17 October 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection was carried out by one inspector.
Service and service type
Mayfield House 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with nine people who used the service and four relatives about their experience of the care provided. We spoke with 14 members of staff including the registered manager, the administrator, the senior team leader, a team leader, two senior care assistants, five care staff, the maintenance operative and the chef. We also spoke with three visiting health care professionals including a doctor, a nurse practitioner and a community nurse. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included multiple people’s care and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including checks and procedures were reviewed.
After the inspection
We continued to seek clarification from the registered manager which included confirmation appropriate recruitment checks had been completed and action taken to address issues with the premises.
17 October 2019
About the service
Mayfield House is a care home providing personal care and accommodation to 49 people living with different health needs, including dementia, at the time of the inspection. The service can support up to 51 people in one purpose built, two storey building.
People’s experience of using this service and what we found
We found that improvements were required in the way the service identified, assessed and reduced the risk of injury presented by people’s living environment. Some potential hazards had not been identified. No harm had been caused by this and the manager took effective action to ensure risk was minimised during the inspection.
Staff recruitment records showed that effective recruitment procedures had not always been followed in accordance with good practice. The registered manager acted during the inspection and completed all outstanding checks to ensure that staff had been recruited safely. We recommend the service develops and implements a quality assurance checklist designed to ensure that all required recruitment checks are in place before the relevant person starts work at the home.
People told us they were supported and treated with dignity and respect, but not always involved as partners in their care. People had been involved in the assessment of their needs, but improvement was needed to ensure that they were also involved in the development of their care and support plans.
The service had a suitable policy and procedure for investigating complaints, but improvement was required to ensure all complaints were acted upon, investigated and taken seriously.
The registered provider had not always notified the Care Quality Commission of incidences of abuse or allegations of abuse.
The systems in place to monitor the quality of the service were not always effective and had not highlighted the concerns identified during this inspection. The registered manager and management team were open and transparent and took immediate action to make necessary improvements and ensure people received safe and effective care.
Effective safeguarding systems, policies and procedures ensured people were safe and protected from abuse. People living at Mayfield House and their relatives told us that their experience of using the service was good overall. People told us that they felt safe and their relatives told us that they were confident that their loved ones were safeguarded from avoidable harm. Safeguarding concerns were responded to and managed effectively.
There was enough suitably trained and experienced staff who had good relationships with the people who used the service.
Medicines were managed safely and effectively.
Staff understood their role and responsibilities for maintaining high standards of cleanliness and hygiene in the premises.
Staff benefited from ongoing training including the nationally recognised qualifications in health and social care.
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 were supported to maintain a balanced diet and were able to access health care services as and when needed.
Visiting health care professionals spoke highly of the staff and management team, reporting that they worked in partnership with them to ensure that people’s health care needs were met.
Morale amongst the staff team was high. Staff told us that they appreciated support, guidance and direction of the management team and all without exception said they were proud to be associated with the service and the standard of care and support provided.
The management team demonstrated a commitment to improving the service and delivery of person-centred, high quality care by engaging with everyone using the service and stakeholders.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (report published 10 January 2017)
Why we inspected
This was a planned inspection based on the previous rating.
We have identified breaches in relation to complaints and the governance of the service.
Please see the action we have told the provider to take at the end of this report.
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.