We undertook an unannounced inspection of Hempton Field Care Home on 1 March 2018.

Hempton Field provides accommodation for up to 29 people who require nursing or personal care. The home is situated in the village of Chinnor, Oxfordshire. On the day of our inspection 28 people were living at the home.

Hempton Field is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rating at last inspection

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Further information is in the detailed findings below

Why the service is rated Good:

People remained safe living in the home. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines safely.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored.

The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People were involved in decisions about their care needs and the support they required to meet those needs.

People had access to information about their care and staff supported people in their preferred method of communication. Staff also provided people with emotional support.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.

The service was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos.

The registered manager monitored the quality of the service and looked for continuous improvement. There was a clear vision to deliver high-quality care and support and promote a positive culture that was person-centred, open, inclusive and empowering which achieved good outcomes for people. The registered manager was supported by the regional manager.

This inspection took place on 4and 5 February 2016. It was an unannounced inspection.

Hempton Field Care Home is a care home providing accommodation for up to thirty people who require nursing or personal care. The home is situated in the village of Chinnor, Oxfordshire. At the time of our inspection 26 people were living at the home.

The registered manager was not available and the home was being managed by the deputy manager. 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.

Mental capacity assessments were not always completed in line with the Mental Capacity Act (MCA) 2005. The Act provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. In the assessments we saw, triggers prompting the assessments were not identified and the assessments did not relate to specific decisions. This meant some people could be incorrectly assessed as having no capacity to make decisions. However, we saw this had not impacted upon people’s care.

Some senior staff and all care staff we spoke demonstrated an understanding of the MCA. We saw staff applied the Acts principles in their work by offering people choices, giving them time to consider, and respecting their decisions.

We have made a recommendation in relation to the Mental capacity Act.

People told us they benefitted from caring relationships with the staff who knew how to support them. Staff were supported through supervision, appraisal and training to enable them to provide the high quality care we observed during our visit.

Staff understood the needs of people, particularly those living with anxiety or depression, and provided care with kindness and compassion. People spoke positively about the home and the care they received. Staff took time to talk with people and provide activities such as arts and crafts, games and religious services.

People were safe. Staff understood how to recognise and report concerns and the service worked with the local authority if there were any concerns. People received their medicines safely as prescribed. Staff assessed risks associated with people's care and took action to reduce risks.

There were sufficient staff to meet people’s needs. The service had robust recruitment procedures in place which ensured staff were suitable for their role.

People told us they were confident they would be listened to and action would be taken. The service had systems to assess the quality of the service provided in the home. Learning was identified and action taken to make improvements which improved people’s safety and

quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

People were supported to maintain good health. Referrals to healthcare professionals were timely and appropriate and any guidance was followed. Healthcare professionals spoke positively about the service.

All staff spoke positively about the support they received from the deputy manager. Staff told us the deputy manager was approachable and there was a good level of communication within the home. People knew the deputy manager and spoke to them openly and with confidence.

Hempton Field Care Home provides nursing care and support for up to 33 older people including those living with dementia. At the time of our inspection there were 29 people living at the home.

Hempton Field Care Home has 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.

This unannounced inspection took place on the 16 October 2014. At our last inspection of Hempton Field Care Home in October 2013 we found the home met all the regulations assessed.

People were positive about their safety and security. Potential risks to people’s safety were identified within their care plans. For example, from falls. Action was taken to address this, falls risk assessments identified the number of staff and equipment required to move the person safely.

The interaction between staff and people living in the home was polite, respectful and friendly. There was a very relaxed atmosphere throughout the home and staff had time to talk informally to people in lounges and dining areas.

People said there were always sufficient staff available. We checked staffing rotas and found they agreed with the set staffing structure. The provider kept staffing under review and adjusted staffing levels according to the number and dependency levels of people. There was very little recent staff turnover which provided consistency of care for people.

Staff confirmed they received regular training to enable them to meet people’s care needs. Domestic support staff confirmed they had received infection control training and training about the safe use and storage of chemical products.

Staff confirmed there was a mixture of formal and informal supervision, together with an annual appraisal. Records showed formal supervision was not at consistent intervals. There were staff meetings, including nurses meetings for qualified nursing staff. This meant although formal supervision was not always planned or carried out at set frequencies, staff felt they had the support they needed as they had the opportunity to discuss any issues with their line manager or the registered manager at any time.

Staff had received safeguarding adults training and this was confirmed from training records. There were ‘Safeguarding Champions’ in place to advise staff of the appropriate action to take if they had any concerns about potential abuse. There was safeguarding information and contact details displayed prominently in the home for staff and others to refer to.

Care plans included evidence of pre-admission assessments to identify individuals’ care needs. This enabled, for example, any specific equipment required to be put in place before the person moved in and ensured their needs could be met from the outset. Staff followed any advice and recommendations given by healthcare professionals involved with the service, for example GPs and specialist nurses. They provided very positive views of their interaction with the service and the quality of care and support they observed. In some cases updates to care records had not been recorded, although care staff were aware of the relevant details and had acted upon them. The need to improve care plans had been recognised and action was being taken to achieve this.

Medicines were administered safely. Routine checks were carried out to monitor records and practice to make sure people received safe and effective support when they needed help with their medicines.

Relatives confirmed they had completed annual questionnaires and had also met informally with the registered manager to discuss their relative’s care and provide feedback. People were positive about the leadership of the registered manager and told us they were "Patient and approachable."

Staff had a good understanding of the implications for them and their practice of the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make specific decisions at a given time. DoLS provides a process by which a person can be deprived of their liberty when they do not have the capacity to make certain decisions and there is no other way to look after them safely.