Fieldhouse Care Home

Updated 4 January 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors, 1 medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Fieldhouse Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Fieldhouse Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and other professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the provider, the registered manager, the deputy manager, the cook, 2 senior care staff, the activities coordinator and 4 care staff.

We spoke with 10 people who used the service and 4 visiting relatives about their experiences of the care provided. We reviewed a range of records including 4 people's care records, risk assessments, medication administration records and associated documents. We observed care in communal areas and the dining room.

We looked at 4 staff personnel files including recruitment records. We looked at staff training and supervision records. We reviewed records relating to the management of the service, including audits and a variety of policies and procedures.

Updated 4 January 2024

About the service

Fieldhouse Care Home is a residential care home providing accommodation for persons who require nursing or personal care to up to a maximum of 42 people. Accommodation is provided over 2 floors, with lift access. There are shared lounges, bathrooms and dining areas and a secure outside garden area. The service provides support to older people, including people living with dementia. At the time of our inspection 40 people were using the service.

People’s experience of the service and what we found:

People’s medicines were not always managed safely. Governance arrangements were not robust. Accurate and up to date care records were not always maintained. Building related health and safety checks had been completed but infection control procedures were not always being followed. Improvements were needed to the design and decoration of the service.

We have made recommendations about developing dementia friendly environments, prioritising record keeping, staff training training and maintaining a Deprivation of Liberty Safeguards (DoLS) tracker.

There were enough staff on duty to meet people’s needs. Staff were recruited safely to ensure they were suitable to support people living at the home. Staff had received safeguarding training and people felt safe living at the home.

People and their relatives had not always been involved in the care planning process and care plans needed to be reviewed to ensure they were accurate. 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.

Further improvements were needed to systems for auditing, assessing, monitoring, and improving the quality and safety of the service. Policies and procedures were in place to guide staff. Staff felt able to approach the management team with concerns. The provider had a development plan which they were working towards to improve the service.

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 the service under the previous provider was good, (published on 21 August 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement [and Recommendations]

We have identified breaches in relation to safe care and treatment and good governance. Please see the action we have told the provider to take at the end of this report.

We recommend the provider consults best practice guidance on developing dementia friendly environments.

We recommend the provider prioritises record keeping, ensuring people’s care records are all up to date.

We recommend the provider keeps an accurate and up to date Deprivation of Liberty Safeguards (DoLS) tracker, including identifying any conditions that may be attached to authorisations.

We recommend the provider prioritises staff training in supporting people living with a learning disability and/or autistic people.

Follow Up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.