Field House Rest Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service was rated as requires improvement. This has now improved and we have assessed this key question as good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they knew who the registered manager was and were positive about her approachability if they had any concerns. One person told us, “I know who the manager is, she always comes and says hello". Another person told us, “She is approachable. Very good manager".

Staff spoke positively about the management structure. Staff told us they feel supported in their role and able to raise concerns, which management would then appropriately act on. Minutes of staff meetings showed that learning from incidents was shared with staff to drive improvements.

Refresher training was offered in-line with requirements or when issues had been identified which ensured staff had ongoing learning and understanding. Monthly risk and accident reports and analysis were completed which highlighted areas of concern and developed processes to ensure lessons were learned and information was shared with staff members.

We saw that people or their relatives were involved in the review of their care plan.

The registered manager ensured people's needs were met and that care plans were kept updated, particularly in the first few weeks and months of a person moving in to the home.

The provider and staff now worked together with external agencies to establish and maintain safe systems of care. No concerns were raised by involved health care professionals we spoke with. District nurses reported that the staff made appropriate referrals as required and staff would contact them in a timely manner with any concerns. They told us staff took their advice for managing clinical conditions. This meant some conditions, such as pressure ulcers, were managed quickly and did not develop which meant the risk of harm to people using the service was minimised.

The systems and processes in place ensured risks were assessed and mitigated effectively. For example, where people were admitted to hospital the service had completed an 'emergency pack' for people that would give hospital staff essential information on the person's needs. Managers completed audits to make sure that people's care needs were assessed and their care plans reviewed when needed.

We received positive feedback from people that they felt safe. One person told us, “We don’t get any abuse and they [staff] are very polite.” Another person commented, “I feel safe because there are always carers around and they are all good.” This view was also shared by relatives who told us they felt their loved ones were safe. One relative told us, “We feel that mum is safe living there.”

Staff were aware of the process to report safeguarding concerns to managers if they observed any signs of abuse. Staff knew who to escalate to if concerns identified were about service managers.

We observed people were comfortable in the presence of the staff who supported them.

Staff had completed safeguarding training relevant to their roles .Where safeguarding concerns had been raised, they had been responded to, acted on and reported to the local authority safeguarding team.

People and their relatives told us they felt safe and were supported to understand and manage risks. When staff assessed people's needs and any risks, people were involved in this process to create a more personalised plan. One person told us, “I do use a walker and a frame which makes me feel safe when moving around the home.”

Staff used an electronic records system in the home to update risk assessments and care plans. The system provided data that enabled the team to closely monitor risk and to have a clear overview of the quality of care given.

We observed staff supported people when mobilising ensuring they had any required equipment and encouraging them. Staff used this equipment in line with instructions and as recorded in peoples' care plans. Staff used this equipment correctly and according to peoples' care plans.

Care plans were person-centred and risks had been assessed and mitigated with clear guidance for staff to support people in their chosen way.

People told us they had access to any equipment needed to keep them safe. One person told us, “I am hoisted as I can no longer walk, I feel safe when they hoist me".

Work was in progress to improve the environment and also to ensure it was safe for people. Plans were also in place to convert some bedrooms that had a bath to a wet room to better meet the needs of people who had mobility issues.

Work was underway to make improvements to the environment. Some windows had broken glass. Plans to repair these windows had been included on the home's maintenance plan and the replacement glass was on site at the time of the inspection, and work had started on repairs. One window was being held open with two blocks to enable a person to have fresh air in the area they preferred to sit in. Following our site visit the registered manager provided a copy of the previously completed risk assessment to ensure there were no significant risks from the blocks being dislodged. We found one bathroom had an unsuitable lock on it which was removed during our site visit when brought to the attention of the registered manager.

The provider had processes to manage and monitor the safety of the environment. A planned maintenance programme was in place and this included updating windows in the home. Certificates showed that equipment was maintained and staff had received training in areas such as fire safety which included fire drills.

People spoke positively about staff. For example, a person commented, “I do think that the staff are trained well to look after me.” Another person told us, “I think that there is enough staff and at night".

The service had sufficient staff to meet people’s needs. Staff told us they had enough time to care for people. Overall staff told us they felt they had enough time to meet people’s needs and there were sufficient staffing levels. Staff told us training enabled them to support people safely.

We observed there were sufficient numbers of staff available to support people safely and staff were able to respond to people’s needs in a timely manner.

Systems and processes were in place to ensure there were enough competent staff on shift. This included completion of a dependency tool to help determine staffing numbers and systems to seek the views of people and staff. Staff surveys indicated some staff had raised that there were insufficient staff to respond to people's immediate needs at night. The registered manager told us they had reviewed the dependency tool which evidenced staffing was appropriate for the floor more frequently but looked at practice on the floor too. This was updated monthly or sooner if a resident is admitted or discharged, or there was a change in a person’s needs. They identified that whilst the staffing levels were correct based on some people being more active at night, it would be beneficial to have the twilight shift changed to a full night shift . This had been introduced and was being kept under review. Systems were in place to ensure all staff had sufficient training to meet peoples’ needs and this was monitored to identify when refresher training was needed. We found systems were in place to ensure people were supported by staff who had gone through the necessary recruitment checks to ensure they were safe to work with people. Where agency staff were used the provider had a system in place to ensure they had an induction to the home.

People and relatives we spoke with told us they felt the home environment was clean and they did not have any concerns. One person said, “The home is clean and so is my room”.

A nominated member of staff worked as the infection prevention and control (IPC) lead. This role was to support and try to embed infection control practice amongst the staff team. The registered manager told us the role was to support and try to embed infection control practice amongst the staff team.

Whilst most areas of the home was clean we observed a number of visibly dirty items which could compromise infection control. We saw a dirty crash mat, toilet and toilet brushes that were dirty which the service immediately rectified when brought to their attention.

The provider had up to date policies in place in respect of infection control practice and these reflected current guidance including managing COVID-19 outbreaks. We reviewed records which demonstrated the provider completed regular audits which included cleaning checklists.

We received positive feedback from people and relatives that they were supported with the medicines. One person told us, “I do have medication; they don’t forget to give me, and they are always on time.”

Staff told us they received training and were competency assessed to administer medicines safely. The management team shared with us the audits they complete to oversee medicines management at the home and evidenced action is taken when issues are identified.

Staff who administered medicines were trained. Manager checked staff remained competent to undertake this task. We checked a number of people's medicine records and found these had been completed and indicated people had received their medicines as prescribed. The provider had systems in place to check people received their medicine safely. Where issues had been identified there was follow up action to resolve this. For example, on one audit it had been identified that it had not always been identified how people preferred to take their medicines, this had been recorded as resolved.