Field's Care Ltd

Field’s Care is a domiciliary care agency that provides care and support to adults living in their own homes. The service is based in Wembley and provides support to people living in the London Borough of Brent. At the time of our inspection the service provided care and support to 41 people. The service specialises in working with people with significant care and support needs associated with, for example, advanced dementia and significant physical impairments. All the people supported by the service required two staff members at all times to assist them with their care.

At our previous inspection of Field’s Care in April 2017 we found that the service was not always meeting the requirements of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that there were failures in the recording of medicines and in the service's staff recruitment procedures. The service's quality assurance systems were limited and we could not be sure that concerns were always identified and acted on. Following this inspection, the provider had sent us a plan describing the actions they were taking to address these failures. During this inspection we found that the service had taken action to ensure that they were not in breach of the regulations.

The manager of the service is the registered provider. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The manager was supported in their role by a deputy manager, a care co-ordinator and a senior care worker.

People and family members told us that they were satisfied with the quality of care that was provided by the service. They spoke positively about the regular staff members who were supporting them.

People using the service were protected from the risk of abuse. The provider had taken reasonable steps to identify potential areas of concern and prevent abuse from happening. Staff members demonstrated that they understood how to safeguard the people whom they were supporting and would report any concerns immediately. Staff members had received training to enable them to ensure that people were protected from risk or harm.

Some people using the service required support from staff to ensure that they received their prescribed medicines in an appropriate and timely manner. We saw that records of medicines administration had been completed. Staff members had received training in safe administration of medicines and their competency in doing so had been assessed.

Staff recruitment processes were in place to ensure that workers employed by the service were suitable for their roles in supporting people. All new staff members were required to undertake induction training which included a period of shadowing more experienced staff before they commenced working with people.

Staff members had received training that was relevant to their roles. They had regular meetings with their manager to discuss their work. The staff we spoke with said they were happy with the support that they received.

People using the service had care plans that were person centred and provided clear information about their care needs with guidance about how these should be supported by staff. These were linked to individual risk assessments which included guidance for staff members on how to minimise any potential risk associated with care and support. We saw that these records were reviewed regularly and had been updated where there was any change in people’s needs.

The service was meeting the requirements of the Mental Capacity Act 2005. Capacity assessments were in place for people. People were asked for their consent to any care or support that was provided. People’s care plans and risk assessments were person centred and included guidance for staff about how to provide care and support. The people and family members we spoke with told us they had been involved in developing and agreeing the plans. The service liaised with other health and social care professionals to ensure that people’s needs were effectively met.

People’s religious, cultural and other needs and preferences were supported. People and family members told us that staff members respected their wishes and treated them with dignity and respect. We noted that people’s communication and language needs were well supported. Where possible, people were matched with staff members who were able to meet any identified cultural or language needs.

The service had a complaints procedure that was available in an easy to read format where required. People who used the service knew what to do if they had a concern or complaint. We noted that no complaints had been received since our last inspection.

A range of processes were in place to monitor the quality of the service, such as audits of records and spot checks of care practice. Monthly calls or home visits were made to people to ask them about their views of the service and we saw that actions had been put in place to address any concerns or comments arising from these.

Systems were in place to identify when actions such as monitoring, spot checks and staff supervision and training were due. We saw that most actions were completed within time and that reasons were documented where these were late in taking place. People and family members told us that they considered the quality of the service and staff was good and that they would recommend it to other people.

Field’s Care is a domiciliary care agency that provides a range of support to adults living in their own homes. The service is based in Wembley and provides support to people living in the London Borough of Brent. At the time of our inspection the service provided care and support to 27 people.

Field’s Care is a new service that was registered with The Care Quality Commission on 4 May 2015. At the time of this inspection the service had been fully operational for one year. This was their first inspection.

The manager of the service is the registered provider. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider had recently appointed a care co-ordinator and senior carer to support them with the management of the service.

People and family members told us that they were happy with the care that was provided by the service. Staff members spoke positively about the people whom they supported and their approaches to care.

People were protected from the risk of abuse. The provider had taken reasonable steps to identify potential areas of concern and prevent abuse from happening. Staff members demonstrated that they understood how to safeguard the people whom they were supporting. Safeguarding raining and information was provided to staff.

The care plans that were in place for people were person centred and provided clear information about people’s care needs with guidance about how these should be supported by staff. These were linked to individual risk assessments which included guidance for staff members on how to minimise any potential risk associated with care and support. We saw that these records were reviewed regularly and had been updated where there was any change in people’s needs.

Arrangements were in place to ensure that people’s medicines were administered and recorded. Staff members had received training in safe administration of medicines. We found, however, that there were gaps in some medicines administration records and although the provider was able to tell us the reasons for the gaps, they had not been recorded.

Staff recruitment processes were in place to ensure that workers employed by the service were suitable. However we found that references from previous employers were not in place for some staff members.

Staffing rotas met the current support needs of people. There was a system for ensuring that care activities were managed and monitored. Staff and people who used the service had access to management support outside of office hours.

Staff training met national standards for staff working in social care organisations. Staff members told us that they felt well supported in their roles. A process for staff supervision and spot checks of care practice was in place. However, some staff members had not received regular recorded supervision from a manager.

The service was meeting the requirements of the Mental Capacity Act 2005. Capacity assessments were in place for people. People were asked for their consent to any care or support that was provided. However, we found that where people were unable to record consent this was not always noted in their care files.

People’s religious, cultural and other needs and preferences were supported. People and family members told us that staff members respected their wishes and treated them with dignity and respect. We noted that people’s communication and language needs were well supported.

People who used the service knew what to do if they had a concern or complaint. Complaints that had been received by the service had been fully investigated and actions had been put in place to people’s satisfaction.

People, family members and staff spoke positively about the management of the service. A range of processes were in place to monitor the quality of the service, such as audits and spot checks of care practice. However, these had failed to identify and address issues such as gaps in medicines administration records and gaps in supervision of staff. The provider had recently appointed two senior staff members to support the growth of the service. However there was further work to be done to ensure that their quality assurance processes were effective..

We found three breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.