CQC report explained · a residential care home
What the CQC found at The Fields Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2018
Rated Good; inspectors found safe, kind and responsive care, with some records and management arrangements still needing attention.
Inspectors visited on 24 and 25 September 2018. The first day was unannounced. They spoke with people living in the home, relatives, staff and health professionals. They also observed care, looked around the building and checked care, medicines, recruitment and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found improvements since the previous focused inspection in May 2018, when the home was rated Requires Improvement overall.
People were supported by enough staff and received their medicines safely. Inspectors saw kind and respectful care, suitable support with food and drink, detailed person-centred care plans and improved checks on the quality of the service. They also found some care records were not always updated when people's needs changed, and staff were not always clear about deprivation of liberty safeguards.
Enough staff
Inspectors found enough staff on duty and saw that people's needs were answered promptly.
“We observed that there were sufficient numbers of staff on duty to keep people safe during our visits and people's needs were responded to promptly.” from the report
Kind and respectful care
Staff knew people well and supported their privacy, dignity, choices and independence.
“Our observations confirmed staff treated people with dignity and respect and care records demonstrated the provider promoted dignified and respectful care practices to staff.” from the report
Food and drink choices
People were offered different meal choices and received support matched to their nutritional needs.
“People were offered a choice as meals were being served and referred to a menu board to know what was on offer.” from the report
Care records not always updated
needs fixingSome care plans and risk assessments did not match people's current needs. The manager corrected the records during the inspection, but further staff coaching and checks were still needed.
“We found that the care files we checked had inconsistencies as people's needs had changed and sections had not been updated correctly.” from the report
Unclear deprivation of liberty information
needs fixingStaff were not always sure which people had restrictions authorised under deprivation of liberty safeguards. The manager updated the care files and told staff about the changes.
“When we spoke with staff they were not sure who was subject to DoLS.” from the report
No registered manager
needs fixingThere was no registered manager in post at the inspection. The service manager had applied to register, but CQC had not yet assessed the application.
“The service did not have a registered manager.” from the report
Temporary gap in activities staffing
minorThe home had not had an activities co-ordinator for four weeks. Staff and some relatives provided activities while a new co-ordinator was awaiting recruitment checks.
“At the time of our visit the home did not have an activities co-ordinator and had not had one in post for four weeks.” from the report
- 01How do you check that care plans and risk assessments are updated promptly when a person's needs change?
- 02Which residents currently have a deprivation of liberty authorisation, and how are staff told about any conditions or restrictions?
- 03Has the manager's application to become registered been assessed, and who has legal responsibility for running the home while this is pending?
- 04Has the activities co-ordinator now started, and what activities are available if they are absent?
- 05What actions from the previous Requires Improvement inspection are still being monitored?
This was an inspection of the whole home, covering all five CQC questions and the accommodation as well as the care provided; the first day was unannounced and the second day was announced. This explanation was written from the published report of 1 November 2018 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, July 2018
The Fields Care Home was rated Requires Improvement; inspectors found improvements, but risks, medicines records and management checks were still not reliable enough.
This was an unannounced focused inspection on 16 and 24 May 2018. Inspectors followed up concerns from the November 2017 inspection, mainly about safety and how the home was managed.
The home had improved in some areas. Staffing levels were sufficient during the visits, call bells were answered promptly, medicines were stored more safely, and people and relatives described a more positive atmosphere.
Important problems remained. Some risk assessments did not give staff enough detail, medicines records had gaps, parts of the building needed attention, and quality checks had failed to find several problems.
The overall rating remained Requires Improvement. Safe and well-led were both rated Requires Improvement. The other three question ratings were carried over from the previous comprehensive inspection because they were not inspected this time.
Staffing and response
Inspectors found enough staff during the visits. Call bells were answered promptly, and staffing had recently increased.
“Staffing levels were sufficient and had increased to meet people's needs.” from the report
Some safety improvements
Medicines storage and the security of records and hazardous chemicals had improved since the previous inspection.
“Previously identified risks about the safe storage of records and hazardous chemicals had been addressed.” from the report
More positive culture
Most people, relatives and staff described the home as more relaxed and open under the new management.
“People and their relatives told us they saw improvement in the home in recent months and that there was a more positive and open culture.” from the report
Staff support
Staff received supervision and new staff were supported through induction and mentoring.
“New staff were being supported and mentored through inductions and the policy reflected that support would be given to new staff until they were assessed as competent in their roles.” from the report
Incomplete risk assessments
seriousSome assessments were generic, out of date or did not explain clearly how staff should manage individual risks, including fire evacuation needs.
“People could not be assured that all risks associated with their care and support would be managed safely because staff did not have accurate, person-centred and detailed risk assessments to follow.” from the report
Medicines records
seriousOne of four medicines records checked had gaps for several medicines. The home could not show from the record that these had been given as prescribed.
“The fourth record had gaps on two days for several different medicines, so we were not able to evidence that the medicine had been given as prescribed.” from the report
Building maintenance
needs fixingSome garden benches were unsafe and hot water was not sufficiently hot in all bedrooms. The benches were removed during the inspection.
“We found that some benches in the gardens were not appropriately maintained and not fit for purpose.” from the report
Weak quality checks
seriousAudits and monitoring systems did not identify several problems found by inspectors. Improvement plans were also not up to date, so progress could not be properly tracked.
“We concluded that systems and processes used for the monitoring the quality of the service were ineffective.” from the report
- 01How are you now checking that every person's risk assessment is detailed, current and personalised?
- 02What medicines audits are now in place, and how do you investigate and prevent gaps in medicines records?
- 03What has been done to make sure hot water is sufficiently hot in every bedroom?
- 04How do you track the improvement plan and make sure audits identify problems before they affect residents?
- 05Has the manager applied to become registered, and have staff competency checks and appraisals now been completed?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous comprehensive inspection. This explanation was written from the published report of 3 July 2018 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 Fields Care Home
4 rated inspections over 3 years: the service has held its Good rating throughout.
- November 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2018Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 2010.
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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