This inspection took place on 10 December 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.

The Fields is a ‘care home’. 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 Fields is registered to provide accommodation for people who require nursing or personal care. The home can accommodate up to 54 people who have learning and/ or physical disabilities. The home is divided into seven units, one of which provides nursing care. The home is situated in the Woodhouse area of Sheffield and benefits from access to local facilities.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

We last inspected the service 27 June 2017 when it was found to be meeting with the regulations we assessed.

There was a manager at the service who was registered with the CQC. 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.

Staff recruitment records needed some improvements to ensure people’s safety was promoted.

People living at The Fields said they felt safe and they liked the staff. Relatives we spoke with felt their family member was in a safe place and did not have any concerns about their family member’s safety. Staff said they had been provided with safeguarding vulnerable adults training, so they understood their responsibilities to protect people from harm.

There was enough staff to meet people’s needs safely and effectively.

There were effective procedures in place for the safe management of medicines. Some improvements were needed surrounding medicine administration. These were addressed on the day of inspection.

Some fire records required improvement and an increase in the frequency of fire drills was needed to ensure all staff know what to do in the event of fire.

Staff were provided with training and supervision to make sure they had the right skills and knowledge to support people.

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

People enjoyed the food provided and were supported to receive adequate food and drink to remain healthy.

We found the home was clean, bright and well maintained.

Staff had a kind and caring approach and showed respect when interacting with people.

People, their relatives, visitors and health professionals we spoke with made positive comments about the care provided by staff.

We found people’s care plans and risk assessments were reviewed regularly and in response to any change in needs.

We saw people participated in a range of daily activities both in and outside of the home which were meaningful and promoted independence.

People living at the home and their relatives said they could speak with staff if they had any worries or concerns and they would be listened to.

Staff told us they felt they had a very good team. Staff, people and relatives said the registered manager was approachable and communication was good within the service.

There were systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. Some systems or processes did not operate effec

The Fields is registered to provide accommodation for people who require nursing or personal care. The home can accommodate up to 54 people who have learning and/ or physical disabilities. The home is divided into seven units, one of which provides nursing care. The home is situated in the Woodhouse area of Sheffield and benefits from access to local facilities.

The Fields had been operating for many years. Cambian learning Disabilities Midlands Limited took over the home and were registered with the Care Quality Commission (CQC) in November 2015. This is the locations first inspection since the new providers were registered.

It is a condition of registration with CQC that the home has a registered manager in place. There was a registered manager in place who was present on the day of our inspection. A registered manager is a person who has registered with CQC 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.

Everyone we spoke with, including people who used the service, their relatives and external professionals said people received individualised care. People told us “I love it here –it’s my happy home.” A relative told us, “Its [my loved ones] home and they [the staff] make it feel like home.

There was an extremely strong person centred and caring culture in the home. (Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual.) The management team and staff shared the vision of the service.

Staff told us they worked as part of a team, that The Fields was a good place to work and staff were very committed to providing care that was centred on people's individual needs and made sure that people were supported to achieve everything they wanted to.

Staff received the training they needed to deliver a very high standard of care. They told us that they received a lot of training and could access any training specific to their job.

Medicines were stored securely and procedures were in place to ensure medicines were administered safely.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this and systems were in place to ensure that staff were working to the safeguards that were in place.

There were systems in place to manage risks, safeguarding matters and medication and this ensured people's safety. Where people displayed behaviour that was challenging the training and guidance given to staff helped them to manage situations in a consistent and positive way that protected people's dignity and rights.

People received care and support that was responsive to their needs. Care plans provided detailed information about people so staff knew exactly how they wished to be cared for in a personalised way. People were at the fore front of the service and were cared for as individuals and encouraged to maintain their independence. A wide and varied range of activities was on offer for people to participate in if they wished. Regular outings were also organised outside of the home and people were encouraged to pursue their own interests and hobbies.

We saw that staff recruited had the right values and skills to work with people who used the service. Where any issues regarding safety were identified in the recruitment process, appropriate safeguards had been put in place. Staff rotas showed that the staffing arrangements remained at the levels required to ensure all peoples needs were fully met and helped to keep people safe.

Systems were in place that continuously assessed, monitored and improved the quality of the service, including obtaining feedback from people who used the service and their relatives. Records showed that systems