Mayflower Court

Mayflower Court is a residential care home providing personal care for older people and people living with dementia. The service can support up to 72 people, at the time of the inspection there were 53 people living in the home.

People’s experience of using this service and what we found

People living at Mayflower Court were safe from the risk of harm or abuse. There were good measures in place to assess people’s risks, people’s support plans were detailed in how best to support them in line with their needs and preferences. Medicines were managed safely and the home was kept clean.

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

People fed back that food was “hit and miss” in terms of quality. Some people’s assessments were not updated in line with guidance, so there was a risk their outcomes could be affected, such as wound healing or managing their nutrition effectively. The home worked well with other professionals to ensure people had access to healthcare services.

People were treated with kindness and compassion by staff and were supported to make decisions about their care and treatment. People’s privacy and dignity was respected, and people’s independence was promoted.

Person-centred care was sometimes compromised by the levels of agency staffing and by overall staffing levels. People fed back that sometimes activities did not happen as planned, and there were no trips out of the home. Although people’s needs were met, sometimes their preferences could not be, such as their preference to have a bath rather than a shower or wash. Some people and their families fed back that they did not always feel listened to, or that complaints were addressed.

There was a positive culture within the home. Staff felt supported, although reflected that they had been working under increased pressure due to staffing levels and supporting agency staff. Some records were not kept up to date or accurately. The service had identified areas for improvement and had clear actions in place to address these.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 31 March 2017). At this inspection we found some areas now required improvement.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels, medicines management, falls in the home and the quality assurance measures in place. A decision was made for us to bring forward the planned inspection and examine those risks as part of a comprehensive inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns and the provider had implemented good measures to reduce risks to people following feedback from the Local Authority. However, we did find that people’s experience was affected by the high level of agency staff. Please see the safe, responsive and well-led sections of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager at the home. 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 felt safe and staff knew how to identify, prevent and report abuse. Legislation designed to protect people's legal rights was followed correctly. Staff offered people choices and respected their decisions. People were supported and encouraged to be as independent as possible and their dignity was promoted.

People, visitors and external health care professionals were positive about the service people received. People were positive about meals and the support they received to ensure they had a nutritious diet.

Care plans provided comprehensive information about how people wished to be cared for and staff were aware of people's individual care needs and preferences. Reviews of care involving people were conducted regularly. People had access to healthcare services and were referred to doctors and specialists when needed.

Medicines were managed safely and people received these as prescribed. At the end of their life people received appropriate care to have a comfortable, dignified and pain free death.

There were enough staff to meet people's needs. The recruitment process helped ensure staff were suitable for their role. Staff received appropriate training and were supported in their work. Staff worked well together, which created a relaxed and happy atmosphere that was reflected in people's care.

Mayflower Court had been decorated and accessorised to provide a positive and suitable environment for the people living there. They were able to access a range of communal facilities and had access to gardens or enclosed balconies providing fresh air. People were offered an extensive range of activities suited to their individual needs and interests providing both mental and physical stimulation.

People and relatives were able to complain or raise issues on a formal and informal basis with the registered manager and were confident these would be resolved. This contributed to an open culture within the home. Visitors were welcomed and there were good working relationships with external professionals.

Plans were in place to deal with foreseeable emergencies and staff had received training to manage such situations safely.

The registered manager and provider were aware of key strengths and areas for development of the service. Quality assurance systems were in place using formal audits and through regular contact by the provider and registered manager with people, relatives and staff.