Staff had access to relevant training and regular supervision. People and relatives told inspectors that staff understood their needs.
“People were supported by staff who had been supported by regular supervision and staff told us their supervision meetings were supportive” from the report
Healthcare links
The home made timely referrals to healthcare professionals, including GPs and palliative nurses.
“Records we reviewed confirmed referrals to healthcare professionals such as GP and palliative nurses had been done when required and in a timely way.” from the report
End of life support
The home had dedicated end of life care plans and worked with relevant healthcare professionals. Relatives of people receiving this care spoke positively about it.
“Relatives of people receiving end of life care were complimentary about the care delivered to their loved one and the positive impact it had on them.” from the report
Risks were not consistently managed
seriousKnown risks were missing from some assessments and care plans. Inspectors found concerns about specialist seating, pressure-relief mattresses and support for people at risk of pressure ulcers.
“The management of risks was not always consistent.” from the report
Medicines records were not reliable
seriousInspectors could not be certain that medicines were always given safely or at the right times. Instructions for as-needed medicines and creams were not always clear.
“At this inspection, we found inconsistency in how medicines were being managed and we could not be certain people were always receiving their medicines in a safe way.” from the report
Care records lacked detail
needs fixingCare plans, consent records and daily notes were not consistently accurate or person-centred. One person who had been staying for respite did not have an initial assessment or care plan.
“We found inconsistency in the quality of people's care plans and in how person centred these were.” from the report
Quality checks had not worked
seriousThe home's audits had not identified several of the problems found during the inspection. Similar record-keeping concerns had been raised at the previous inspection.
“The quality assurance systems in place were not effective in ensuring the best delivery of care.” from the report
- 01What changes have been made to medicines administration records and checks since this inspection?
- 02How are pressure-ulcer risks, repositioning and air-flow mattress settings now recorded and checked?
- 03How do you make sure every person, including someone staying for respite, has a complete and personalised care plan?
- 04How are mental capacity assessments and best-interest decisions now recorded?
- 05What evidence can you show that your quality audits now find and correct problems across all records?
This was an unannounced inspection of the overall quality of the care home, including premises and care, and it assessed all five CQC key questions. This explanation was written from the published report of 24 May 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Fieldhead Court
4 rated inspections over 7 years: the service has held its Good rating throughout.
- April 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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