We carried out a review of the data available to us about The Fields on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Fields, you can give feedback on this service.
The home was large, bigger than most domestic style properties. It was registered for the support of up to 54 people. 54 people were using the service at the time of this inspection. This is larger than current best practice guidance. The service has not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. However. the size of the service having a negative impact on people was mitigated by the home being split into seven individual units. At the time of our inspection these units were not socially mixing due to the risk of cross-infection from Covid-19.
The home is located within a residential area. This ensures people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
We found the following examples of good practice;
Family visitors to the home were required to complete and record negative lateral flow tests (LFTs) to show staff upon entry onsite on the morning of their visit. The service’s management team told us nearly all family visitors showed staff proof of vaccination although this wasn’t legally required. The service’s management team had helped some professionals and resident family visitors to sort their Covid-19 vaccination passports for future use.
The service carried out drive-by visits from a minibus with residents to their family homes so they could meet and socialise without contact outdoors. Residents could videocall their family relatives via social messaging networks at any time including during lockdowns when they were unable to visit. The service bought two tablet devices to facilitate this.
The service used their own minibus transport for any residents needs including day trips, outings, medical appointments and shopping runs. A driver dropped off and picked up residents visiting family before thoroughly cleaning the bus. Residents onboard were distanced by being spaced apart, all staff wore facemasks and the bus windows were kept open.
Staff would tell and help any site visitors wearing cloth masks to use proper personal protective equipment (PPE) instead.
The Fields is a care home providing personal and nursing care to people with learning disabilities aged 18 and over.
The home was a large home, bigger than most domestic style properties. It was registered for the support of up to 54 people. 53 people were using the service at the time of this inspection. This is larger than current best practice guidance. The service has not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. However. the size of the service having a negative impact on people was mitigated by the home being split into seven individual units. The home is located within a residential area. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
The exceptional leadership of the home ensured the vision and culture of the organisation was embedded within all the staff team. There was a culture of continuous improvement with a clear focus on ensuring any changes enhanced the quality of the service people received. There was an open and inclusive culture at the home, where people and staff were actively encouraged to be involved and feedback about the quality of the service.
There were systems in place to protect people from the risk of harm or abuse. Risk assessments were in place, specific to people’s individual needs. Staff were recruited safely and there were enough staff on duty to meet people’s needs. Medicines were administered by appropriately trained staff. The home was clean and free from odour.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
People achieved good outcomes as their needs were holistically assessed and their care and support was delivered in line with current good practice. People’s care was provided by a highly knowledgeable staff team who had access to a wide variety of training and support. The service had extremely strong working relationships with health professionals which ensured people's healthcare needs were fully met.
People were supported by kind and caring staff who knew them well. People’s right to privacy was respected and staff ensured peoples dignity was maintained. Staff encouraged and enabled people to make choices about their daily care and support.
Care records provided sufficient person-centred information to enable staff to meet people’s needs. Information could be provided in formats people could understand. People were supported to develop and maintain relationships and take part in activities they enjoyed. No formal complaints had been received, however there was a process in place in the event a complaint was raised.
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 outstanding (published 19 August 2017). There was also an inspection on 10 December 2018 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.
Why we inspected
This is a planned re-inspection because of the issue highlighted above.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Fields had been operating for many years. Cambian learning Disabilities Midlands Limited took over the home and were registered with the Care Quality Commission (CQC) in November 2015. This is the locations first inspection since the new providers were registered.
It is a condition of registration with CQC that the home has a registered manager in place. There was a registered manager in place who was present on the day of our inspection. A registered manager is a person who has registered with CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Everyone we spoke with, including people who used the service, their relatives and external professionals said people received individualised care. People told us “I love it here –it’s my happy home.” A relative told us, “Its [my loved ones] home and they [the staff] make it feel like home.
There was an extremely strong person centred and caring culture in the home. (Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual.) The management team and staff shared the vision of the service.
Staff told us they worked as part of a team, that The Fields was a good place to work and staff were very committed to providing care that was centred on people's individual needs and made sure that people were supported to achieve everything they wanted to.
Staff received the training they needed to deliver a very high standard of care. They told us that they received a lot of training and could access any training specific to their job.
Medicines were stored securely and procedures were in place to ensure medicines were administered safely.
We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this and systems were in place to ensure that staff were working to the safeguards that were in place.
There were systems in place to manage risks, safeguarding matters and medication and this ensured people's safety. Where people displayed behaviour that was challenging the training and guidance given to staff helped them to manage situations in a consistent and positive way that protected people's dignity and rights.
People received care and support that was responsive to their needs. Care plans provided detailed information about people so staff knew exactly how they wished to be cared for in a personalised way. People were at the fore front of the service and were cared for as individuals and encouraged to maintain their independence. A wide and varied range of activities was on offer for people to participate in if they wished. Regular outings were also organised outside of the home and people were encouraged to pursue their own interests and hobbies.
We saw that staff recruited had the right values and skills to work with people who used the service. Where any issues regarding safety were identified in the recruitment process, appropriate safeguards had been put in place. Staff rotas showed that the staffing arrangements remained at the levels required to ensure all peoples needs were fully met and helped to keep people safe.
Systems were in place that continuously assessed, monitored and improved the quality of the service, including obtaining feedback from people who used the service and their relatives. Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were managed very well and that management took steps to learn from such events and put measures in place which meant lessons were learnt and they were less likely to happen again.