Archived: Mayfair Residential Home

Updated 13 September 2019

The inspection:

•We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

•On day one of the inspection, one adult social care inspector, one registered nurse, who had experience of working with older adults in care homes, and one expert by experience carried out the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. On day two of the inspection, two adult social care inspectors carried out the inspection.

Service and service type:

•Mayfair Residential Care 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.

•The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.’ The registered manager was also the owner of the business, for this report we use the word, provider, when we talk about the registered manager.

Notice of inspection:

•The inspection was unannounced on the first day. The inspection site activity started on 25 March 2019. The second day inspection site activity was announced and took place on 26 March 2019.

What we did:

•Before the inspection, the provider completed a Provider Information Return (PIR). This form asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

•We looked at the information in the PIR and other information we held about the service including safeguarding records, complaints, and statutory notifications. Notifications are information about specific important events the service is legally required to send to us.

•During the inspection, we spoke with nine people who lived at Mayfair Residential Home. We also spoke with one family member who was closely involved in their relative’s care and support. We met with the provider and spoke with four staff members. Following the inspection, we contacted three health and social care professionals for feedback, one responded.

•We looked around the premises, and reviewed five peoples care and support plans. We also looked at records associated with people’s care and support such as daily care notes, risk management plans and six medicine records. We reviewed records relevant to the management of the service, including staffing rotas, policies, incident and accident records, six recruitment files, training records, meeting minutes and quality assurance audits.

Updated 13 September 2019

About the service:

•Mayfair Residential Home is a care home registered to provide personal care and accommodation to up to 16 people. The home specialises in the care of people who have mental health needs. At the time of the inspection 13 people lived at Mayfair Residential Home.

People’s experience of using this service:

•Some staff had not been provided with safeguarding training and risks to people had not always been assessed, monitored or reviewed. Where risks to people were identified, detailed management plans were not always in place and people were not always protected from environmental risks. The provider did not keep any records of legionella testing in the home even though there were several unused water outlets.

•Safe practice was not followed to ensure people’s medicines were safely administered. The provider did not have a competency assessment process to determine if staff were competent to administer medicine safely. Staff told us they did an on-line training module and that was not refreshed once completed.

•The home was not clean or well maintained. Toilet seats were broken and coated in faeces. People did not have working showers in their rooms. People told us, “No, it’s (the home) not cleaned enough. I can’t remember when they cleaned my room”.

•There were not enough staff to meet the needs of the people living at Mayfair Residential Home. Recruitment processes did not minimise the risk of employing unsuitable staff.

•Staff did not have a clear understanding of the Mental Capacity Act, (MCA). The provider had not completed specific capacity assessments for people.

•People were not always fully involved in their care and support. Care plans were not person-centred and lacked information about people’s needs, wishes and preferences and confidential information was not stored securely.

•The provider had not ensured there was an effective management structure in place to monitor the care provided. They had also failed to ensure staff were given the support they required to provide safe, effective, responsive care.

•We saw some positive interactions during the inspection, with most staff being kind and friendly when supporting people.

•The provider was trying to make improvements with limited resources available. Following the inspection, the provider sent us an action plan of how the planned to improve the service.

More information about the detailed findings can be found below.

Rating at last inspection:

•At the last inspection the service was rated as Requires Improvement (May 2018). At this inspection we found the service had deteriorated in several areas. The home has therefore been rated as inadequate overall.

Why we inspected:

•This inspection was a scheduled inspection based on the previous rating and aimed to follow up on concerns we found in May 2018.

Enforcement

•During the inspection we identified seven breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. People were at risk from harm because the provider’s actions did not sufficiently address the ongoing failings.

•Full information about CQCs regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up:

The overall rating for this registered provider is 'Inadequate'. This means that it has been placed into 'Special Measures' by CQC. The purpose of special measures is to:

•Ensure that the provider found to be providing inadequate care, significantly improves.

•Provide a framework within which we use our enforcement powers in response to inadequate care, and work with, or signpost to, other organisations in the system to ensure improvements are made.

•Provide a clear timeframe within which the provider must improve the quality of care they provide, or we will seek to take further action, for example cancel their registration.

•If the provider does not demonstrate enough improvement is made within this timeframe, and there is still a rating of inadequate for any key question or overall, we will act in line with our enforcement procedures to begin the process of preventing the provider from operating this service.

•This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action.

•Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded. We will have contact with the provider following this report being published to discuss how they will make changes to ensure the rating of this service improves to at least Good.

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