This inspection took place on 1 and 5 June 2017 and was unannounced. The Fieldings is situated in Sutton in Ashfield in Nottinghamshire and is registered with the Care Quality Commission to provide accommodation for up to 47 people. The focus of the service is to allow people to receive care and support in regard to their mental health needs. On the day of our inspection there were 26 people using the service.

The service had a registered manager at the time of our visit. 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 were supported by staff who were aware of the risk of abuse and knew what action to take in response to concerns about possible abuse. Risks to people’s health and safety were assessed and if required measures identified and used to help keep people safe. People were supported by sufficient numbers of staff who had been recruited safely. People were supported to take their medicines as prescribed and these were managed and stored safely.

People were supported by staff who had received or were in the process of completing an induction and training specific to their role. People were asked for their consent before care was provided however improvements were required to ensure that people were being supported in their best interests if they lacked capacity to make a decision themselves. People were supported to maintain their healthcare needs and to eat and drink enough.

People were supported by staff who were kind and compassionate. People were involved in planning their own care and encouraged to maintain their independence. Staff were knowledgeable about the likes and dislikes of the people they supported, respected their privacy and upheld their dignity.

People received support in line with their preferences. People’s needs were assessed before they moved to the service and people had care plans which informed staff about their needs. People were supported to maintain their interests and could be assured that any complaints would be responded to appropriately.

People were supported in a friendly and open environment. People and staff felt able to discuss any concerns or issues with the management team. People, relatives and staff were complimentary of the registered manager who understood their responsibilities and sought people’s feedback regarding the running of the service. Quality monitoring systems were in place and effective in maintaining oversight of the service.

This unannounced focused inspection took place on 22 August 2016. The Fieldings is situated in Sutton in Ashfield in Nottinghamshire and is registered to provide accommodation for up to 47 people. The focus of the service is to allow people to receive care and support in regard to their mental health needs. On the day of our inspection 24 people were using the service.

We carried out an unannounced comprehensive inspection of this service on 24 and 25 May 2016. Breaches of legal requirements were found. We issued a warning notice in relation to one of these breaches.

We undertook this focused inspection to confirm that the provider had met the requirements of the warning notice. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Fieldings on our website at www.cqc.org.uk.

The service had a registered manager in place at the time of our inspection. 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 and associated Regulations about how the service is run.

At our last inspection on 24 and 25 May 2016, we asked the provider to take action to ensure that people were provided with safe care and treatment through the proper and safe management of medicines.

During this inspection, we found that the required action had been taken by the provider to ensure that medicines were managed safely.

We could not improve the rating for effective from requires improvement because to do so requires consistent good practice over time. We will check this during or next planned comprehensive inspection.

We inspected the service on 24 and 25 May 2016. The Fieldings is situated in Sutton in Ashfield in Nottinghamshire and is registered to provide accommodation for up to 47 people. The focus of the service is to allow people to receive care and support in regard to their mental health needs. On the day of our inspection 25 people were using the service.

Prior to our inspection the registered manager had left the service. A new manager had been appointed in March 2016 and had applied to become registered at the service. 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 did not always receive their medicines as prescribed and the management of medicines was not safe. People were not supported in an environment that was always clean and hygienic and were not always protected from risks associated with infection. People were at risk of measures identified to reduce the risk of harm to them not being followed and not being involved in discussions about the risks they took.

People felt safe in the service however not all staff had received training in safeguarding adults to help them identify potential abuse.Records showed that when incidents of suspected abuse were identified these were reported to the relevant authorities. Staffing levels were sufficient to support people’s needs.

People were not always supported by staff who had sufficient support, knowledge and skills. People were supported to make their own decisions and in the event a person lacked capacity, a capacity assessment had been completed. Applications had been made to ensure people were not deprived of their liberty without the required authorisation, however improvments were required to ensure conditions were being complied with.

People were supported to maintain their nutritional and hydration needs and to attend healthcare appointments. However the suggestions and recommendations of healthcare professionals were not always followed.

People did not always have their privacy respected and were not always treated in a dignified way. We observed that people were treated with kindness by staff but were not always supported to be involved in planning their care.

Staff did not always read people’s care plans which meant there was a risk that staff would not follow guidance contained within plans. Improvements had been made to people’s new care plans about people’s preferences and how they wished to be supported. People expressed mixed views regarding the activities on offer at the service and records did not always reflect whether people were supported to maintain their interests or achieve their goals.

People felt comfortable approaching the manager with any concerns and complaints. However, there was little oversight of concerns raised to identify any trends. People could not be assured that the quality monitoring of the service was robust and effective.

People’s views on the running of the service were sought and people, their relatives and staff felt that the new manager had implemented positive changes at the service.

You can see what action we told the provider to take at the back of the full report. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

This unannounced inspection took place on 30 September 2015. The Fieldings is run and managed by Prime Life Limited. The service is situated in Sutton in Ashfield in Nottinghamshire and provides accommodation for up to 47 people. The focus of the service is to allow people to receive care and support in regard to their mental health needs. On the day of our inspection 23 people were using the service.

The service had a registered manager in place at the time of our inspection. 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 and associated Regulations about how the service is run.

People were protected from the risk of abuse and staff had a good understanding of their roles and responsibilities if they suspected abuse was happening. The registered manager shared information with the local authority when needed.

We found that basic risk assessments were in place in many aspects of people’s care but that sometimes these were not in place or lacked detail to explain how the risks could be reduced.

People received their medicines as prescribed and the management of medicines was safe.

Staffing levels were sufficient to support people’s needs and people received care and support when required.

We found people were encouraged to make independent decisions. Staff had basic awareness of legislation to protect people who lacked capacity and that some specific decisions had been made in people’s best interests.

People were not deprived of their liberty without the required authorisation.

People were supported to maintain their nutrition and their health needs were met. Referrals were made to health care professionals for additional support or guidance when needed.

People were treated in a caring and respectful manner and staff delivered support in a relaxed and supportive manner.

Staff were knowledgeable about people’s likes and dislikes and what support people required. People who used the service and their relations knew who to speak with if they had concerns and were confident that these would be responded to.

The views of people who used the service were sought in monitoring the quality of service provision. Regular audits were undertaken within the service and action taken where required.