The inspection of Fieldhead Park took place on 22 and 24 August 2017. We previously inspected the service on 26 November 2013; we rated the service Good. The service was not in breach of the Health and Social Care Act 2008 regulations at that time.

Fieldhead Park Care Home is registered to provide personal and nursing care and accommodation for 54 older people. The home has two units; one unit provides personal care and accommodation for older people, the second unit provides care for people who have been assessed as needing nursing care. Within this unit six beds were allocated for use by the intermediate care team; this is a service which aims to prevent admission to hospital or to provide a period of rehabilitation following a hospital stay.

The service had a registered manager in place. 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.

People told us they felt safe. Care plans contained a range of risk assessments and included details of how moving and handling equipment should be fitted and used. There was a system in place to ensure the premises and equipment were suitably maintained. Personal Emergency Evacuation Plans were in place and regularly updated however, plans did not record evacuation routes if people were situated in areas other than their bedroom.

There were safe recruitment procedures in place and we observed staff met people’s needs in a timely manner. There had been recent increases to the ancillary staffing hours to meet people’s changing needs and demands on the service.

People’s medicines were kept, mainly in locked units in their bedrooms. We saw staff administered people’s medicines safely although the management and recording of people’s creams needed to be improved to ensure an accurate record was retained.

New staff were supported in their role and existing staff received on-going training and management supervision.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People spoke positively about the meals provided at Fieldhead Park. People were provided with a choice of meals, hot and cold drinks. Staff assessed people’s nutritional risk regularly and care plans reflected people’s individual needs in regard to eating and drinking. When required, staff kept a record of the food and fluid people consumed.

Everyone we spoke with told us the staff were caring and kind. Staff knew people well and were pro-active in ensuring they respected people’s privacy and dignity. People were offered choices in regard to their daily activities and were enabled to retain their independence. The registered manager had begun to involve people and their families in the care planning process.

There was a range of activities for people to participate in and feedback regarding this was positive. Activities included; trips out in the local community, games, quizzes and exercise classes.

At the time of the inspection a new care planning system was being introduced. The care plans we reviewed were person centred and recorded an adequate level of detail to enable people to receive care and support which met their needs.

Where a complaint had been received, we saw the registered manager had investigated the issues raised and responded to the complainant with their findings.

People and their relatives spoke positively about the day to day management of the home.

There was a system of governance in place to monitor the quality of the service people received, these included, internal audits, the submission of a monthly manager report to senior managers and audits of the home by

The inspection of Fieldhead Park took place on 26 November 2014 and was unannounced.

We last inspected Fieldhead Park on 5 September 2013. The service was not in breach of the Health and Social Care Act regulations at that time.

Fieldhead Park Care Home is registered to provide personal and nursing care and accommodation for 54 older people.  The home has two distinct units. One unit provides personal care and accommodation for older people. The second unit provides an intermediate care service which aims to prevent admission to hospital or to provide a period of rehabilitation following a hospital stay.

The service had a registered manager in place. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe. In each of the care records we looked at we saw risk assessments were in place.

People told us there were sufficient numbers of staff. We saw procedures were in place for the recruitment and selection of staff and appropriate checks had been carried out prior to the staff starting work at the service.

We saw that people’s medicines were stored and administered safely.

Staff told us they received regular supervision and training which included moving and handling, safeguarding and infection control.

We saw evidence in peoples care plans that people had made an informed decision to consent to the care they were receiving. People were supported to eat and drink and were provided with a choice of suitable and nutritious food and drinks.

People looked well cared for. We heard staff interacting with people in a caring, discreet manner. Staff were able to describe to us how they ensured people’s privacy and dignity was maintained. People who used the service told us about the activity programme at the home and the trips they had been on. They said the trips included a trip to the seaside and Leeds Armouries.

Staff we spoke with spoke positively about the registered manager. We saw the registered provider had systems in place to enable the registered manager to audit and asses the quality of the service provided to people.

We spoke with six people who were using the service, three members of staff and a visiting physiotherapist. These were some of the things they told us:

“I am quite happy here; the staff are good, kind and patient.”

“There is a choice of food and they are very obliging the cook told me just to let them know what I would like.”

“The staff are lovely and can’t do enough for you. They have a good attitude and good hearts.”

“There are activities on offer if you want to join in. Today people have gone on a barge trip, I was offered but didn’t want to go.”

“The staff are very nice and follow any instructions that I leave for them to follow. “

We found that people had been involved in developing their care plans and staff were aware of what care and support they needed to provide. The medication system was being managed properly and people were getting their medication at the right times.

There were enough staff on duty to meet people’s needs who had received the necessary training and who were being supported by the manager.

There were systems in place to monitor the quality of service that people were receiving.

We spoke with ten people who were living at the home, one visitor and five staff. These are some of the things they told us:

“Most of the staff are very good.”

“The food is lovely and there is a choice.”

The home is kept clean and tidy and I like my bedroom.”

“There are some activities organised for us like dominos and bingo. We are going on a barge trip tomorrow.”

“If I ask for something I usually get it.”

“They are short of staff sometimes and then I have to wait longer than I would like for assistance.”

“We have a handover meeting in the morning, which I find very helpful. We are told if anyone is going home and who is coming in so we can get the rooms ready.”

“I enjoy working here, but it is hard when staff don’t turn up for their shift.”

We also spoke with 3 patients in the Intermediate Care Unit who told us

“The staff are lovely and would do anything for you”

“The staff have looked after me but I expected more attention from the physical therapy people”

“The staff are beautiful and look after me well”

We carried out this review as part of our routine schedule of planned reviews. However, we also received concerns in relation to the care people received and these issues were included for review as part of this inspection.

Everyone we spoke with told us they could choose what time they got up in a morning and what time they went to bed at night. We observed people could choose where they spent their time, for example some people had chosen to stay in their bedroom rather than sitting in one of the lounges. These are examples that people had choice and staff respected people’s wishes in relation to their care.

The people we spoke with told us they were happy living at Fieldhead Park Care Home. One person who was living on the intermediate care unit told us the care team had been very helpful and couldn’t have done enough for them.

We inspected several bedrooms and they were personalised with small items of furniture and belongings. Showing people were encouraged to make themselves at home and settled in their surroundings.

With the exception of one bedroom, the home was clean and did not have any unpleasant odours. The manager showed us correspondence relating to room where she had identified issues with odour control and the actions she had taken to address the situation.

People were seen to have their own personal mobile call alarms. Throughout the day we heard the call alarms ring and answered in a timely way. Staff were also seen attending to people’s needs and no one was seen to be left unattended for unreasonable periods of time. The atmosphere was relaxed, and staff had a pleasant manner and seen to have banter with people as they went about their duties.

No-one raised any concerns with us.

The purpose of this visit was in response to a concern received by the Commission. The concerns identified were surrounding care practise and the supervision of new staff.

The atmosphere in the home was calm and staff and people were observed having respectful banter together. Staff spoke to people patiently and had pleasant attitudes towards people.

We observed staff providing support to people in a sensitive and dignified way, and staff were seen to regularly check on people, asking them if they would like a drink and generally if they were alright.

Staff spoken with were aware of people’s needs, discussed freely the privacy and dignity of people, and where aware of the infection control procedures in place to help prevent the spread of infection.

People told us the staff respect their privacy and dignity at all times.

Comments also included,

“The staff are really good and they can’t do enough for you.”

“I like some staff better than others, but there is always someone there when I need them”.

People who use the service were relaxed and receiving good outcomes of care. Staff were polite, courteous at all times and people spoke positively about the care they received.

People told us that staff treated them with dignity and respect, and staff were seen responding to peoples needs in a dignified manner.

Individual Comments included:

“The staff are good, some more than others and we are looked after.”

“Staff are really good, can’t fault them.” The same person also said that there were always things going on at the home to keep people entertained.

The three people who were spoken with on the intermediate care unit had the following comments:

One person said that they had not signed a care plan but they were seen everyday and helped with their walking. They said that the food was good, and that the staff were very kind and helpful.

The second person said that they had not signed a care plan but the staff had explained the care that they would receive during their stay and this included daily physiotherapy and occupational therapy. The same person said that the food was excellent, the staff were very kind and helpful and maintained their privacy and dignity at all times.