Mayfield Hall

Mayfield Hall is a care home without nursing and is registered to provide accommodation and support for a maximum of 20 people. The registered manager said they would consider themselves full at 18, as some rooms were registered for shared occupancy if needed. At the time of the inspection there were 16 people living at the service. People living at Mayfield Hall were older people, living with frailty or dementia.

The service is an older building set over three floors with a lift to access rooms above the ground floor. Only the ground and first floors are available for people needing care, as the second floor is used for private staff accommodation.

People’s experience of using this service:

People told us Mayfield Hall was a good place to live. We saw good practice during the inspection, when people were supported well by staff.

There was an established management team at the service, who worked alongside care staff each day. Other quality assurance systems and regular audits were in place to assess, monitor and improve the quality and safety of the service provided. Some of these would have benefitted from further development and this was discussed with the registered manager. We have made a recommendation about the management of laundry systems.

Risks to people from living with long term health conditions were assessed. These included risks such as from falls, choking, poor nutrition or pressure ulcers, and included actions taken to mitigate risks where possible. People told us they ate well, but where there were concerns over people’s nutrition or hydration appropriate actions were taken.

Systems were in place to safeguard people from abuse, and the service responded to any concerns or complaints about people’s wellbeing. The service learned from incidents to prevent a re-occurrence. People’s rights were being respected, and decisions had been made and recorded in people’s best interests where they were not able to make these decisions themselves. The service respected and supported individual people’s equality and diversity.

There was a recruitment process in place that helped ensure potential staff were safe to work with people who may be vulnerable. Enough staff were in place to meet people’s needs, and staff received the training and support they needed to carry out their role.

Care plans were based on up to date assessments of people’s needs. They contained details about people’s wishes and guided staff on how the person’s care should be delivered. We saw people’s care plans were being followed in practice. Staff knew people well.

People received their medicines as prescribed, and there were safe systems in place to manage the storage, administration and disposal of medicines. The service was being audited in the fortnight following the inspection by the local pharmacist. The registered manager planned to discuss some areas of prescribing practice with them, for example ensuring clarity around the use of ‘as required’ medicines.

Staff told us Mayfield Hall was a good place to work, and they were well supported by the management team, who were always available on call. The building was older and in need of some updating, although we did not identify any areas of potential risk.

More information is in the full report

Rating at last inspection: This service was last inspected on 20 January 2017, when it was rated as good in all areas and as an overall rating.

Why we inspected: This inspection was scheduled for follow up based on the last report rating.

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.

We carried out this inspection on 20 December 2016. The service was last inspected in November 2013 and was found to be meeting the regulations.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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.

Relatives told us they were happy with the care and support their family member received and believed it was a safe environment. One relative said, “The service is as good as it can be. My mother is safe living at there.”

With met with several people living in the service but most were unable to tell us their views about the care and support they received. However, we observed people were relaxed and at ease with staff, and when they needed help or support they turned to staff without hesitation.

On the day of our inspection there was a calm, relaxed and friendly atmosphere in the service. People had good and meaningful relationships with staff and staff interacted with people in a caring and respectful manner. Comments from people and relatives included, “Staff are brilliant, very kind and patient”, “They [staff] do look after me well here”, “Staff are lovely” and “I have no complaints, staff are kind.”

People were able to take part in a range of activities of their choice. Where people stayed in their rooms, either through their choice or because they were cared for in bed, staff spent one-to-one time with them. This helped to prevent them from becoming socially isolated and promoted their emotional well-being. There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes.

Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

People had access to healthcare services such as occupational therapists, GPs, chiropodists and dieticians. Visitors told us staff always kept them informed if their relative was unwell or a doctor was called. Relatives commented, “They always let me know if my father is unwell” and “My mother’s health has greatly improved since moving into Mayfield Hall. There is good communication between staff and the district nurses.”

Staff supported people to maintain a balanced diet in line with their dietary needs and preferences. Where people needed assistance with eating and drinking staff provided support appropriate to meet each individual person’s assessed needs. People were given plates and cutlery suitable for their needs and to enable them to eat independently wherever possible.

Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. Details of how people wished to be supported were personalised to the individual and provided clear information to enable staff to provide appropriate and effective support. Any risks in relation to people’s care and support were identified and appropriately managed.

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA). Where people did not have the capacity to make certain decisions the management and staff acted in accordance with legal requirements under the MCA. Staff applied the principles of the MCA in the way they cared for people and told us they always assumed people had mental capacity.

People and their families were given information about how to complain. There was a management structure in the service which provided clear lines of responsibility and accountability. Staff had a positive attitude and the management team provided strong leadership and led by example. Staff told us they felt supported by the management commenting, “They are very approachable”, “Management are always around, and you can talk to anyone of them at any time” and “Management are great, the best home I have worked for.”

Relatives described the management of the service as open and approachable and thought people received a good service. One relative told us, “The management are always available and very hands on, working in the service.”

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. Management worked alongside staff, regularly providing care for people and this enabled them to check if people were happy and safe living at Mayfield Hall.

We saw people being treated with respect and dignity. We observed staff knocking on bedroom doors before entering. We saw staff asking people what they wanted to eat. We observed that people were given a choice about where they sat and activities they wanted to do. We observed staff and managers communicating with people verbally and by writing information down when the person found that easier. We saw staff sitting down beside people when helping them to eat their lunch. We observed that people appeared to enjoy their food and that it had been prepared to take into account their capacity to eat and preferences.

We reviewed care records which showed that consent to care had been obtained from the person or their representative. The care records provided evidence that people's history, likes and dislikes were taken into account.

Whilst there were some minor maintenance issues, the home was safe, in good repair and there were systems to ensure people's safety.

We reviewed records which showed staff had regular supervision and training and an annual appraisal. We talked with staff who told us they had been supported to undertake a relevant qualification.

We observed that records were well organised, up to date and stored securely.

We found that care plans reflected people's individuality and included information about how they had lived their lives before they had made Mayfield Hall their home.

We saw people's rights to privacy and dignity were respected by care workers.

We saw that staff interacted with people in a relaxed, friendly and respectful manner. Staff worked at the pace of each individual and encouraged their independence

We found that people had opportunities to engage in activities that met their needs. We saw that people related well to the staff and we saw positive relationships in place.

We found that staff were not receiving supervisions. Not all staff had received up to date training.