The inspection took place on 6 March 2018 and was unannounced.The Field View Residential Home is a home which provides care to older people including some people who are living with dementia. The home is two storeys with bedrooms on the ground and first floor. There is lift access to the first floor. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The Field View Residential Home is registered to provide care for up to 20 people. At the time of our inspection there were 16 people living at the home.
The provider had taken over the home as a ‘going concern’ in July 2017. This was their first ratings inspection since taking ownership of the home.
A registered manager is a person who has registered with the Care Quality Commission 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. The previous registered manager had recently left the home. The provider had appointed a new manager who had been in post for eight weeks at the time of our inspection visit. The new manager had submitted their application for registration.
People felt safe living at The Field View Residential Home because there were enough suitably qualified and experienced staff to keep them safe. The provider had a programme of training to ensure staff refreshed their knowledge and kept their skills up to date.
Care plans included risk assessments related to people's individual needs and abilities. However, there were no risk management plans to advise staff how to support people who could demonstrate behaviours if they became anxious or frustrated because of their medical condition. Some environmental risks had not been identified. Improvements were needed to ensure the checks and audits that kept people safe and protected were always implemented effectively.
People’s needs were assessed before they moved to the home and they were supported to obtain advice from their GP or healthcare professional when their health needs changed. People received their medicines as prescribed to manage their medical conditions, but guidelines to support good medicines management were not always in place.
The provider was keen to promote a caring environment and led by example. People told us the staff were kind, caring and approachable and took time to understand them as individuals. Care staff recognised and respected people's diverse needs and promoted their independence.
Staff worked within the principles of the Mental Capacity Act 2005. They explained how they used their knowledge of the legislation to support people in line with their choices or known preferences. Staff used different methods of communication to ensure people consented to the care they received. Where restrictions on people's liberty had been identified, the appropriate applications had been submitted to the authorising authority.
Each person had a care plan which contained the basic information staff needed to meet people’s needs safely. However, some care plans needed additional information to help staff respond to people’s emotional and communication needs and provide consistent care and support. Care plans included information about people’s dietary needs and staff supported people to eat and drink enough to maintain their health.
The provider understood the importance of ensuring people had stimulation and engagement to maintain the social aspect of their lives. Improvements were being made to the activities provided, but when staff were busy they had limited opportunities to keep people occupied and interested.
The home was clean and staff understood their roles and responsibilities in relation to infection control and hygiene. The provider had procedures to manage risks in the event of an emergency.
The provider and new manager were working together to raise standards, keep people safe and encourage staff. Staff spoke highly of the commitment and motivation of the provider. They told us the provider visited the home regularly and took time to understand the service, the people who lived in the home and the staff who worked there. The new manager was described as ‘hands on’ and had introduced new processes to make the home safer.
People and relatives were encouraged to engage in the community of the home and to provide feedback and share their experiences so outcomes for people were improved.