The inspection took place on 23 and 24 May 2017 and was unannounced.The Mayfields Care Home provides residential care for up to 60 older people. Accommodation is over two floors. At the time of our inspection, 18 people were living in Primrose which was located on the ground floor. The first floor, entitled Bluebell, supports those living with dementia and 29 people were living there at the time of this inspection. The home had a number of communal areas and outside spaces.
The home did not have a registered manager in post at the time of our inspection although one had been recruited and was due to start. 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. The home was being managed by two unit managers with the support of senior management.
The service had procedures in place that minimised the risk of employing people not suitable to work with those that used the service. Staff received regular training and supervision, had their competency to perform their role regularly assessed and told us they felt supported.
There were enough staff to meet people’s needs in an individual manner and we saw that staff worked effectively as a team. The culture of the home was positive, open and transparent with a warm and friendly approach. Staff morale was good.
People told us that all staff were kind, patient and compassionate and went out of their way to provide help and support. They told us that staff were prompt at meeting their needs and we saw that staff were quick to support those who were becoming distressed or upset.
Staff were discreet when supporting people with their personal care and maintained their dignity. Their approach was a respectful one and they considered people’s level of independence. Choice was encouraged and supported.
Procedures were in place to help protect people from the risk of abuse and staff had knowledge in safeguarding people. The risks to individuals had mostly been identified, assessed and managed. The risks associated with the premises had been effectively managed and preventative measures were in place including a plan for adverse incidents. Accidents and incidents were recorded and used to mitigate future risk and occurrences.
People received their medicines as prescribed and medicines administration and management followed good practice guidance. However, although no harm came to any of those living in the service, there were discrepancies in regards to the auditing of medicines.
The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. Staff had received training in the MCA and had good knowledge of it. Where there was doubt over a person’s capacity to make a decision, this had been assessed and best interests decisions made as appropriate.
People had been involved in the planning of their care and they received a person centred service. Care plans were in place that gave staff guidance on how to support people. These were individual to each person, accurate and had been reviewed on a regular basis.
People’s nutritional needs were met and they had a choice in what they had to eat and drink. We saw that people had plenty of drinks available and were encouraged to ensure they had a good fluid intake. Access to a variety of healthcare professionals was in place.
The service provided a number of activities that were varied and catered for those that liked both group events and individual support. People were encouraged to take part and contribute to the planning of them.
The provider had an effective and robust system in place to assess, monitor and improve the service. This ensured a good quality service was delivered. Senior managers had good oversight of the service and were motivated to continually improve and develop the experiences of those that lived at the home. Plans were in place to further develop the environment.
People were complimentary about the service, staff and senior managers. They told us they were well cared for, supported and that the service was proactive at ensuring their happiness and comfort. They told us their feedback was sought and that they were listened to. People told us that they would recommend the service.