CQC report explained · a residential care home
What the CQC found at The Fieldings
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2022
The Fieldings was inspected but not rated; inspectors found well-organised infection prevention and control arrangements.
Inspectors visited on 5 January 2022. This was an announced, targeted inspection during the COVID-19 pandemic. They looked at infection prevention and control, visiting arrangements and whether staffing pressures were affecting the service.
The home was registered for 47 people and 40 people were living there. Inspectors were assured that visitors were checked, personal protective equipment was used safely, testing was available and people were admitted safely.
Inspectors found organised records for vaccinations, isolation periods and test results. The home had plans for outbreaks, used zones to reduce cross-contamination and carried out extra cleaning and observation checks where people could not keep apart.
The service was inspected but not rated. This visit did not provide an overall quality rating or ratings for most of the five areas of care.
Visitor infection checks
The home carried out comprehensive checks for visitors when they arrived, to reduce the risk of infection.
“This included comprehensive checks for visitors on arrival.” from the report
Organised COVID-19 records
Records of vaccination status, isolation periods and test results were described as methodical, organised and up to date.
“The registered manager had a methodical and organised approach to recording individuals COVID-19 vaccination status, isolation periods and COVID-19 test results.” from the report
Managing infection risks
The home used regular observation checks when people could not socially distance and increased cleaning of frequently touched areas.
“The Fieldings managed risk in relation to infection well, where people were unable to social distance regular observation checks were recorded and increased touchpoint cleaning was undertaken.” from the report
Outbreak planning
The home had contingency plans and was arranged in zones to help reduce cross-contamination if there was an outbreak.
“In the case of an outbreak contingency plans were prepared and the home was already set up in zones to reduce the risk of cross contamination.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you currently managing any COVID-19-related staffing pressures?
- 02How do you check visitors and visiting professionals before they enter the home?
- 03How are vaccination status, isolation periods and test results recorded and kept up to date?
- 04How would you use the home's zones and contingency plans if there were an infection outbreak?
- 05How do you make sure visits follow current guidance?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it did not provide ratings for the other areas of care. This explanation was written from the published report of 13 January 2022 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, December 2019
Rated Requires Improvement; inspectors found progress since the last inspection, but medicines, care planning, dignity and management still needed attention.
This was an unannounced comprehensive inspection on 10 October 2019. Inspectors spoke with 12 people, seven staff members and a visiting healthcare professional. They reviewed care and medicine records, staff files, training information and the home's audits.
The overall rating was Requires Improvement. All five areas were rated Requires Improvement: Safe, Effective, Caring, Responsive and Well-led. Medicines were not always managed safely, some care records were out of date, and people's privacy and dignity were not always respected.
There had been clear progress since the previous inspection on 3 May 2019, when the home was rated Inadequate in every area and several regulations were breached. New systems, staffing arrangements and management processes had been introduced, but inspectors said these changes still needed to become established.
Improved risk management
Risk assessments had been improved and contained relevant, updated information. The home had also introduced checks and assessments around smoking and fire risk.
“Risk assessments were completed and contained relevant updated information.” from the report
Cleaner environment
The home was described as safe, clean and suitable. Staff had cleaning routines and understood how to reduce the risk of spreading infection.
“Cleaning schedules were available, and the cleaners worked systematically cleaning people's rooms and all of the communal areas.” from the report
Safe recruitment
The home checked references and criminal records before employing staff. Staffing levels were planned according to people's needs.
“Safe recruitment procedures were followed, this included taking references and checking criminal records to ensure that new staff were safe to work with vulnerable people.” from the report
Communication support
People's communication needs were assessed. Information could be provided in other formats, including pictorial information.
“People's communication needs were assessed, and it was clear how people wanted to be communicated with.” from the report
Medicine records and checks
seriousMedicine records had missing signatures. Some medicines were not dated when opened, and some checks requiring two staff were completed and signed by only one person.
“Medicines were not always managed safely and effectively. There were missing signatures on the Medication Administration Records (MAR).” from the report
Nutrition monitoring
seriousFood and fluid charts were not always properly maintained for people who had lost weight. Inspectors said this left people at risk from poor nutrition and hydration.
“Risks associated with weight loss were not always managed safely.” from the report
Rights and consent
seriousItems had been removed from one person's room to reduce self-harm risk, but there was no evidence of consent or a capacity assessment at the time.
“There was no evidence they had consented to this and no capacity assessment to show that this had been considered.” from the report
Care plans not up to date
needs fixingSome care plans had not been completed or updated to reflect people's current needs. Inspectors gave the example of a person's bowel condition and dietary requirements not being included.
“However, not all care plans had been completed and needed work bringing them up to date and ensuring that all care plans were live documents, up to date and relevant.” from the report
Privacy and dignity
needs fixingPeople queued at the medicine room to receive medicines, which inspectors said was not person-centred. Some people also reported that staff did not always listen or care about their needs.
“Medication was not given in a dignified way. People queued at the medication room to receive their medicine, this was institutionalised and not person centred.” from the report
Activities and personal wishes
needs fixingSome people had no planned activities, and activities were often basic. A request made years earlier to arrange a will had still not been followed up.
“However, there was no allocated activity person employed and the in-house activities tended to be very basic such as dominoes, jigsaws and Cluedo.” from the report
- 01What checks now make sure every medicine dose is recorded and that medicines needing two staff are checked by two staff?
- 02How do you monitor food and fluid intake for people who have lost weight or have specific dietary needs?
- 03How are capacity assessments and consent recorded when staff remove belongings or restrict someone's choices?
- 04Which activities are currently planned for my relative, based on their own interests and preferences?
- 05How are care plans reviewed so that current health conditions, dietary needs and personal wishes are included?
This was a full comprehensive follow-up inspection covering all five key questions, after the previous inspection on 3 May 2019 rated the home Inadequate in every area. This explanation was written from the published report of 7 December 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 The Fieldings
6 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- January 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- December 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2019Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- July 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2016Requires improvementstayed Requires improvementSafe: Requires improvement
- July 2016Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Registered with the Care Quality Commission on 25 November 2014.
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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