Field View

People who used the service were supported by sufficient staff who had the skills and training to support them safely. Staff were safely recruited and underwent an induction process. We found local inductions were not in place for staff who had recently transferred from another of the provider’s services. We fed this back to the provider who gave us assurance tailored local inductions would also be recorded in future. Staff were well supported by the management team and received appropriate training and checks on their competency. Some staff were not fully confident in all areas of practice. The provider acknowledged this and committed to refresh staff knowledge and understanding where needed. Some staff received additional training to enable them to administer medicines and had their competency to do this checked. Medicines were safely managed although the timing of one person’s medication required review and two staff were not clear about a particular medicine and its potential impact.

Staff understood their responsibility to report and act on safeguarding concerns, should they suspect a person was at risk of abuse or experiencing abuse. The registered manager reported safeguarding concerns to the local authority safeguarding team and to CQC. However, we identified two instances where this had not taken place. People were not injured and had not come to harm, but best practice would have been to report any concerns. The registered managers acknowledged this and noted for future occasions.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that nobody was subject to a DoLS authorisation. Staff and management worked within the MCA and people were not subject to unlawful or excessive restrictions and had choice, control and freedom over their lives.

Risks were identified, mitigated and regularly monitored to ensure changes to risk assessments were not required. However, we identified cluttered areas which could impede evacuation in the event of a fire. The provider addressed this whilst we were onsite. Risks relating to infection prevention and control required some review. The environment was safe and suitable for the people who used the service who accessed all areas of the service independently. Maintenance staff carried out regular safety checks to ensure systems were working correctly and to keep the building in a good state of repair.

People’s needs were assessed prior to them coming to live at Field View and regularly reviewed. Some care plans were not sufficiently detailed. The provider has begun a review of care plans. Health needs were monitored and appropriate referrals to healthcare professionals were made when needed. People consented to their care and care plans reflected this.

Care was person centred and people were involved in decisions about their care and treatment. People received the care they needed whilst their independence was maintained as much as possible. Staff were kind and relationships between staff and the people they were supporting and caring for, were very good. Care was unhurried and the atmosphere was calm and happy throughout the service. Staff were very positive about the service and proud of the support and care they provided.

There were systems and processes in place to monitor the service. However, these systems had not identified issues relating to the safety of the environment, staff knowledge and a lack of detail in some care plans. The provider acknowledged this and gave us assurances the relevant processes would be reviewed. Staff were supported with supervision sessions and regular staff meetings. There was a shared direction and a culture based on a ‘familial’ model of care in this small care home.