Field View

Updated 3 October 2023

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by 2 inspectors 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

Field View 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. Field View is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service also provides care and support to people living in a 'supported living' setting, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at their personal care and support.

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

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and 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 spent time observing how staff interacted with people to help us understand the experience of people living at the service. We spoke with 2 relatives about their experience of the care provided to their family member. We spoke with 8 members of staff including the registered manager, senior support workers, support workers and the compliance and quality assurance officer. We reviewed a range of records, this included 4 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including quality assurance records were reviewed.

Updated 3 October 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Field View is a residential care home that provides personal care and support for up to 8 people with a learning disability and/or autism. At the time of the inspection 7 people lived at the service and one person received a supported living service in their own home.

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

Right Support: Risks associated to people's health and welfare were not always effectively managed. Overall 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; but there were inconsistencies in the policies and systems in the service to support this practice. The outcomes for people were not always appropriate and the management team and staff were not always aware of what might constitute restrictive practice. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. There were enough staff to meet people's needs. Medicines were managed safely.

Right Care: People did not always receive care that was person-centred. There were gaps in staffs training to support people with specific needs and communication. People had enough to eat and drink, and individual dietary needs were met.

Right Culture: The provider's governance arrangements did not provide assurance the service was well-led. Systems and processes to oversee the safety and quality of the service were not used effectively and had not identified the shortfalls we found during our inspection. Regulatory requirements continued not to be met. Staff knew and understood people well and supported them to live a quality life of their choosing.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 3 December 2021).

At our last inspection we recommended the provider seek advice from a reputable source on their rota systems and recruitment and review their procedures to ensure medicines were managed in line with best

practice guidance. At this inspection we found the provider had made improvements.

Why we inspected

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

We initially looked at the safe and well-led domains but opened the inspection up to include the effective domain due to concerns about staff training and the application of the Mental Capacity Act, and the potential impact this might have on people using the service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection. We have found evidence the provider needs to make improvements. Please see the safe, effective, and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last inspection, by selecting the 'all reports' link for Field View on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches of regulations in relation to safe care and treatment and good governance.

We have made recommendations in the effective domain in relation to staff training and the Mental Capacity Act. Please see this section for further details.

Please see the action we have told the provider to take at the end of this report.

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.