10 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, an assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Mayflower Court 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 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. We reviewed information we held about the service, information from the Local Authority and the provider’s website. We used this information to plan our inspection.
During the inspection
We spoke with six people who used the service and five relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager, senior care workers, permanent, agency and bank care workers and the maintenance person.
We reviewed the home’s facilities and visited people in their rooms. We observed staff interactions with people during mealtimes, activities and in shared living spaces within the home. We observed staff administering medicines to people.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
10 October 2019
About the service
Mayflower Court is a residential care home providing personal care for older people and people living with dementia. The service can support up to 72 people, at the time of the inspection there were 53 people living in the home.
People’s experience of using this service and what we found
People living at Mayflower Court were safe from the risk of harm or abuse. There were good measures in place to assess people’s risks, people’s support plans were detailed in how best to support them in line with their needs and preferences. Medicines were managed safely and the home was kept clean.
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 fed back that food was “hit and miss” in terms of quality. Some people’s assessments were not updated in line with guidance, so there was a risk their outcomes could be affected, such as wound healing or managing their nutrition effectively. The home worked well with other professionals to ensure people had access to healthcare services.
People were treated with kindness and compassion by staff and were supported to make decisions about their care and treatment. People’s privacy and dignity was respected, and people’s independence was promoted.
Person-centred care was sometimes compromised by the levels of agency staffing and by overall staffing levels. People fed back that sometimes activities did not happen as planned, and there were no trips out of the home. Although people’s needs were met, sometimes their preferences could not be, such as their preference to have a bath rather than a shower or wash. Some people and their families fed back that they did not always feel listened to, or that complaints were addressed.
There was a positive culture within the home. Staff felt supported, although reflected that they had been working under increased pressure due to staffing levels and supporting agency staff. Some records were not kept up to date or accurately. The service had identified areas for improvement and had clear actions in place to address these.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 31 March 2017). At this inspection we found some areas now required improvement.
Why we inspected
The inspection was prompted in part due to concerns received about staffing levels, medicines management, falls in the home and the quality assurance measures in place. A decision was made for us to bring forward the planned inspection and examine those risks as part of a comprehensive inspection.
We found no evidence during this inspection that people were at risk of harm from these concerns and the provider had implemented good measures to reduce risks to people following feedback from the Local Authority. However, we did find that people’s experience was affected by the high level of agency staff. Please see the safe, responsive and well-led sections of this full report.
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.