Mayflower Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Before people moved into the service their needs were assessed. These assessments were used to develop the person’s care plans and make the decisions about the staffing hours and skills needed to support the person. The assessment included making sure that support was planned for people’s diversity needs, such as their religion, gender, marital status, culture and their abilities.

Each person’s care plan and assessments were also reassessed once a month as part of the ‘resident of the day’ process. This ensured that every person’s care plan and risk assessment was updated at least monthly. People were reassessed as their needs changed to ensure the care they received met their needs. Some assessments included information about what people could do for themselves. People told us they were involved in their assessments and care planning processes. A person said, “They refer to my care plan when talking to me.” Relatives told us they had been involved in the assessment and care planning process when their family member first moved to the service. Comments included, “My sister deals with this I know they keep her updated as they have a resident day where they look at care plans and they let her know of any changes to his care needs”; “They ring me if there have been any changes” and “They have a resident day where they update their plans and we can see on the portal 24/7 if there have been any changes, they will call me once a month to check in.”

Staff told us important information and changes to people’s care needs were passed on at handover meetings and documented in handover notes on the electronic system.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

We carried out observations at mealtimes. The food looked appealing and smelt appetising. Staff were seen to be attentive in the dining areas and lounges. We observed staff showing people plated up options of food to help them make an informed choice. Staff gently encouraged people to eat and supported people to be as independent as possible.

The food was served from a hot trolley in the main dining areas first and then was taken to other areas in the service for people who were eating in those areas. The management team and activities staff assisted at mealtimes to encourage and support people who were living with dementia to eat. Having additional staff at mealtimes enabled people to be less distracted and less likely to walk out of a room without eating or without finishing their meal. A person was supported to eat outside their room at a table and chair. Staff explained that the person sometimes became agitated in busy or louder environments, this then affected others. The person preferred a quiet place to eat and therefore was always supported in the corridor.

Care plans and risk assessments clearly described what modified diet people were prescribed and the care plans followed The International Dysphagia Diet Standardisation Initiative (IDDSI) framework. The guidance was also available in the kitchen for staff responsible for preparing, cooking and serving meals. Kitchen staff and those responsible for supporting people with their food had a good understanding of people’s assessed needs in relation to type and texture of food as well as any allergies and food intolerances. Staff told us they helped people to make their meal choices if they needed it.

We received mixed feedback about the food from people. Comments included, “It’s alright, I eat anything”; “It’s nice, it’s very nice” and “I don't like it, the coffee is cold and so is the food.” Relatives gave us mostly positive feedback. They told us, “The food is ok, she does not have any specific needs”; “He has no preference to what he has to eat, he does not always eat his food”; “[Loved one] eats everything, good choice on the menu, well balanced diet offered, and menu is changed every day, encouraged to drink”; “He used to be quite traditional with his food but is enjoying a variety of foods now” and “He must have his food pureed now and has 2 lots of everything as he is always hungry, he will eat anything.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. The provider had a clear process in place to escalate health concerns within a timely manner. People’s care plans included hospital passports. Staff worked with health professionals to ensure people got the care and support they needed. A health professional told us, “I would say that health concerns are shared in a timely manner. The staff that I usually have contact with would be the nurse in charge of the floor that day. I have never had any concerns regarding their ability to recognise health concerns and they are quite quick to refer onwards if they feel it is appropriate.”

The registered manager and nurses told us, they worked with the local hospice when people were at end of life, to seek advice and support. Nursing staff and other staff told us there were good links with other health professionals such as SaLT (Speech and Language Therapy), physiotherapy, the GP, TVN (Tissue Viability nurse). Trained nurses within the service reviewed and updated people’s clinical records daily if they required nursing care. Relatives told us staff worked with GPs and health professionals to meet their loved one’s health needs. Relatives said, “They facilitate the GP visit for him”; “They have a link nurse that is from the practice and they help with any needs” and “She sees a chiropodist once a month and would see other health professionals as and when needed as staff would report or deal with any concerns.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Relatives told us their loved ones were supported with their healthcare. A visiting enhanced healthcare team carried out a weekly visit on behalf of the GP practice. They told us that staff supported people well to understand the medical appointment and what was going on. A healthcare professional told us,

“I have found that I have built a good relationship with staff and clinical services manager and that staff feel confident to report changes. We have encouraged that they include NOK (next of kin) when health changes have been noticed so that we all work together to treat and support. I also will elevate accordingly any urgent concerns to GP who will also respond quickly. We have worked alongside Mental health team jointly to ensure mental health and physical health needs are met and staff in the home understand that one can affect the other.”

People living at the service had access to onsite nurses employed by the provider and other health care professionals, for example, the community mental health team, chiropody, dietician, dentists and SALT (Speech and language therapists). Visiting was encouraged and people were supported to attend medical appointments. Staff had a good understanding of meeting people’s changing needs. We observed staff supporting people to maximise their independence such as encouraging them to walk with equipment, providing lots of praise and providing reassurances.

We observed that plenty of fluids were offered to people to keep them hydrated and in good health. Fluid charts demonstrated that people had been given enough fluids to meet their identified needs.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff worked together as a team to support people and to ensure people received their care and support in the way they chose. A health care professional told us, “When I contact the Mayflower team for medication reviews, staff consistently provide any updated information on residents’ health, including any recent changes in medications initiated by the Mental Health team, and demonstrate awareness of when to seek further advice or referrals to other healthcare services as required.” Another healthcare professional said, “Mayflower is one of many homes that I visit, however, I would say that it is one of a kind. Lots of residents have been refused by other care homes due to behaviours but settle in very well at Mayflower. I watch their interactions with the residents and they get to know them all very well.”

A staff member told us about a person who had frequent monitoring of their blood sugar levels throughout the day. They said, “If their sugars are low the nurse would tell us and we can give what is needed.”

Where it had been recommended people were referred on to other health care professionals, referrals had been completed in a timely manner. Relatives told us, “His aggression is managed well”; “The staff here know my dad well and seem to be aware of all the residents individual needs to make sure they are well cared for” and “Her health and needs have changed. [Staff member] asked if things have happened it the past that could affect some of her behaviours and has passed this information on to the rest of the team so they all have the knowledge needed to support her.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service worked within the principles of the Mental Capacity Act (MCA). When people were assessed as lacking capacity to make decisions, appropriate procedures were followed to ensure principles within the MCA were followed. Decisions made were appropriately documented to demonstrate who had been involved in the decision. People had signed consent forms within their care records. People's ability to consent to care and support had been assessed.

Care was person centred; people were offered choices throughout the day, people were listened to, and their views and opinions were important to staff. A relative told us, “She can make her own choices most of the time and the staff are here to support her.” Other comments from relatives included, “Dad does not really understand anymore so the staff will support him to make choices based on what he used to do and liked when he first moved in as his health and capacity has changed a lot since he moved in”; “Mum can make some choices she usually goes to bed about 10 but will get up again as she likes to wander the staff will make her a cup of tea and will try to settler her down again later” and “They will ask and show him his clothes from his wardrobe so he can make a choice.”